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fall 2016

DOCTORS

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Just for C

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DOCTORS life + leisure

contents

fall 2016

fall 2016

Publisher Linh T. Huynh

Editor Barb Sligl

Art Direction BSS Creative

Contributing Editor Janet Gyenes

Editorial Assistant Adam Flint

Contributors Cover photo

Yvette Cardozo Michael DeFreitas Janet Gyenes Stacey McLachlan Chris Pengilly Manfred Purtzki James Ross Barb Sligl Roberta Staley iStock

19 31

Senior Account Executive Monique Nguyen Account Executive Wing-Yee Kwong

Production Manager Ninh Hoang

Circulation Fulfillment Shereen Hoang

CE Development Adam Flint

Sales, Classifieds and Advertising In Print Circulation Office 200 – 896 Cambie Street Vancouver, BC V6B 2P6 Canada Phone: 604-681-1811 Fax: 604-681-0456 Email: info@AdvertisingInPrint.com

clockwise from top left: stacey McLachlan; JAmes Ross; istock

Just For Canadian Doctors is published 4 times a year by Jamieson-Quinn Holdings Ltd. dba In Print Publications and distributed to Canadian physicians. Publication of advertisements and any opinions expressed do not constitute endorsement or assumption of liability for any claims made. The contents of this magazine are protected by copyright. None of the contents of the magazine may be reproduced without the written permission of In Print Publications.

FEATURES

19 Big in Japan for offbeat discoveries and adventures 31 On the edge on the Cabot Trail in Nova Scotia COLUMNS

DEPARTMENTS

12 photo prescription

5 fall mix 16 side trip

In the Amazon

15 pay it forward Healing invisible wounds

18 the thirsty doctor

From farm to bottle

35 doctor on a soapbox

to the Central Coast of BC

23 CME calendar 37 sudoku 38 parting shot

The physician shortage

36 the wealthy doctor

In Print Publications 200 – 896 Cambie Street Vancouver, BC V6B 2P6 Canada

Tax strategies for your mortgage

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want to reach us? check out our website!

cover photo You never know what you’ll find in Japan…like a camel amidst the Tottori Sand Dunes (page 19).

Fall 2016 Just For Canadian Doctors

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from the editor Exploring the central coast of BC means a lot of stopping amidst spectacular scenery to simply stare in awe. Story on page 30.

far-out this fall

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Just For Canadian doctors Fall 2016

he air is cooling but your feet may be getting itchier. Because after a leisurely summer—whether lounging dock-side or on your patio— you’re likely thinking about going beyond the backyard. The autumn vibe is about back-to-school or -work, wherever that may take you. It’s time to explore again. First stop: Japan. Far across the Pacific is another world. One you might not expect. There’s more than Tokyo…take the lessknown path to tour kooky art, bike to sand dunes, sip sake with locals and sample copious amounts of ramen (page 19). Go farther west (or east, depending on where you’re coming from) and discover all the tea in China…or at least the coveted Dragon Well variety in a tea village in Hangzhou (page 5). Closer to home, on the east coast of Canada, get edgy on the Cabot Trail (page 31). Famous yet still inauspicious enough that you can chant with monks on a clifftop overlooking a seemingly endless expanse of ocean. And, this being Nova Scotia, there’s the requisite lobster feast, in which you can indulge right on the beach in Cape Breton Highlands National Park as part of a new Parks Canada program. In Europe, Munich is hopping with beer lovers in lederhosen for Oktoberfest, but there’s another side to this Bavarian city besides beer gardens and BMW’s headquarters (both worthy of visits, of course). Like a stunning new minimalist museum that documents the Nazi past (page 23), or a nearby historic—and rather posh—resort that hosted last year’s G7 Summit (page 9). It seems that fall is about channeling that nomadic spirit (see pages 6–7 for traveller must-haves) and getting back out into the great wide world. So, pack your camera and head to the Amazon (page 12) or take a trip to your local farm-to-bottle brewery (page 18). It’s all an adventure. Embrace it! Reach us at feedback@ InPrintPublications.com with any ideas, comments or and the questions. is…

winner Calgary, d Liu of Dr. Edmon our CME Email on w e $1,000 AB. H Contest: a Subscriber ward a CME to it ed cr ng. his choosi course of ations! Congratul


what/when/where > fall

style | food | drink | festivals | places | getaways | gear‌

taste

tour

time in

china

yvette cardozo

Including Dragon Well at a tea village in Hangzhou‌

sip + sample

tea

mix

Fall 2016 Just For Canadian Doctors

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mix

fall

on the move

Tasting (and eating!) become a tea in Hangzhou nomad

if you go The best time to visit Hangzhou is fall or spring. Summer temperatures can hit

over 35 degrees. Winter is cold and can be rainy. Peak time is spring (mid March to early June). Most people fly into Shanghai from which it’s 45 minutes by bullet train (at speeds up to 250 km/h) to Hangzhou. For information on Hangzhou: e.gotohz.com. For Meijiawu Tea Village: visitourchina.com/hangzhou/attraction/meijiawu-tea-village.html. good to know China blocks virtually all social media. You can’t access Facebook, Instagram, Twitter or anything connected to Google, so save your posts for back at home.

old world

tradition

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Just For Canadian doctors Fall 2016

“N

ot all those who wander are lost.” The words from J. R. R. Tolkien’s Lord of the Rings tome have long fired the imagination of travellers. While this line is integral to the plot of his epic fantasy novel, another book spurs a more permanent quest, one rooted in reality. The New Nomads: Temporary Spaces and a Life on the Move, by Robert Klanten and Sven Ehmann, explores how today’s digital of globetrotters guide generation have become more mobile. Rather than dropping out, these entrepreneurs are very much plugged in and taking advantage of a high-tech life in which the whole world is their home. Flexible work spaces, multi-use objects and sustainability— all integral parts of this trend of living and working differently— are explored in this book. $53, Amazon.ca —Janet Gyenes High-tech style Smart watch or stylish timepiece? You can have both, thanks to a creative collaboration between Apple and Hermès. Available in 38 mm and 42 mm stainless steel cases (with other customizwear able options) and paired with an Hermès signature leather strap, Apple Watch lets you indulge both chic and geek. Choose from single tour (shown in the Capucine colour) or double tour in a new array of hues, such as Peacock blue and Pewter, so you can change-up your look with ease. —J. G. Apple Hermès watch, from $1,500; bands from $410. apple.com/ca

far left: yvette cardozo (2)

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ilk, tea and porcelain go back thousands of years in Hangzhou, a city in southeast China not far from Shanghai. Here, you can paint parasols, carve delicate chops (also called seals and used as stamps), visit tea plantations…almost any kind of cultural workshop. I pick tea. And more importantly, learn how to properly brew it. Meijiawu Tea Village sits at the west end of Hangzhou’s beautiful West Lake. Once poor, the village now is famous for its Longjing (Dragon Well) green tea. So famous, it gets a million visitors a year. Though the Chinese government owns the land, family-run plots cover the hillside, which sip+ looks like a waist-high carpet of tea plants so thick that you could walk atop it. Families sample plant, harvest, process and sell tea for their own profit. The tea plants take three or four years to mature and then last a good quarter century, producing top-quality leaves. The best tea comes from plants at the top of the mountain. And the best harvest time is at dawn during March and April, when the cold and rain of winter has ended and the blistering 38-plus degree summer heat has yet to start. “We pick only the very young leaves,” says Yuan Le Ha, holding a delicate yellow tea blossom. She points to the tiny, light-green leaves. These are “cooked” in an electric wok, stirred constantly for three hours, after which they’re set on a roof to dry in the sun. After another round in the wok and sun they become Longjing green tea (below, right). Green tea is not fermented, unlike black tea, Le Ha explains. And you do NOT steep green tea in boiling water; the ideal temperature is 80 degrees. Your first cup should be for sniffing, not drinking (Le Ha demonstrates, below left). And never steep green tea covered. “That will destroy the nutrients,” she says. Le Ha follows with a graceful tea ceremony in which she warms the glasses and carefully prepares and pours the tea. The ritual is worthy of an entire meal. And, as one local tells me, “Here we say we don’t drink tea, we eat it, because we eat the leaves.” Alas, to me, it looks much like cooked spinach and tastes like it too. But everyone else experiencing the tea ritual and tasting raves about it. So I’m happy to bring home a collection of beautiful tins filled with the tiny green leaves—as gifts. —Yvette Cardozo


go deeper

fall

Ditch the 9-to-5 but stay connected on the road Written + produced by Janet Gyenes sea change We’ve all been there: sitting on the shore watching sailboats skim across the sea, ogling yachts destined for deserted beaches. Nowboat, described as an all-in-one digital seafaring platform, has made it easier for adventurers and professional boat operators to connect safely and easily. Created by kite surfer Giovanni Alessi Anghini, the tech company invites comparison to tech disrupters, but Anghini dispels such notions, saying “we built Nowboat as a commitment to support the existing business system of seafaring operators, adventurers, and NGOs by including them in the equation—a need in this particular industry.” Waterbound travellers can find and book their trip online or through Nowboat’s app and use the new Ask a Porter function to customize excursions based on their level of adventure or relaxation, time and budget. Operators are availed the use of business tools to offer original trips like snorkelling Phuket’s west coast on a longtail boat, kite surfing in the Philippines or cruising to Greece’s Zakynthos Island. nowboat.com

Navagio Beach, Zakynthos Island power tripping There’s a downside to the craze to be connected when travelling: wireless devices eat up energy and often need to be refuelled en route. Suitcases are rising to the occasion and almost acting as personal travel assistants with smart design and thoughtful touches. From RIMOWA comes the revolutionary Electric Tag line that talks to your airline (exclusive gear actually to Lufthansa, with plans to expand), streamlining the luggage check-in and drop-off process to seconds. The rugged, tamper-proof case uses the world’s first integrated digital data module to replace the paper label: you can check-in using the smartphone app, connect your luggage and send a digital tag to your bag. Bluesmart’s eponymous TSA-compliant carry-on has a built-in charger to juice up your device at least six times. Its smartphone app lets you track your bag as you globe-trot— hopefully together. If not, rest (somewhat) assured that you can use the app to lock your bag. It’s even smart enough to lock itself once you leave its side. Another bonus: a scale that lets you know if those tins of pâté have fattened your case too much. Another choice is the affordable Carry-On by Away (two of its founders have Warby Parker cred), which promises “first-class luggage at coach prices.” It sports two USB ports for charging multiple devices, plus an interior battery that you can re-charge overnight in your hotel.

1

RIMOWA Multi-wheel Electronic Tag 63 (in Topas) 68 x 45 x 28.5 cm; 4.6 kg $1,190, rimowaelectronictag.com

2

Bluesmart One Carry-On 56 x 35.5 x 22.9 cm; 4.3 kg From $590, bluesmart.com

choose your adventure

Plugged in

mix

3 Away Carry-On 55 x 34.5 x 22.3 cm; 3.3 kg $296, away.com

travel

ease

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to the Schloss!

Bavarian beauty

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3

schloss

elmau

wish list

2

barb sligl

5

mix

fall

6

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hen the G7 Summit took place at Schloss Elmau last year, just outside Munich (see page 23), the historic château feted the likes of President Obama and Chancellor Merkel. Billed as a luxury spa retreat (it has a massive hammam) and “cultural hideaway,” 1 it’s a bit of hedonism for the cerebral type, complete with the largest independent bookstore in a hotel anywhere.

getaway

1

Award-winning authors like Ian McEwan and T. C. Boyle come here to give lectures or just escape for a while. It makes sense that this is where the world’s leaders convened to sort through global issues. If you could solve problems anywhere, it might be here, with the bucolic backdrop of the Bavarian Alps, surrounded by forest and blooming gentian 2 . Schloss is the German word for a château- or

palace-like building. And this, a baby by European standards (it’s celebrating its 100th anniversary of completion this year), evokes all the charm of a country manor: set on a meadow overlooking the Wetterstein mountains 3 , there are some 60+ hiking trails and even an alpine hut, the adorable 1927 Elmauer Alm-Hütte. And yet this place is seriously posh (with celeb devotees like Hugh Jackman, who decamped

here for a month). There’s a concert hall which transforms to the ultimate conference room 4 , infinity pools (yes, plural) 5 , a Michelin-chef-helmed restaurant and very slick bar 6 serving haute cocktails (try the Hugo with elderflower…). And for those wanting to channel some G7-level introspection there are 25 yoga retreats that take place here each year. Sign me up. —Barb Sligl

if you go Schloss Elmau is 100 km south of Munich, nestled in the Bavarian Alps. And, while it’s one of Germany’s top retreats, this Bavarian beauty is still relatively undiscovered. schloss-elmau.de.

Fall 2016 Just For Canadian Doctors

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mix

Zen kids

fall

Mysti ca Daisi e l s

gift idea

10

Just For Canadian doctors Fall 2016

Channel some Zen into your busy life by outfitting your little ones in Japanese-inspired onesies and playsets from Redfish Kids. The new fall collection from the Vancouver-based company draws its street-style aesthetic from hotspots such as Tokyo (see style Asian “Big in Japan” on page 19) while manufacturing locally. Fashionable, yet approachable, the clothing embraces the company’s commitment to inspire courage, freedom of expression and confidence in kids’ individuality. Baby onesie kimonos bloom with bold patterns like Mystical Daisies and the eye-catching geometric Cartwheel Karasu. The kimono’s signature wrap style gives your wee one more movement, which can only create more calmness during dressing and diapering. For older kids, the versatile two-piece kimono playsets are a pleasing departure from sloppy sweats, letting kids romp about unencumbered while still looking sharp. For statementmaking style, swap out the wrap top with a T-shirt emblazoned with Redfish’s signature hashtag: #COURAGE. —J. G. Onesie kimono, $58; Kimono playset, $74; #COURAGE T-shirt, $32. redfishkidsclothing.com ­

courtesy of redfish kids

A little Japanese


fall

mix

[stay]

High in the hills of Costa Rica at Finca Rosa Blanca Coffee Plantation Resort. fincarosablanca.com And low on the seaside and by the jungle at Arenas Del Mar Beachfront & Rainforest Resort (top, left + right). arenasdelmar.com

Fitness-minded people like Michele Shorter know that finding your bliss is about tuning in and setting goals, not dropping out. “In today’s connected world, it is more important than ever to take time for self-care, to move our bodies, breathe in the sweet air and savour our surroundings,” says Shorter. The wellness advocate who extols the virtues of both yoga and bootcamp is teaming up with GreenSpot Travel to offer the Pura Vida Luxury Wellness Retreat: The Shorter Approach Does Costa Rica this fall (October 8–15). Who says indulgence can’t be that rush get- of endorphins you get while hiking a volcano away in Costa Rica? The calmness that suffuses your mind after a yoga class, bare feet balancing in the sun-warmed sand? Or fuelling body and mind by harvesting organic vegetables you’ll later prep with a chef for lunch? Unlike many wellness retreats that tend to be ascetic escapes, Pura Vida promises a supercharged week of adventure at the Condé Nast Traveler award-winning Finca Rosa Blanca Coffee Plantation Resort and the Arenas Del Mar Beachfront & Rainforest Resort, both part of the Cayuga Collection’s ecoluxe resorts and lodges. —J. G. From US $3,295 per person; theshorterapproach.com/costarica or cayugaonline.com

Fall 2016 Just For Canadian Doctors

off-call in Costa Rica

courtesy of cayuga collection

Indulge yourself

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p h o t o p r e s c r i p t i o n m i c h a e l d e f r e i ta s Michael DeFreitas is an award-winning photographer who’s been published in a wide variety of travel publications. With his initials, MD, he’s been nicknamed “doc,” making his photography prescriptions apropos.

Jungle fever

The Amazon offers adventure and an abundance of unique photo opportunities

Send photos and questions to our photography guru at feedback@ inprintpublications.com and your shot may be featured in a future issue!

destination photography

Apply your photography skills to the shooting situations and scenery of the amazon.

up close + personal

The Amazon people are beautiful, friendly and very accommodating. That doesn’t mean you should jam a camera in their face. If you don’t speak Portuguese, smile, point to your camera and then them. They usually nod an okay. Since most have dark skin and brown eyes it’s best to use a bit of fill flash to put a twinkle of light in their eyes. Set your camera to aperture priority and f5.6, then set your flash to f2.8 so it doesn’t overpower the ambient light.

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Just For Canadian doctors Fall 2016

if you go

Iberostar: thegrandcollection. com/en/hotels/ manaus/iberostargrand-amazon

michael defreitas

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he late afternoon sky geared up for another spectacular tropical sunset as we glided up a small feeder stream of the Rio Negro. The overhanging jungle engulfed us, making it easy to spot wildlife. Amazon kingfishers darted back and forth across the water, and the calls of squawking blue-andgold macaws and raucous howler monkeys echoed through the surrounding jungle. Shooting from a moving boat is challenging especially in lower light conditions, but with few roads, water is the best way to get around in the Amazon. In these shooting conditions I use a tripod with a 70mm– 200mm zoom lens. As we motored slowly through the overhanging canopy, I preset my speed to 1/60 second and ISO to 400. Around a bend in the river our guide pointed to a blue-and-gold macaw perched on a branch. I composed within my camera frame so that the bird’s tail formed a leading line to its head and was able to get a few shots before it flew away. A few minutes later a pod of six pink river dolphins approached the boat, so I quickly grabbed my other camera with its 24–70mm lens and shot handheld at 1/60 second. I managed to shoot about 20 frames before they swam off—and I managed to get a few sharp images. On the way back to our mother ship (Iberostar’s Grand Amazon) we came across a couple of fishermen in a dugout canoe. I used the low sun and its reflection on the water as backlight and placed the men in the bottom left third of the frame. My 70–200mm zoom lens allowed me to easily compose the scene. Since I was handholding my camera, I used a higher shutter speed of 1/400 second to minimize camera shake. Besides wildlife the region offers a fascinating culture and indigenous people. During our rainforest adventures we met dozens of native people. Like the young Amerindian girl paddling her dugout canoe. I asked our guide to swing the boat a bit so I could use the sun to sidelight her and include some of the background to place her in the environment. I used a bit of fill flash to help light her face and shot at 1/125 second and f8 with my 24mm–70mm zoom lens. On our rainforest wildlife viewing hikes I also looked for natural plant patterns and


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photo prescription [continued]

Amazon adventure

other details. I shot clumps of variegated leaves and the intricate patterns on an owl butterfly wing. I opted to use a tripod and slow shutter speed to get the depth-of-field and sharpness instead of a higher ISO (to

confluence of the Solimões and Negro rivers where they join to form the Amazon River. It’s the cultural hub for the region and its Renaissance-inspired opera house, built in 1896, seems out of place with the surrounding jungle. After documenting the elaborate interior and grand dual staircase, I used the swirly mosaic tile patterns of

welcome to the jungle

reduce digital noise). I used a remote shutter release for my 2–3 second exposures (your camera’s self timer will work too). Nestled in the center of the jungle, Manaus, the capital of Brazil’s Amazonas state, is a fascinating town located at the

From Renaissancestyle opera houses to multi-hued macaws, the Amazon offers an unlimited palette for photography.

the adjoining square to accentuate its grandness. I placed my camera with a wide-angle zoom on the ground and shot at f22 for maximum depth-of-field.

Across town overlooking the river is the Adolpho Lisboa Municipal market with its fish and produce vendors. The bags of spices and friendly vendors made good subjects and a wide-angle lens gave me the ability to shoot without bringing the camera up to my face (less intimidating). I used fill-flash, an ISO of 400 and slower shutter speeds (1/30–1/60 second). I shortened my camera strap so I could firmly press the camera against my chest to reduce shake. A word of caution. The Amazon is hot and humid but ship interiors/cabins are air-conditioned. This combo can quickly ruin your camera equipment if you’re not careful. After a day of shooting I placed my cameras inside garbage bags (removing all air) before taking them into the air-conditioned room or cabin and waited a couple hours until they reached room temperature before removing them. Each morning I re-bagged them in my room and placed them on my outside balcony to acclimatize before removing them from the bags. A few of my travelling companions didn’t do this and fogged up the inside of their lenses. Not something you want to deal with when trying to capture the awe-inspiring scenery of the Amazon.

step back… then close in

michael defreitas

To get a sense of the vast expanse of jungle canopy, step back and let it seemingly swallow your subject. And then look down to capture the texture of the rainforest floor’s variegated greenery.

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Just For Canadian doctors Fall 2016


pay i t f o r w a r d

r o b e r ta s ta l e y

Roberta Staley is an award-winning magazine writer and the editor of the Canadian Chemical News, published by the Chemical Institute of Canada. She is also a magazine writing instructor at Douglas College and a graduate student at Simon Fraser University.

Healing invisible wounds

From war-torn Vietnam to Vancouver, where this psychiatrist now helps Syrian refugees

courtesy of Dr. Soma Ganesan

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he girl was one of many refugees who had come to Canada from war-torn Vietnam. The effects of the conflict were still evident, manifesting in such baffling behaviours as a refusal to eat meat—sometimes a refusal to eat at all—as well as self-induced vomiting. In Vietnam’s Communist “re-education camps,” which were eventually filled with about 500,000 prisoners after the fall of Saigon (Saigon is now officially known as Ho Chi Minh City) in 1975, the girl “had seen people fight with each other over a small piece of meat,” says psychiatrist Dr. Soma Ganesan, founder and director of the Vancouver General Hospital Cross-Cultural Clinic, which offers mental health services to refugees. For the girl, food, in essence, triggered memories of suffering and deprivation. The wounds of the mind that are inflicted by violence and oppression can be the longest lasting in survivors of war—as well as the most difficult to treat. Ganesan knows this first-hand; he was a resident of Saigon, as well as a newly graduated physician, the son of an East Indian father and a Vietnamese mother, when the city fell on April 30, 1975. At the time, Ganesan’s family lived a comfortable life; his father, Soma Sundaram, an immigrant from South India, worked for the Indian consulate as well as a French bank. He died when Ganesan was five years of age so his mother, Manh Duong, ran the family’s chain of hotels. The Communists confiscated the hotels after the takeover, but allowed Ganesan’s grandmother, mother and sister to continue living in their Saigon home. Ganesan had specialized in pediatrics at medical school, and continued working at the Saigon Children’s Hospital after the Communist takeover. This meant that Ganesan was exempt from fulltime imprisonment at the forced-labour camps, although he was transferred to one of these prisons every weekend. During the week, he attended evening “re-education classes” following his hospital rounds. Ganesan was not exempt from the brutality heaped upon inmates by the Communist guards and, while he deigns to provide details, admits to being physically abused. The experience

gave him insight into the suffering of the torture victims he would later counsel in Canada. “It opened my mind and made me more sensitive,” says Ganesan, who suffered symptoms of post-traumatic stress disorder (PTSD) such as flashbacks and sleepless nights for years. Ganesan eventually arrived in Canada in 1981—unable to speak English—as a refugee following a long and circuitous journey. Vietnam officials allowed him to leave after the Indian consulate issued him special papers stating that he was a member of an Indian citizen’s family. His first stop was a Singapore refugee camp, followed by temporary asylum in India and France. During the years he spent training to re-qualify for a Canadian medical licence, Ganesan worked to get his remaining family to Vancouver from Vietnam. This included sister Truc, grandmother Truong Duong and his mother. (Ganesan’s older brother, Dr. Mani Soma, an associate vice provost at the University of Washington, had immigrated to the United States before the fall of Saigon.) While he awaited the arrival of his family, Ganesan undertook numerous initiatives to help his fellow Vietnamese, creating a refugee support settlement program in Vancouver. He was also co-founder of the Vancouver Association for Survivors of Torture (VAST), now located at the recently opened Immigrant Services Society of British Columbia (ISSofBC) Welcome Centre, the first facility in the world to offer refugees transitional housing and services under one roof. As Ganesan studied for the examinations that would allow him to practise medicine in Canada, his focus shifted from pediatrics and diseases of the body to those of the mind. Studying psychiatry, a combination of “art, science and philosophy,” would allow him to assist other people who had been traumatized, as well as “help me a lot with myself personally.”

Treating people with PTSD is challenging; the symptoms are not straightforward and often manifest as physical complaints, such as headaches, an inability to sleep or, as with the Vietnamese girl, an eating disorder. It is also something that never goes away, says Ganesan. “Whenever anything small comes up and reminds you of your experience, the symptoms could flare up again.” Drugs or surgery—the standby Dr. Soma

Ganesan treats some of the most difficult wounds—those of the mind, inflicted by violence and oppression.

of most medical treatment—do not work for those who have been tortured or suffered deprivation. Often, counsellor and patient communication is hampered by language differences. However, “you can show you care even though you don’t speak the language.” Cultivating trust is key. “Unless people trust you they will not talk to you,” Ganesan says. Such skills are vital to provide help to the Syrian refugees who have been coming into Canada since last December. Many of the Syrian refugees—25,000 in Canada and about 1,800 in BC, with more to come—are victims of torture. When it comes to the scars of abuse, time often is not a healer; however, restoring health and mental equilibrium can be possible under the care of people like Ganesan, whose own horrific experiences as a young physician in Vietnam gave him the powerful gift of understanding.

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on the

[central]

side trip

coast Where mountains + fjords meet at the western

I

f trees could talk, what would they tell us? Tales of mystery and monotony, joy and woe, reign and ruin? Walking amidst the giants on the Big Cedars trail near Bella Coola, BC, it’s as if I’m caught up in the ebb and flow of time. Surrounded by living pillars that are a testament to more than I can imagine. “Let’s walk here with some reverence,” says Doug on the Trail, as my guide is simply nicknamed (he also goes by Doug in the Bar). He calls for reverence for this forest’s age and for those that were here before us. The Western Red Cedar giants date back to “pre-contact,” says Doug, meaning before the mid-1700s, when the First Nations were living here in harmony and seclusion. And then we stop at a colossal cedar that’s more than 1,000 years old. I feel as if I should kneel before it. I feel this way in much of the Central Coast of BC as I make my way from Anahim Lake to Bella Coola: flying over the Talchako Glacier in a de Havilland Beaver floatplane, standing atop sheer cliffs overlooking the third-highest free-falling waterfall in Canada,

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Just For Canadian doctors Fall 2016

floating down a placid river as bald eagles watch, coming across a paw print the length of my forearm on a dusty trail. The Beaver (an original from 1949 piloted by a handsome outdoorsy type with a belt buckle as wide as his smile) flies from Nimpo Lake over the Chilcotin Plateau, Coast Mountains and Monarch Icefield to land on Turner Lake, which empties into those 260-metre-high Hunlen Falls. We unload at a dock by a wilderness campsite used by outback hikers and paddlers (Turner Lake is part of a seven-lake chain that’s a canoeist’s wet dream), complete with serious-looking bear caches…because we’ve landed where it would otherwise take a 16-km hike into the wild to get to, deep in Tweedsmuir Provincial Park, BC’s largest. From here we hike to the falls, stopping along the way at lookouts that jut over the curves of Lonesome Lake and the bluest blue of a lake with no name. “You can name it if you want to,” says park operator George Probek. But I think perhaps its beauty speaks for itself and it should remain one of the few places left without a label. Much of the Central Coast seems uncharted, untouched

and, yes, unnamed. Or unnameable. From being on top of the world, as if on a dish that can’t contain its beauty and must spill it out in the form of falls and cliffs and glaciers, I descend 5,000 feet to the Bella Coola Valley floor via The Hill. Like the nameless lake of the bluest blue, The Hill is the all-too-simple name for a dramatic section of the “Freedom Road,” or Highway 20, an hour-and-half of twists and turns from the arid Chilcotin Plateau to the lush Great Bear Rainforest. It’s in this valley and rainforest that I meet Doug on the Trail amidst giants. And see grizzly tracks. My base at Tweedsmuir Park Lodge (home of the largest multi-tenure heli-ski operation in the world and once host to Mt-Everest-conqueror, Sir Edmund Hillary) is set on the Atnarko River, a prime bear-watching spot when salmon spawn in late summer and early fall. I’m here too early to see a grizzly catching dinner on the riverbank but I do stop in one’s tracks and, again, almost drop to my knees. I keep scanning for the maker of that massive paw print as I float down the river on an eco-drift excursion, mountains ris-


Overlooking Lonesome Lake in Tweedsmuir Provincial Park, just off a trail to the top of Hunlen Falls on the Chilcotin Plateau. far left Walking along the Big Cedars Trail among giants. left The turquoise water of South Bentinck Arm. right Old fishing nets, in shades of the blues of the fjord they were used in, hang from rafters at Tallheo Cannery Guest House.

edge of British Columbia ing on either side. The class-one river is a leisurely way to take in the scenery, with the adrenaline rush coming not from rapids but wildlife spotting (grizzly sightings are almost guaranteed during the salmon run). Tweedsmuir Park Lodge guide Mike Rilley, another seriously outdoorsy type, tells stories of bear encounters and how he can smell grizzlies before seeing them if the wind’s right (think wet dog and salmon breath). I’m content to have had a moment with one’s paw print. The next morning I rise from mountain base to peak, getting a heli ride to a ridgeline starting at Goat Mountain. And it’s here that I get my first glimpse of the fjord— the easternmost tip of the Pacific, where it crooks its finger deep into the Coast Mountain Range from Bella Bella to Bella Coola. The milky aquamarine waters are almost opaque, a spectacular silty swathe. Later, on the surface, on what’s called the South Bentinck Arm, local captain, fisherman and hunter Leonard Ellis tells stories during a fjord tour aboard his boat, the Nekhani. He points out where he found himself atop a massive basking shark; what

story + photography by barb sligl

he thought were two sharks’ fins was actually one shark’s dorsal fin and tail on either side of him. In a bit of a reversal, he also once found himself beneath a grizzly, sliding so close that the bear “woofed” in his face with “G-force” breath. This is the hardy sort you’ll find in these parts. Leonard takes us to Tallheo Hot Springs, where a beer never tasted as good as under cool drizzle in a natural in-the-rocks “hot tub” on the fjord’s edge. Practising hotand-cold therapy, I take a breath-stealing dip into the fjord, immersed in water that’s as blue as in the Caribbean (yet infinitely colder). After the spa session, the Nekhani chugs back through the surreally turquoise water, past waterfalls, pristine coastline and mist-shrouded trees. Leonard stops at his spot-prawn traps to collect our lunch. Just another day on the Central Coast… I stay on the fjord overnight at the Tallheo Cannery Guest House, a cannery that opened in 1910 and is now repurposed as a bed-and-breakfast only accessible by water. An old rooming house has become a boutique hotel of sorts and yet remains utterly rustic. There’s no electricity (power

if you go comes from a diesel generator) For more on the and the entire property is like Cariboo Chilcotin, a living museum. I meander its see page 38. grounds, stumbling upon huge coils of old rope, weathered buoys, beached boats, rusting machinery and an otherworldly display of fishing nets suspended from rafters that could be a contemporary art installation. Back on shore in Bella Coola, I hike a short way on First Nations land into another lush corner of the rainforest. Ancient carvings in rocks have been uncovered (one benefit of the logging industry here) and seem to shimmer under the canopy of trees that likely stood and watched just as solemnly when they were first etched. Chris Nelson, a local Nuxalk guide, stands and addresses the trees. He sings the “Cedar Bark Softening” song. Accompanied by the rushing creek and rustling branches, the sound echoes and deepens, soft and powerful, ethereal and timeless. When I tell Chris this afterwards he nods and says, “You can almost feel the age of that song.” Yes. I feel sure that the trees do too. And that they chanted along with him.

Fall 2016 Just For Canadian Doctors

17


the thirsty doctor janet gyenes Janet Gyenes is a magazine writer and editor who likes to dally in spirits, especially when discovering something like corenwyn jenever (a gin-like Dutch spirit)—straight or in cocktails like the “bramble.” Have a boozy idea or question? Send it to feedback@inprintpublications.com

Farm to bottle

“W

e were two farm guys trying to make it in the city of Winnipeg and trying to expose people to craft beer who were used to [drinking] Bud Light,” says Chris Warwaruk, recalling how he and his brother Lawrence came to start a gastropub in 2008. The pair served more than 100 types of craft brews from around the globe before the concept got big in Canada. In 2010 there were 310 licensed breweries in Canada. By 2015 that number swelled to 644, according to Beer Canada, a voluntary trade and advocacy association. And that thirst for craft beer started a hunger to learn about the brewing process, from farm to bottle. “Beer farms” across the country are fuelling both. In Neepawa, about 185 km northwest of Winnipeg, the Warwaruks found fertile ground for their newest venture, Farmery Estate Brewery. Like an estate winery, the brothers plan to brew beer on their rural farm using ingredients grown there too. “We wanted to show that we could still do farming on a smaller scale and with value added to make it profitable,” says Warwaruk. “It’s definitely fulfilling to make something with your own hands.” In Neepawa the brothers grow 10 varieties of hops, plus barley and rye. They’re contract brewing Farmery beer with their own barley and hops, but their first estate-grown craft beer will be available in September. On the West Coast of BC, Brian Smith and Mark Brand’s original plan of opening an East Vancouver brewery took a detour— and a 40-minute ferry trip—to the Sunshine Coast. The pair co-founded Persephone Brewing Company in 2012 after driving past a flower farm for sale in the seaside community of Gibsons. “And then the wheels just started turning,” says Brian Smith, CEO of the

T

BETTER BIZ

11-acre craft micro-brewery and hop farm. “We could grow our own hops and add it to the beer and that could be part of the brand.” The Beer Farm, as it’s known in local circles, includes an acre of mature Cascade, Centennial and Goldings hops used for seasonal brews such as its Harvest IPA. Another five acres of hops were planted earlier this year. People can tour the farm brewery’s operations or wander the demonstration hop yard and inhale the resiny aroma from the cone-like flowers. Last spring a handful of hobby brewers took a day-long course in hop farming and brewing here. When I visited, visitors streamed inside the big red barn to buy bottles and growlers to go. Others sat at the communal table in the tasting room, swigging pints. Outside, an Airstream trailer and pizza oven work in tandem to feed hungry visitors. Everything else is in symbiosis here too, with chickens grazing on spent grain and laying eggs and wastewater systems irrigating crops. A serial entrepreneur with an economics background, Smith sees Persephone, a certified B Corp, as an exemplar of sustainability and small-scale farming. The farm brewery is growing, following the lead of a Scottish brewery. “Brew Dog started using crowdfunding to grow their company in 2008 and they now have 35,000 owners,” says Smith. Persephone launched its campaign in summer (and has plans for a campaign in 2017) through FrontFundr. “For $250 they’ll be able to be an owner of a company.” (At the time of writing Persephone had

[W hat’s a B Corp? ]

B Corps are for-profit companies certified by the nonprofit B Lab to meet rigorous standards of social and environmental performance, accountability and transparency.

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Just For Canadian doctors Fall 2016

from left Lawrence and Chris Warwaruk; hops harvest; Persephone Brewing Company.

reached 85 per cent of its goal. It expects to have a 100 new owners.) Meander River Farm and Brewery stretches 186 acres in Newport, Nova Scotia. Alan Bailey and his wife purchased the property from his parents in 2004. “We were looking for opportunities to make the farm more sustainable and viable long term,” he says. Years ago, Bailey and his wife envisioned opening a micro-brewery, but it was growing hops in 2010 that rekindled the dream, says Bailey and “got us hanging around and talking to folks in microbreweries.” Today, eight varieties of hops are grown here: Cascade, Centennial, Brewers Gold, Galena, Newport, Nugget, Perle and Zeus. In autumn, Bailey brews Homegrown, its annual harvest ale, made entirely with hops grown on the farm. “We use everything fresh. The hops are picked today and brewed tomorrow,” he says. And that satisfies a loyal clientele; some even participate in the community shared brewery (CSB) program, buying “shares” at the beginning of the season. “We’re in the middle of the woods and people are coming out to us and supporting us by buying into our company,” says Bailey. “When it comes to harvest and big jobs on the farm we throw a party and invite people to help.” They also explore the hop and lavender fields, take educational tours of the operations and visit the pasture livestock: pigs, chickens and turkeys. And they drink farm-fresh beer made where the river meanders, in the middle of the woods.

far right: Janet Gyenes; other photos: courtesy of Farmery estate Brewery

A new crop of beer farms is satisfying the thirst for craft beer culture


travel the world

big in

Japan + photography by Stacey McLachlan

story

Traditional kimonos in Ginza; pumpkin sculpture in Naoshima by artist Yayoi; green tea ceremony at the Kannon-In temple in Tottori; and biking en route to Tottori’s sand dunes in coastal Japan.

Tokyo may get all the glory, but hop on a train and you’ll discover Japan has plenty to discover outside of the big city


travel the world

I

’m in a train station 7-11 in Osaka, puckering my lips at on a timeline (the last ferry leaves back to the mainland at 9:15) so the cashier and fanning my fingers out from my face. we opt for the faster option. Well, fast-ish: the one-speed bikes we Like fins. Or maybe gills. Whatever—it’s clearly the rent from the train station are hilariously ineffective on the island’s international sign for fish, because the cashier points to rolling hills, but it makes for an excellent excuse to make frequent the onigiri (a seaweed and rice pocket) on the counter, stops to check out the public artwork that’s scattered across the labelled with an unintelligible pink sticker, and nods island—like the giant, neon-orange speckled pumpkin, painted by enthusiastically. I pay, unwrap the intricate package, and avant-garde artist Yayoi Kusama, sitting gracefully at the end of a take a bite. Not fish, exactly: fish eggs. Close enough. dock jutting out into the Seto Inland Sea. And better yet, the tough Yes, there’s a bit of a language barrier. But I’m getting ride will make a soak at the Shinro Ohtake-designed “I Love Yu” by with my few phrases (bīru, kore onegaishimasu and watashi no onsen (hot spring), decorated like a kaleidoscope with thousands of hīrō, which translate respectively to “beer,” “this, please!” and the mosaic pieces, that much sweeter. surprisingly versatile “you are my hero!”), the occasional charades session, and the help of my more seasoned travel companions There is a place on Dōtonbori street where you can [surprise #2] make your own takoyaki—fried octopus balls. It’s a who have taught me something more important than the lanThe best guage: that the best part of Japan is the discovery and surprise baseball-themed bar called Toracy, where the wary memories are found in every moment. bartender brings a steel deep-frying contraption to edible ones Until you’re here, you don’t know what it’s like to have a deer your table and demonstrates the process using the eat crackers out of your hand in Nara (answer: thrilling, terrifying). only English phrase he knows: “quarter-turn.” You don’t know what you’ll discover in the base of a 200-foot-tall, It’s unfortunately hard to focus on perfecting said turns, pure white Kannon statue in the Kurume suburbs (answer: a hilaribecause the bustling street outside presents so many other delicious opportunities. So we continue our gluttonous journey by following red left Colourful cranes lanterns to yakitori stands, where we pair hang at the Hiroshima fresh shrimp and icy pints of Sapporo, Children’s Peace Monument. opposite, and gobble up kushikatsu—crispy friedclockwise from top left everything on skewers, served with a The Inari shrine in Kyoto communal dipping sauce that’s made by glows at dusk; colourful such a tall man that we’re able to return to ramen ad in Harajuku; the same place by googling “kushikatsu the view from Mt. Misen in Miyajima; the giant.” Along the buzzing road, neon fish Itsukushima Shrine in glow and oversized novelty gyozas spin Kyoto offers a moment of overhead. There’s a playful hedonism serenity; archives at the here, where locals are said to bankrupt Suntory Whisky library; themselves on food and drink (there’s sand dunes of Tottori; fresh uni (sea urchin) even a word for it: kuidaore). at Osaka’s Kuromon Market; a swan spotted on the art-focused island of Naoshima; long lines at Fukuoka’s Ramen Stadium.

ously spooky animatronic replica of the Buddhist circle of hell). You don’t know why you would stop at a convenience store 14 times a day (answer: fresh sushi and ice-cold cans of sweet coffee are perfectly acceptable for breakfast, lunch and dinner alike). So armed with my rail pass and companions—and a belly full of fish-egg onigiri—I’m ready for my next surprise. On the tiny island of Naoshima, abandoned houses have been transformed into experimental galleries— one former dentist’s abode has become a walk-inAn island can be a work collage, plastered floor to ceiling in painted galaxies of art and postcards, with a replica of the Statue of Liberty bursting through the ceiling; another is home to a darkened theatre that oscillates between pitch blackness and something slightly brighter. Just as Okayama boasts (as much as the Japanese boast) about its peaches and Hiroshima shapes its identity around its tragic past, this community has a brand of its own: art. Here, the truly dedicated check into the hotel-museum hybrid Benesse House and spend a weekend strolling the island’s paths and checking out the subterranean Chichu Art Museum. But we’re

[surprise #1]

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Just For Canadian doctors Fall 2016

There are 200 bars packed into three square blocks in [surprise #3] Drinking is Tokyo’s Golden Gai neighjust better bourhood, each seating here approximately six people and each with its own super-specific theme: think ‘90s alt-rock, race horses or Troll dolls. Wandering the narrow alleyways is like navigating a dream—each door a portal to something completely unexpected, and your glass is never empty. It’s a beautiful cacophony that also seems like a major fire hazard. We find the opposite in the sleepy town of Yamazaki, 30 minutes outside of Kyoto. There isn’t even a 7-11: we’re really off the beaten path. Maybe the residents here subsist purely off of the output of the Suntory Whisky headquarters. It certainly proves to be a solid way to spend an afternoon or, at the very least, strolling the library of golden bottles and selecting a mix-and-match flight to sample in the high-ceilinged tasting room. But even with Japanese whisky enjoying a moment on the world stage, sake is still the country’s signature spirit. We arrive at Saijo’s annual Sake Festival at a fashionably late 6 pm (wearing equally fashionable headbands from the local dollar store, Daiso, in a commemorative Samurai-style). Everyone else has been here since morning, and the atmosphere is suitably jovial. We have some catching up to do, but luckily 20 yen gives us access to all-you-candrink sake from all over the country, poured into commemorative ceramic cups with the volume of a ping-pong ball. There is a lot of


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travel the world spilling. The more seasoned members of the crowd put their tiny cups into slightly lesstiny wooden boxes—the traditional serving dish for the rice wine. Under glowing paper lanterns, we toast cups against boxes and boxes against cups, and rosy-cheeked locals invite us into their circles to practise their English and compliment our headgear.

solution from Summer 2016 contest

Everyone we encounter in Tottori asks us the same thing: [surprise #4] “Why are you here?” You might Suffice to say, this isn’t meet a camel exactly a hotspot. And truth be told, we discovered it by accident, plotting our trip along the train line and googling the stops. We entered “Tottori” and up popped images of sprawling sand dunes, so (naturally) we booked a hotel immediately. The sand museum is impressive—inside, we find some mind-bending sculptures of South American legends as part of the current international exhibits—but the main attraction is the real thing: the miles and miles of sand, piled high like in the Sahara, but with a sparkling ocean awaiting on the other side. We don’t swim, though: instead, I strap

made noodles served in on a sandboard and carve if you go my way down the sandy savoury bone broth. take the train All Nippon Not four hours later, slopes. My partner Airways and Japan Airlines offer elects to “wander the we find ourselves direct flights into Tokyo, where transit sitting at another dunes” and disappears can easily get you into the city or counter, eating into the hills, appearconnect you to a train station. ana.co.jp + jal.com Order your 7, 14 or 21-day rail ing an hour later with another batch of pass ahead of time to take advantage noodles, but this reports that he has of the tourist discount—if you’re seen a camel. (We’ll situation is like no traveling every few days, it’s food court I’ve ever never know if it was a a worthwhile investment. been in: food carts mirage.) japan-rail-pass.com called yatai that are set up with awnings and seating Fukuoka is the [surprise #5] birthplace of around the edge, the original There’s no such ramen, and they pop-up restaurants. thing as too This time, we order up our ramen fried. take this stuff seriously: much ramen so seriously that there’s a This is hardly the lantern-lined, orderly Ramen Stadium. Yes, in reality experience we had at lunch. Our stools are wobbly on the uneven sidewalk, and it’s just a very nice food court, but the proprietor of this food stall is actually looking closer, I see that each ramen station chain-smoking while he cooks. I’m skeptiis actually representing a different style cal. But the noodles are at once crispy and from a region of Japan. Pork broth from perfectly tender, drizzled in some mystic Kagoshima; miso ramen from Sapporo. (Mr. combination of dashi and sesame and porkNoodles does not make an appearance.) bone broth, an unexpectedly perfect dish We pre-order from a machine—a common served up on the Fukuoka streets as the ramen-joint feature that makes the language world goes by. Really though: the surprise barrier that much easier—and wait our turn should be no surprise at all. to sit at the counter and slurp up the fresh-

sudoku 2 harder solution 1 9 4 7 6 3 2 5 8 8 2 7 5 9 1 6 3 4 5 3 6 2 4 8 7 1 9 2 6 3 9 1 4 5 8 7 7 8 9 3 2 5 1 4 6 4 1 5 6 8 7 9 2 3 3 5 8 1 7 6 4 9 2 6 4 2 8 5 9 3 7 1 9 7 1 4 3 2 8 6 5

solution from page 37

Puzzle by websudoku.com

sudoku 1 easier solution 2 6 7 5 9 8 3 1 4 8 1 5 2 3 4 6 7 9 3 9 4 7 1 6 8 5 2 5 2 8 1 4 7 9 6 3 6 7 9 3 2 5 4 8 1 1 4 3 8 6 9 5 2 7 9 8 2 4 5 1 7 3 6 7 3 6 9 8 2 1 4 5 4 5 1 6 7 3 2 9 8

Puzzle by websudoku.com

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Just For Canadian doctors Fall 2016


munich / melbourne / zhanjiang / cincinnati / nevis … | c a l e n d a r

cMe

A n intern ation a l guide to c ontinuing medical Education

fall 2016 + beyond

1

3

munich

5

2

3

5

4

Munich or Munchen is the mecca of beer, especially during Oktoberfest, but there’s so much more to this Bavarian city—from BMW to bespoke shoes (CME events in Munich + beyond are highlighted in blue.)

Barb Sligl

W

hen you fly in to Munich it’s to a five-star airport. MUC achieved the first such five-star designation in Europe, offering everything from “napcab” sleeping pods to Weissbier or white beer (with Weisswurst or white sausage, of course, sauerkraut and a pretzel) at Airbräu, the airport brewery. Sehr gut. And, this year, MUC was named Europe’s Best Airport—again (it’s the ninth time in 11 years)—and it’s ranked third in the world after Singapore and Seoul (munich-airport.de). It even has a huge square in the grand tradition of European cities that’s one of the largest roofed outdoor spaces on the continent. Here, you can surf (there’s a wave pool), play polo or beach volleyball, watch a tennis match and experience a full-on traditional German Christmas market. Or sit in the beer garden. So, think Munich and, yes, think great beer 1 (this is where the famous 1516 purity law, Reinheitsgebot, was written in 1487 before it was adopted across Bavaria, decreeing the use of just a few key ingredients: water, hops, barley), but also some serious style. Like the sleek BMW headquarters (bmw-welt.com/en/) 2 . The awardwinning architecture evokes the dynamic movement of a

four-cylinder engine and propeller. BMW Welt or World, as it’s aptly named, is an altar to German engineering and for those with the means, you can even personally pick up a car on site and drive your new machine down the spiral ramp and out the building. More exquisite craftsmanship is found at the centuries-old shoemaker and clothier Ed Meier (edmeier. de). Peter Eduard Meier is the great grandson of the original purveyor to the Bavarian court and, if you’re lucky, you may catch a glimpse of the impeccably dressed gentleman at the flagship store 3 . A short walk away (perhaps in some new custommade shoes) is the Kunstareal or arts district where Munich’s museums are clustered, including three Pinakotheken museums (the Alte or Old, Neue or New and Pinakothek der Moderne), the Glyptothek (founded in 1830 by Bavarian King Ludwig I to showcase his collection of Greek and Roman sculptures), the Lenbachhaus (showcasing local modern art), the Museum Brandhorst and more. The newest is a stark modern cube on Königsplatz (Kings Square) with the wordy name of the Munich Documentation Center for the History of National

Socialism (ns-dokuzentrum-muenchen.de). Inside, it’s a stripped-down look at the very-close-to-home Nazi past; this, after all, is where the Nazi party was born and made its base. The museum is built atop the ruins of Hitler’s Nazi headquarters, Das Braune Haus (Brown House). After this, it’s probably a relief to get back to beer. And, better yet, a stein at the loveliest Schwemme or taproom anywhere, Hofbräuhaus, which has served the likes of Wolfgang Amadeus Mozart (hofbraeuhaus.de) 4 . And, if you don’t make it to the Oktoberfest tent grounds alongside six million others (it’s the world’s largest fest, going on since 1810, and taking place this year from September 17 to October 3), then you must at least make it to Augustiner Keller (augustinerkeller.de), one of Munich’s oldest and most famous beer gardens under ancient chestnut trees. It’s a slice of Bavarian bliss with a stein of local favourite Edelstoff in hand 5 . Edel means special—on the level of a gemstone— and it seems that paean applies to much in Munchen. Ja, sehr gut. — Barb Sligl For more info on Munich, go to muenchen.de and for Bavaria, check out bavaria.us and read more on page 9.

Fall 2016 Just For Canadian Doctors

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Endocrinology

Emergency Medicine

Diabetes

Cardiology

Anesthesia

Aesthetic Medicine

c Mcmee cwhen alendar where

24

topic

sponsor

contact

website

Nov 16-20

Dubai UAE

5th Annual Dermatologic & Aesthetic Surgery International League (DASIL) Congress

DASIL

847-577-6543

thedasil.org

Feb 12-16 2017

Maui Hawaii

39th Annual John A Boswick, MD Burn & Wound Care Symposium

JAB Symposium

info@jabmauisymposium. com

jabmauisymposium.com

Oct 03

London England

Developing World Anaesthesia

Royal College of Anaesthetists

011-44-207092-1729

rcoa.ac.uk

Oct 03-06

Paradise Island Bahamas

Current Anesthesia Topics

Northwest Anesthesia Seminars

800-222-6927

nwas.com

Sep 24-25

ReykjavĂ­k Iceland

Resuscitation 2016

European Resuscitation Council

32-3-246-4666

erc.edu

Oct 26-28

Berlin Germany

3rd European Congress On eCardiology & eHealth

Europa Organisation

011-33-5-34452645

e-cardiohealth. com

Feb 02-05 2017

Steamboat Springs Colorado

2017 Annual Vascular & Endovascular Surgery Society Winter Meeting

Administrare, Inc.

978-927-7800

vesurgery.org

Oct 05-08

Doha Qatar

2016 Arab Diabetes Medical Congress

Maarefah Management

011-971-4-3619616

arabdiabetescongress. com

Oct 21-22

La Jolla California

Advanced Therapeutic Interventions To Optimize Obesity And Diabetes Care

Scripps Health

858-652-5400

scrippshealth. org

Mar 08-12 2017

Barcelona Spain

9th International DIP Symposium On Diabetes, Hypertension, Metabolic Syndrome & Pregnancy

ComtecMed, ComtedMed

011-972-3-5666166

comtecmed. com

Jul 31Aug 07 2017

Alice Spring Australia

Australia’s Red Centre 2017 Medical Conference

Unconventional Conventions

1800-633-131 See Ad Page 11

uncon-conv. com

Nov 08

Halifax Nova Scotia

Airway Intervention And Management In Emergencies ADVANCED Using Cadavers

Canadian Association of Emergency Physicians (CAEP)

613-523-3343

aimeairway.ca/ programs

Nov 21-24

Queenstown New Zealand

33rd ACEM Annual Scientific Meeting

The Australasian College for Emergency Medicine

See website

acem2016.com

Feb 05-12 2017

South America Cruise

Emergency Medicine: Clinical Topics, Personal Development, And Leadership Skills

Continuing Education, Inc./University at Sea

800-422-0711

continuingeducation.net

Feb 09-21 2017

Baja and Sea of Obstetrics, Emergency Medicine And More Cortez Cruise

Sea Courses Cruises

888-647-7327

seacourses. com

Oct 13-15

Munich Germany

2016 Power Of Programming: Developmental Origins of Adiposity & Long-term Health

University of Munich

EarlyNutrition@med. lmu.de

munich2016. project-earlynutrition.eu

Oct 26-29

Ottawa Ontario

2016 CSEM/CDA Professional Conference And Annual Scientific Meetings

Canadian Society of Endocrinology and Metabolism

613-594-0005

endo-metab.ca

Mar 02-05 2017

Cannes France

7th International Conference On Fixed Combination Therapy In Cardiovascular Disease, Hypertension, Diabetes, Dyslipidemia & The Cardio-Metabolic Syndrome

Paragon Group

011-41-22-5330948

2017.fixedcombination.com

Just For Canadian doctors Fall 2016


Internal Medicine

Geriatrics

General & Family Medicine

Gastroenterology

cme

calendar

cMe

when

where

topic

sponsor

contact

website

Nov 05

Grand Rapids Michigan

5th Annual Western Michigan Liver Round-Up

University of Michigan Health System

734-615-0832

umich.edu

Nov 29

London England

2016 Annual Update On Paediatric Gastroenterology Study Day

Academy for Paediatric Gastroenterology

011-44-778591-4542

fomf.de

May 18-20 2017

Mallorca Spain

1st International Congress Of MicroImmunotherapy

MeGeMIT

katharina. krueger@ megemit.org

icomi2017.org

Sep 28Oct 11

Spice Islands Cruise

Immunology, Allergy, Pediatrics And Rheumatology

Unconventional Conventions

1800-633-131

uncon-conv. com

Oct 25-29

Lenox Massachusetts

8th Annual Physicians Conference: The Heart And Science Of Yoga

The American Meditation 518-674-8714 Institute

Nov 04-05

Munich Germany

7th International Hip Arthroscopy Meeting

Intercongress Freiburg

011-49-761696-99243

hipmeeting.de

Dec 10-17

Disney Caribbean Cruise

Medical CBT Tools: Ten-Minute Techniques For Real Doctors

CBT Canada

877-466-8228

cbt.ca

Jan 20 2017

Banff Alberta

Common Fractures And Dislocations Course

University of Calgary

403-220-8786

cumming.ucalgary.ca

Mar 24Apr 08 2017

Argentina, Patagonia Cruise Chile

Update On Family Medicine Including Visits To Local Hospitals In Buenos Aries And Santiago

Doctors-On-Tour

855-362-8687

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Jun 15-24 2017

Cuba & Guatamala

Cuba & Guatemala 2017 Medical Conference

Unconventional Conventions

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Oct 05-07

Lisbon Portugal

12th European Union Geriatric Medicine Society Congress

Aristea International

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Dec 07-09

Kish Island Iran

2016 International Society For Evidence-Based Healthcare Congress

Iranian Evidence Based Medicine Center of Excellence

011-98-413335-6561

isehc2016.com

Nov 02-04 2017

Toronto Ontario

9th Canadian Conference On Dementia

University Health Network

416-597-3422

canadianconferenceondementia.com

Nov 05-06

Augusta Georgia

Update In Cardiovascular Disease Management For Primary Care Providers

Augusta University

800-221-6437

gru.edu

Dec 01-04

Papagayo Peninsula Costa Rica

Internal Medicine For Primary Care: Derm/Endo/ Neuro/Pulm

Medical Education Resources

800-421-3756

mer.org

Feb 03-05 2017

Orlando Florida

2017 Rehabilitation Medicine Update In Orlando

Mayo Clinic

507-293-1876

mayo.edu

Feb 25 2017

Victoria British Columbia

2017 Internal Medicine Update

Nova Clinical Services

250-658-6056

novaclinical.com

americanmeditation.org

NYU Radiology CME Presents

35th Annual Head to Toe Imaging Conference December 12-16, 2016 • The New York Hilton Midtown • New York City

Earn up to 43.75 AMA PRA Category I Credits www.med.nyu.edu/courses/cme/h2t16

Fall 2016 Just For Canadian Doctors

25


Oncology & Palliative Care

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Neurology

Mental Health

Infectious & Chronic Diseases

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mdBriefcase Inc.

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Ongoing

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Meningococcal Serogroup B Frequently Asked Questions

Dec 11-22

Southeast Asia Conference Singapore to Hong Kong

Topics In Infectious Diseases, Regenerative Medicine, And Wellness Medicine: 2016 Update

Continuing Education, Inc./University at Sea

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continuingeducation.net

Expiry Feb 27 2017

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Influenza Knowledge Transfer Series: Clinical Challenges In Protecting Children Under 2 Years Of Age From Influenza

mdBriefcase Inc.

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The Complex Challenges Of Treating Gout & Its Comorbidities

mdBriefcase Inc.

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Mar 25-29 2017

Maui Hawaii

Medical CBT For Depression (And Happiness): Ten-Minute Techniques For Real Doctors

CBT Canada

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cbt.ca

Apr 10-12 2017

Kauai Hawaii

Medical CBT Tools: Ten-Minute Techniques For Real Doctors

CBT Canada

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Apr 15-29 2017

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South Pacific Cruise

Medical CBT For Depression (And Happiness): Ten-Minute Techniques For Real Doctors

CBT Canada

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cbt.ca

Aug 03-12 2017

Japanese Cruise (Princess Cruises)

Medical CBT For Depression (And Happiness): Ten-Minute Techniques For Real Doctors

CBT Canada

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Sep 24-28

San Diego California

2016 Congress Of Neurological Surgeons Annual Meeting

Congress of Neurological Surgeons

847-240-2500

cns.org

Feb 24-26 2017

Miami Florida

1st Pan American Parkinson’s Disease & Movement Disorders Congress

International Parkinson & Movement Disorder Society

414-276-2145

pascongress2017.org

Oct 26-28

Maui Hawaii

Primary Care-Maui

University Learning Systems

800-940-5860

universitylearning.com

Oct 29-31

Lisbon Portugal

16th Biennial Meeting Of The International Gynecologic Cancer Society

Kenes International

011-41-22-9080488

igcs2016.com

Feb 05-17 2017

Australia and New Zealand Cruise

Psychiatry, Dermatology And Women’s Health

Sea Courses Cruises

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seacourses. com

May 18-19 2017

Brussels Belgium

2017 Obstetric Anaesthesia

Obstetric Anaesthetists’ Association

011-44-207631-8882

oaa-anaes.ac.uk

Ongoing

Online

Modernizing The Code Of Medical Ethics: Chapter 5 - Ethical Issues In Caring for Patients At The End Of Life

American Medical Association

800-621-8335

ama-assn.org

Oct 01-02

Munich Germany

European School Of Oncology (ESO) / Technische Universität München Institute For Advanced Study Master In Ethical Counselling In Oncology & Gender Issues

European School Of Oncology

011-39-2-8546451

eso.net

Oct 17-25

New England & Canada Cruise on Crystal Serenity

Advances In Caring For Our Aging Population

Professional Education Society

877-737-7005

pestravel.com

Having a facial difference can create barriers to opportunities and aspirations. It affects over 1.5 Million Canadians. AboutFace promotes positive mental and emotional well-being of individuals with facial differences and their families through social & peer support, information and educational programs. We work to encourage, empower and educate. For more information on how you can get involved, visit www.aboutface.ca “It was the first time in my life that I met people who had facial differences, as I did. It was also one of the few times in which I walked into a room full of strangers and did not feel even the tiniest air of judgment.” -Samantha Loucks, 23

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Just For Canadian doctors Fall 2016


Primary Care

Practice & Personal Management

Pediatrics

Ophthalmology

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Nov 01-12

Tokyo Japan

Ophthalmology In Japan

Jon Baines Tours

011-44-207223-9485

jonbainestours. co.uk

Jan 11-13 2017

Vienna Austria

8th International Course On Ophthalmic & Oculoplastic Reconstruction & Trauma Surgery

Advanced Ophthalmic Trainings

011-43-22-4320898

ophthalmictrainings.com

Feb 03-04 2017

Rovigo Italy

2017 Vitreo Retinal Experience

AIM Group International

011-39-2-566011

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Ongoing

Multiple Cities Colombia

Capacity Building Internship For HIV/AIDS Orphanage (Volunteer Opportunity)

The Humanity Exchange

778-300-2466

thehumanityexchange.org

Oct 15-21

Kauai Hawaii

Aloha Update: Pediatrics 2016

Children’s Hospital Los Angeles Medical Group / Laura Evans

323-361-2752

childrenshospitallamedicalgroup.org

Dec 21Jan 02 2017

Southern Caribbean Cruise

Dermatology, Pediatrics And Emergency Medicine

Sea Courses Cruises

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Jul 06-09 2017

Kuala Lumpur Malaysia

11th International Symposium On Pediatric Pain

My Meeting Partner by Anderes Fourdy

011-60-3-27884534

ispp2017.org

Nov 16

London Ontario

Genetics And Your Practice Day

London Health Sciences Centre

519-685-8500

schulich.uwo.ca

Dec 13

London England

Demonstrating & Improving Prescribing Competence & Practice

Healthcare Conferences UK

011-44-193242-9933

healthcareconferencesuk. co.uk

Mar 26Apr 08 2017

Australia and New Zealand Cruise from Auckland to Sydney

Optimizing Health For You And Your Patients: Evidence-Based Lifestyle Factors That Enhance Cardiovascular, Cognitive, Metabolic, And Hormone Function

Continuing Education, Inc./University at Sea

800-422-0711 See Ad Page 39

continuingeducation.net

Oct 31Nov 04

Duck Key Florida

7th Annual Essentials In Primary Care Fall Session I

Continuing Education Company

800-327-4502

cmemeeting.org

Nov 12-16

Colorado Springs Colorado

North American Primary Care Research Group Annual Meeting

North American Primary Care Research Group

913-906-6000

napcrg.org

Jan 23-27 2017

Marco Island Florida

5th Annual Essentials In Primary Care Winter Medical Conference

Continuing Education Company

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Jan 30Feb 02 2017

Breckenridge Colorado

Primary Care Ski And CME

A-Cross Medicine Reviews

719-538-0006

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Feb 20-24 2017

Maui Hawaii

5th Annual Primary Care Winter Conference

Continuing Education Company

800-327-4502 See Ad Page 37

cmemeeting.org

Mar 27-31 2017

Palm Coast Florida

11th Annual Primary Care Spring Conference: Session I

Continuing Education Company

800-327-4502

cmemeeting.org

Nov 04-11 2017

Tahiti and the Society Islands Cruise Conference

Topics In Neurology For Primary Care Providers

Continuing Education, Inc./University at Sea

800-422-0711 See Ad Page 39

continuingeducation.net

We believe in putting the patients first. - Do you? If so, we are looking to recruit the following positions: Family physicians

You Require Balance. You Demand the Best. Imagine Health Centres are multidisciplinary health clinics located throughout Calgary and Edmonton. For more information, e-mail us at Corporate@ImagineHealthCentres.ca www.ImagineHealthCentres.ca

Retiring physicians wishing to transition and scale down their practice Medical Specialists: Gynecologists Physiatrists Sports Medicine Specialists Dermatologists Psychiatry Internal Medicine Pediatrician

Fall 2016 Just For Canadian Doctors

27


Wilderness and Travel Medicine

Surgery

Sports Medicine

Radiology

Psychiatry/ Psychology

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topic

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Oct 16-19

Melbourne Australia

1st Annual Rehabilitation Medicine Society Of Australia & New Zealand Scientific Meeting

DC Conferences Pty Ltd

011-61-2-99544400

dcconferences. com.au

Oct 27-29

Zhanjiang China

9th International Stress & Behavior Society (ISBS) Regional Biomedical & Neuroscience Stress & Behavior Conference / 6th Mind-Body Interface International Symposium / Marine Drug & Nutrition For Brain Diseases Symposium

International Stress & Behavior Society

info@stressandbehavior.com

stressandbehavior.com

Oct 29

Cincinnati Ohio

Psychopharmacology Update

Global Acaemy for Medical Education

973-290-8258

evvnt.com

Jan 22Feb 05 2017

South America Cruise

Psychiatry, Endocrinology, Rheumatology And Sports Medicine

Sea Courses Cruises

888-647-7327 See Ad Page 24

seacourses. com

Oct 24-28

Santa Barbara California

NYU’s Fall Radiology Symposium In Santa Barbara

New York University Department of Radiology

212-263-3936 See Ad Page 25

med.nyu.edu

Oct 31Nov 04

Napa California

2016 Update In Advanced Imaging

UC Davis Health System

916-734-5390

ucdmc.ucdavis. edu

Dec 12-16

New York New York

35th Annual Head To Toe Imaging Conference

New York University Department of Radiology

212-263-3936 See Ad Page 25

med.nyu.edu

Jan 23-27 2017

Nevis West Indies

Clinical Imaging Symposium In Nevis

NYU Langone Medical Center

212-263-0724

radcme.med. nyu.edu

Dec 09-10

Boston Massachusetts

Active Lives: Transforming Our Patients & Ourselves

Harvard Medical School

617-384-8600

hmscme.com

Jul 06-07 2017

Cambridge Massachusetts

16th Cambridge / UCLA Course on Clinical Exercise Testing & Interpretation - A Practical Approach

Cambridge Postgraduate Medical Centre

011-44-122321-6376

cam-pgmc.ac.uk

Dec 01

Liverpool England

Training And Assessment In The Clinical Environment

Broadgreen Hospital

011-44-151706-3580

rcseng.ac.uk

Mar 22-25 2017

Houston Texas

2017 Society Of American Gastrointestinal & Endoscopic Surgeons (SAGES) Annual Meeting

SAGES

310-437-0555

sages2017.org

Nov 07-11

Guanacaste Costa Rica

Medical Spanish For The Healthcare Professional

Medical Studies Abroad

512-328-6431

medicalstudiesabroad.com

Nov 09-14

Paradise Point California

Fly Fishing Northern California Wilderness & Travel Medicine

Bio Bio Expeditions

800-246-7238

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Nov 30Dec 10

Ghana

Tropical Medicine Excursion (Since 1995)

TROPMEDEX

49-15255698101

tropmedex.com

Feb 15-19 2017

Big Sky Montana

The National Conference On Wilderness Medicine

Wilderness and Travel Medicine

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Apr 08-12 2017

Big Island Hawaii

The National Conference On Wilderness Medicine

Wilderness and Travel Medicine

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For feedback, requests DocAd.pdf 1 30/08/2016 6:23:27 PMor to have your course featured please email cme@inprintpublications.com or submit your course via www.justforcanadiandoctors.com

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About the Hospital:

AC wing (13 beds), LTC wing (25 beds) and ER department ensure all basic services are met. Patient care is integrated with the Chapleau & District Family Health Team and the numerous programs and clinics that are offered.

About the position:

The position follows the Rural Northern Physician Group Agreement. Emergency and Hospital call arrangements are shared equally between four physicians.

For community, Hospital or Physician Practice information, contact: Gail Bignucolo, CEO Chapleau Health Services 705-864-3053

More information can be found at the following web-sites:

Chapleau Health Services at: www.sschs.ca Community Information at: www.chapleau.ca

The Chapleau community recently achieved the highest possible level of Accreditation with Exemplary Standing from Accreditation Canada.

Many people visit Nova Scotia. It’s the lucky few who stay.

o p p o r t u n i t ies

Our clinic and hospital is located in Chapleau, Ontario, a friendly and open community with rich character in both English & French traditions. The town has a population of approximately 2,779 and is nestled in the heart of the Canadian Shield with access to provincial parks and year-round recreational activities. If you’re looking for a great work-life balance in a friendly community, come and visit.

e mploy me n t

THE COMMUNITY OF CHAPLEAU is seeking ONE FAMILY MEDICINE PHYSICIAN to join an established RNPGA

Calling Nova Scotia home means ocean views, active living and welcoming communities. Practicing here means working with passionate colleagues, providing world-class care, and helping people be healthy and stay healthy. We are actively recruiting family physicians, hospitalists and specialists for full-time, part-time and locum opportunities across the province. We also have a new Vacancy Replacement Program that could be right for you. Connect with us today – we’d love to have you. Call Joanne at 902-473-7174 physicianrecruit@nshealth.ca www.nshealth.ca/physician

Come and find new ways to become lost in your passions! Fall 2016 Just For Canadian Doctors

29


o p p o r t u n i t i es

FAMILY MEDICINE & SPECIALIST PHYSICANS

Photo courtesy Marikay Falby

emp loy me n t

Exciting opportunities are available in the Saskatoon Health Region for Generalist and Specialist Physicians. Opportunities include Physical Medicine and Rehabilitation, Family Medicine practices in Urban and Rural settings and various Medicine specialties, Emergency and Pediatrics, including Pediatric Gastroenterology. Please see our website for a complete list of available opportunities: www.saskatoonhealthregion.ca/joinourteam/Pages/ Physician-Opportunities.aspx

Home of the Canadian Light Source Synchrotron

service

Saskatoon is home to the Canadian Light Source. The Synchrotron is a unique national resource and the largest Science project in Canada in more than 30 years.

To Apply:

The City Saskatoon Shines – with more hours of sunshine than any other major Canadian city. With a population of 255,000, Saskatoon is the largest city in Saskatchewan, boasting small town spirit and big city amenities, an International airport, world class events, with a strong arts and music focus. The city is noted for its outstanding walking and biking trails along the riverbank, and excellent educational facilities, including the University of Saskatchewan. What's more everything is within 20 minutes of home.

If you are seeking a challenging career opportunity, please apply in confidence to either: Jackie McKee Phone: 306 655-0196 Fax: 306 655-0192 jackie.mckee@saskatoonhealthregion.ca OR Lois Spizawka Phone: 306 655-0195 Fax: 306 655-0192 lois.spizawka@saskatoonhealthregion.ca

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Just For Canadian doctors Fall 2016


travel at home

on

t e r B e p a C n i e g d e e h t

on

Hiking, kayaking, monks and music along Nova Scotia’s famous Cabot Trail drive Driving on the edge, the Cabot Trail follows the rugged coastline on the western side of Cape Breton Highlands National Park.

story + photography by

James Ross

Fall 2016 Just For Canadian Doctors

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travel at home

I

stand waist-deep in the rushing Margaree River, while my savvy fly fishing guide and instructor, Ed McCarty, works patiently on my technique. It comes, slowly but surely, from getting tangled in the line and hooking my own vest to snapping the long rod and flicking the fly in the vicinity of my desired pool. Ed tells the story about teaching Canadian astronaut Chris Hadfield to fly fish in this very spot. “He was much smarter than me, a genius really,” says the humble expert. “But his casting needed some polish.” Mine too, and I don’t have nearly the acumen of Ed’s previous protégée,

over long sandy curves of deserted beaches. You can drive the 297-kilometre trail in a day, but to truly experience its splendour, you need to venture off the main road onto the spectacular hiking trails, off the beaten track into the colourful fishing villages that hug the coast. My journey starts and ends in the charming village of Baddeck on Bras d’Or, Canada’s largest inland sea, and although there is much debate on which direction is best, I go counter-clockwise, because I like to drive on the edge, with the cliffs and sea dropping precipitously just below me. “You can call me Seamus.” I learn that Seamus is my Gaelic name while doing a tour of Colaisde na Gàidhlig, the Gaelic

At the very northern end of the trail I take a detour on a gravel road into the High Capes north of Pleasant Bay to visit the monks of Gampo Abbey. In this remote retreat, you can hide away on a nine-month residency, with lots of meditation, solitude and quiet time. Abstinence and silence not being my forte, I only stay a couple of pleasant hours in the late afternoon, joining a small group of like-minded travellers gathered around a smoky fire high on the cliffs above the Atlantic. Like old friends, we all make much noise, banging pots and chanting in a monotonous cadence to ring in the Summer Solstice and welcome a new season—it seems the island’s trademark

College that celebrates Cape Breton’s traditional lifestyle and keeps the Gaelic language, music, dance and culture alive. I’m shown how to don a great kilt and master the step dance—well, kind of. I also discover that “Ciad Mile Failte,” a sign that greets you all along the trail, means “One Hundred Thousand Welcomes.” And I feel as if I’ve been continually welcomed as I’m immersed in the vibrant Gaelic and Acadian cultures of the island. At every opportunity, I duck off the trail into a hidden harbour, where boats bob at the quay and coiled rope, old nets and creels for lobster and crab stand in neat piles. I explore the tiny towns with their simple homes, huddled together to face the best and the worst of the weather. Everywhere, the locals are friendly with thousands of welcomes.

open-armed spirit is infectious. As I continue skirting the island’s edge, the roadway meanders through Cape Breton Highlands National Park at its northernmost point. Here, lush river canyons carve themselves into the ancient plateau, while granite rock breaks up the green-coloured hills that sweep down in folds and gullies to the golden sands and blue sea. I wish I had more time to hike some of the 25 trails in the park, such as Franey, Jack Pine, the Margaree Valley and the Coastal route. I settle for the Skyline Trail, a 9.2-kilometre loop that takes me to a dramatic look-off point. An easy trek, it’s fairly flat simply because it begins at the top of the mountain, and the vista at its end, 405 metres above the sea, is magnificent. To the south, the Cabot Trail hugs the ocean wall high above the Atlantic, but it’s the view

Lobster traps. right The monks of Gampo Abbey on Cape Breton’s north end, take a break from their meditations to bring in the Summer Solstice.

but still my form improves with each flick of the line. I find it a peaceful, serene and artistic endeavour. I don’t land the big one, neither wild salmon nor trout—but, hey, neither, apparently, did Mr. Hadfield. My fishing experience takes place at the end of my week-long journey around one of the world’s most famous drives, Nova Scotia’s Cabot Trail. Named for explorer John Cabot who first spied the island in 1497, the trail winds around the rocky splendour of Cape Breton’s northern shore, ascending to the incredible plateaus of Cape Breton Highlands National Park and then back down to the Acadian forest region along the Gulf of St. Lawrence. Rolling blue-green mountains run down to the sea, broken intermittently by meadows covered in wildflowers. Farther below, the surf rolls in

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Just For Canadian doctors Fall 2016


travel at home

The view from the end of the Skyline Trail. left Fly fishing guide Ed McCarty shows off his technique in the Margaree River.

The rugged granite coastline in Cape Breton Highlands National Park on the eastern side of the island.

A lobster boat sets its traps on Bras d’Or Lake. above Jeremy White, owner of Big Spruce Brewery, enjoys some of his craft. right Margie Beaton teaches the art of fiddling at the Gaelic College.

The bottom feeding lobster was once thought of as only fertilizer —now it is a culinary delight.


travel at home

if you go

out to sea that I find most captivating, across the Gulf of St. Lawrence to some distant land, the water changing from a brilliant turquoise over sandbars to dark blue in the deep where the howling Atlantic wind stirs the waves. I see a lone lobster boat bobbing in the chop far below, checking traps. I think that perhaps the boat is picking up my dinner. You can’t experience this island without sampling lobster. And I do so during “Learn to Lobster Boil,” a new program put on by Parks Canada. I enjoy the evening event on the beach, savouring my crustacean picnic and keeping my eyes open for moose and bald eagles. I also hope to spot a Minke or Pilot Whale breaching while watching the sunset over the St. Lawrence on La Bloc beach. It’s all part of the Celtic colours on this coastal drive. Colours that come through in all the senses, and especially in sound as I listen to the wind and waves (and my lobster screaming, although the Parks Canada guide dispels that myth—it’s actually just air escaping the shell as it boils)…and music. Music is woven into the Cape Breton Island tapestry. Celtic music is the sound and soul of the trail (and Celtic Colours is

The Cabot Trail winds its way south towards 34Cheticamp. Just For Canadian doctors Fall 2016

HISTORY Parks Canada’s Alexander Graham where I end with Bell National Historic Site commemorates the that flick of the renowned inventor. Exhibits show how he and his associates achieved Canada’s first powered flight, fishing line. produced the world’s fastest boat, advanced recording From here the technology, designed giant kites and, of course, rolling farmland invented the telephone. parkscanada.gc.ca/bell of the Margaree TASTE Tour Glenora Distillery (glenoradistillery.com) River Valley to discover Canada’s first single-malt whiskey, and cradles the road Spruce Brewery (bigspruce.ca) for Cape Breton back to Baddeck. craft beer. KAYAK with Angelo Spinazzola, After driving the singing kayaker of North River Kayaks. northriverkayak.com along the water’s MORE Cape Breton Tourism: edge for the last cbisland.com few days, I feel the

also an autumn music festival, taking place this October 7–15). I realize early in my journey that full parking lots at roadside pubs or community centres are an invitation to take a break and pull in for a pint of Big Spruce microbrew or a dram of Glenora single-malt whiskey, because there is a Ceilidh happening—a jam session of Celtic musicians that becomes a party of Gaelic folk music and dancing. Cape Breton boasts some of the finest musicians in the Celtic fiddle world and locals often tell tales of when a young Natalie MacMaster or the Rankin Family graced these same stages. Both cheery and haunting, it begs you to dance and then, with a few more notes, to shed a tear. South of Margaree Harbour, the trail swings inland to the wistful Margaree River,

need to actually get on that sparkling surface, so I go for a moonlight paddle on Bras d’Or, out to Beinn Bhreagh, an island that once housed the summer home of Alexander Graham Bell. After a thrilling paddle through unusually rough water, I take a break at the Baddeck lighthouse for some sushi and wine, then kayak back into the sleepy harbour to spend one last night here—the end or the beginning of the Cabot Trail. Whichever way you go, it’s full of wonder, seafood, music, pot banging, kilts and just a wee bit of craft beer and single-malt scotch.


d o c t o r o n a s o a p b o x d r . C h r i s P e n g i l ly Dr. Chris Pengilly is Just For Canadian Doctors’ current affairs columnist. Please send your comments to him via his website at drpeng.ca.

Physician shortage

With fewer general practitioners, doctors need to do some problem solving

A

t the time of writing there are over 4.5 million Canadians looking for a family physician, and failing to find one. The causes of this situation are multiple, which means that there is no one simple solution—and some of the solutions will take a quantum leap of thinking concerning the optimum use of healthcare dollars. Here is a roller-coaster ride…in 1961, a federal commission on health services perceived a potential shortage of physicians by the next decade. In response, it suggested creating at least four new medical schools to accommodate the increasing population. In 1991 the perception was abruptly reversed. A new report presented to the Federal, Provincial and Territorial Conference of Deputy Ministers of Health predicted an imminent over supply of physicians; it suggested cutting medical school admissions and licensing of foreign medical graduates. Disincentives, including limited physician fees, succeeded in driving doctors to the United States. By 2002 a report for the Canadian Institute for Health Information predicted an imminent shortage of physicians. Disincentives that had not already been disallowed by the courts (for example, compulsory retirement of physicians at age 75) were quickly withdrawn and incentives were then

(British Columbia is used as an example below.) A 22% increase in funding sounds impressive initially—but spread over 10 years, it is little more than the rate of inflation. Nonetheless the figures indicate a worrying increase in the average age of physicians. It also reflects that physicians are following a healthier lifestyle for themselves by not working excessive or dangerous hours. Another noteworthy factor is the quality improvement in primary care delivery with creation of full-time hospitalists, dedicated surgical assistants and urgent care physicians—physicians, who until relatively recently, would have been in family practice offices. Doubling the number of family physicians, I think, will still not solve this situation. Ways of increasing the efficiency and productivity of primary care physicians should be researched and implemented. The electronic medical record opens opportunities. Technically, it is now easily doable to offer community physicians transcription services as have long been offered to hospital physicians. This will simultaneously improve record keeping and save each physician up to an hour a day in recording. Computer voice recognition is okay but still not as easy, accurate or as quick as a live Family Median Total Working transcriptionist. Physicians Age Expenditure Year The telephone is underused. There has 2005 4,679 48 $773 m 191 days been a long-standing $947 m 176 days 5,596 reluctance to offer 51 2014 (+ 22%) (– 8%) (+ 9%) a fee-for-service for telephone “office visits.” There are also several introduced at an escalating (and recently useful secure smartphone applications such proven) ineffective rate. as Vsee. With careful safeguards, these will Meanwhile other changes have been goenable follow-up visits to be quickly and efing on that also explain the evident shortage. ficiently dealt with.

graphic by dream icons from noun project

Here is a chance for physicians to do what they do best— problem solve

Roller coaster ride… Or the

back-and-forth response to the physician shortage in Canada

The role of the medical office assistant has changed with the transition away from paper charts. Physicians should learn early, even at medical school, how to effectively delegate tasks to their office staff. Then the staff will feel appreciated as part of a team and not fear being rendered redundant by the EMR. Doctors need to look carefully at the tasks that they do each day to see what else office staff can deal with. A registered nurse or, better still, a nurse practitioner, exponentially increases the quality and productivity of any group of physicians. A ratio of about one nurse for four physicians is a reasonable balance of productivity and affordability. I suggest that the current all-inclusive fee-for-service is no longer relevant in the 21st century. A fundamental mind-set shift is needed, on both sides, at the negotiation table to create a professional fee and a separate overhead subsidy of, say, 90%—at least until fully equipped and staffed primary care clinics are provided to family physicians. With the all-inclusive fees, a progressive physician productively delivering teamwork will take home fewer dollars than a Jurassic colleague who is able to cut corners while boasting of “low overheads.” The current system has failed and continues to fail badly. Here is a chance for physicians to do what they do best—problem solve.

Fall 2016 Just For Canadian Doctors

35


t h e w e a lt h y d o c t o r M a n f r e d p u r t z k i Manfred Purtzki is the principal of Purtzki & Associates Chartered Accountants. You can reach him at manfred@purtzki.com.

Take care of home base

Take a close look at your financial situation and these tax strategies for your home mortgage

E

ven at a low mortgage rate of 3%, you need about $2.4 million of pretax practice cash flow to pay off a $1-million-house mortgage. To minimize the after-tax cost of the mortgage payment, consider the following scenarios to deduct the mortgage interest for tax purposes.

Account A and funds are withdrawn to repay your personal loan. The practice expenses, including office overhead and staff salaries, are paid from Account B, which is funded by a practice line of credit. Since the borrowed money was used to pay for practice expenses, the interest deductibility test is met.

1 The sale and buy back You own an investment worth $300,000. You sell the investment and use the proceeds of $300,000 to pay down your mortgage. Subsequently, you borrow $300,000 to repurchase the investment. The interest is now tax deductible because the borrowed money was used to acquire the investment, to pay for operating expenses, including debt servicing, before compensation is paid to the owner-doctor. The point of zero income and zero loss is the “breakeven point.”

3 Sale to company You own real estate that cost $500,000 and has a market value of $900,000. You sell the real estate to your medical corporation or holding company at an elected value of $500,000. Your Corporation borrows $500,000 to pay for the real estate. You use the proceeds to pay down your personal mortgage. The interest expense is deductible in the corporation. By electing the transfer value of the asset at the tax cost, the transaction does not trigger any capital gains which normally would apply if the property was disposed of to a third party.

2 Cash damming This is a great technique, especially for unincorporated doctors to convert a personal loan into a practice loan. You establish two bank accounts. Your professional income is deposited into

4 Share sale You own the shares of your medical corporation, which owns the practice and the office strata. The shares have a value of $500,000. You sell the shares to family

clas s ified a d s office space / positions / locums / + more

Richmond, BC — Family Physician Recruitment december 2016 Our colleague will be leaving her busy practice which is a part of our group family practice in the south-east of Richmond BC (juncture of Richmond, Ladner and Tsawwassen), with easy highway access. We require a family physician who must be comfortable with good primary care, women’s health and EMR skills. Fast paced, friendly environment, supportive staff, 3 -5 working days, competitive split. Seeking a long term associate to take over a built up longitudinal care practice with some walk in component. www.IronwoodMedicalClinic.com CPSBC Provisional Licensure Applicants from IMGs also encouraged to apply. For information please contact office number: (604)-448-9595 or email: msinghalmd@gmail.com

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Just For Canadian doctors Fall 2016

Richmond, BC — ­ Cosmetic/Aesthetic Dermatology Wishing Lasers We are interested in sublease of Dermatology Lasers as demand for such services grow. Our practice is located in the south-east of Richmond BC (juncture of Richmond, Ladner and Tsawwassen) with easy highway access. We are seeking to sublease with potential to buy or lease takeover of Dermatology Lasers for Cosmetic/Aesthetic Dermatology. We recognize there are quite a few physicians who have leased or purchased lasers which are being underutilized and would wish a symbiotic agreement in using the Lasers for private patients. www.IronwoodMedicalClinic.com and www. richmondcosmetics.ca For enquiries please contact office number: (604)-448-9595 or email: msinghalmd@ gmail.com

members (spouse and children) for $500,000 in exchange for a promissory note. There is no tax on the sale since you are able to claim the capital gains exemption of up to $800,000. The family members borrow $500,000 to repay the promissory note, which repays the house mortgage. The interest on the $500,000 loan is deductible since the money was used to purchase shares. 5 Payment of dividends Here is another method to maximize the interest deductibility. The medical corporation borrows money to pay dividends to the shareholders, who use the funds to pay off personal loans. The interest is deductible in the company as long as the dividend is paid out of the accumulated profits or retained earnings of the company. Check the “retained earnings” amount in the shareholder equity section of the practice balance sheet. You cannot borrow money and deduct the interest if the bank loan exceeds the retained earnings. 6 The equity strip This strategy works well where the doctor has injected his or her own capital, usually in the form of a shareholder loan, into the corporation. Consider the following series of transactions:

a. The company takes out a temporary loan of, say, $300,000 to repay the shareholder loan; b. You, as a shareholder, use the proceeds to pay down the personal mortgage; c. You take out a new mortgage on your house and invest the funds in the company; d. The company uses the new mortgage proceeds to repay the bank loan. Nothing has really changed in your debt structure, except that the house mortgage is now tax deductible on your personal tax return. Take a close look at your financial situation to see if you can devise the appropriate strategy to make your personal loans, including house mortgages, tax deductible.


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Fall 2016 Just For Canadian Doctors

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pa r t i n g s h o t

wish you were here on the central coast of BC, at the 1910 Tallheo Cannery, where the weathered structure provides the perfect frame for this scenic view of the fjord of North Bentinck Arm, near Bella Coola. See story on page 16.

n St o r y o pa g e 1 6

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Just For Canadian doctors Fall 2016

barb sligl

if you go

DISCOVER BC’s Central Coast via Cariboo Chilcotin Coast Tourism: landwithoutlimits.com. TOUR BY AIR with Tweedsmuir Air’s Beaver floatplane (tweedsmuirair.com), then do a heli-hike on 4 Mile Ridge with Tweedsmuir Park Lodge (tweedsmuirparklodge.com). TOUR BY BOAT on the Nekhani with Bella Coola Grizzly Tours: bcgrizzlytours.com. STAY on Nimpo Lake at the Dean on Nimpo (thedeanonnimpo.com), in Bella Coola Valley at Tweedsmuir Park Lodge (tweedsmuirparklodge.com) and on the fjord at Tallheo Cannery Guest House (bellacoolacannery.com).


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Argentina & Chile CME: Northern Patagonia Multi Sport Adventure January 26 – February 3, 2017

Profile for Just For Canadian Doctors

Just For Canadian Doctors Fall 2016  

Just For Canadian Doctors Fall 2016  

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