Department of Clinical Neurosciences
A fellow-locum program that began in July 2015 has proven to be a win-win for patient care and participating fellows. Fellows who are Royal College certified may spend 10-20 per cent of their time doing general neurology clinics. This provides additional clinical service and allows fellows to develop practice experience in a well-supported environment while enhancing their income.
Late in 2015 we piloted the role of a neuro-hospitalist. This helped us determine how to implement the neuro-hospitalist role.
A procedure teaching clinic was initiated in late 2015. While concurrently providing a clinical service, residents from many programs gain experience performing spinal taps, doing cervical nerve blocks, and administering botulinum toxin for migraine.
Neurology is organized into several subspecialty programs. These programs include headache, neuromuscular, ALS, multiple sclerosis, neuroimmunology, movement disorders, epilepsy, general neurology, urgent neurology, neuro-ophthalmology, neuro-vestibular, stroke, and cognitive neurosciences. Section members also play important roles in Calgary’s neuro-oncology and chronic pain programs and provide outreach services to the Calgary Urban Project Society (CUPS) and ‘The Alex’ medical clinics.
Most neurologists are based at one of four hospital sites—Foothills Medical Centre (FMC), Peter Lougheed Centre (PLC), Rockyview General Hospital (RGH), and South Health Campus (SHC)—to support outpatient general neurology and sub-specialty clinics and neurophysiology labs. Most are funded through an Academic Alternative Relationship Plan (AARP).
The section operates as a cohesive unit to provide city-wide emergency and hospital services. One team provides general neurology support to all four adult acute care hospitals, including inpatient consultation services at the four sites and neurology inpatient ward services at FMC and SHC. A team of stroke neurologists provides acute stroke care at FMC and provides city-wide leadership in stroke management. A third service of epilepsy neurologists manages two inpatient seizure-monitoring units, provides extended hour city-wide EEG support, and provides 24-hour EEG support to city intensive care units.
The Section of Neurology is well recognized for research productivity and the major clinical impact of its research endeavours. We continue to demonstrate that care can be improved through innovative research. The Alberta Health Services President’s Excellence Award for Outstanding Achievements in Research was awarded to the ESCAPE Trial Team and the Calgary Stroke Program won the ASTech Award (Alberta Science and Technology Award) in the category of Society Impact. The team, led by neurologists Michael Hill and Andrew Demchuk, along with neuroradiologist Mayank Goyal, demonstrated that endovascular treatment can dramatically improve patient outcomes after acute ischemic stroke.
Our researchers include clinician scientists and population health investigators, who spend up to 80 per cent of their time undertaking research, as well as clinical researchers who spend 20-65 per cent of their time doing research. Neurologists continue to hold major research leadership positions within the University of Calgary. Sam Wiebe continued as Associate Dean of Clinical Research and Michael Hill completed several years as Associate Dean of Clinical Trials. Greg Cairncross continued as Director of the Arnie Charbonneau Cancer Institute.
Excellence in education is highly valued in our section. Dedicated neurologists lead our residency program (Michael Yeung), the undergraduate neuroscience course (Gary Klein, David Patry, Jeptha Davenport), the neurology clerkship (David Patry), and continuing medical education (Justyna Sarna). Neurologists also lead our sub-specialty fellowship programs and hold important education leadership positions within the University of Calgary. Lara Cooke is Associate Dean of Continuing Medical Education and Kevin Busche is Assistant Dean of Undergraduate Education. Many others contribute to program leadership and everyone is involved in both didactic and bedside teaching.
Our residents were all successful in obtaining their Royal College certification in 2016 and all continued in fellowships or initiated careers in independent practice. We continue to have residents who are undertaking graduate degrees in medical education. This speaks to the positive examples provided by our neurologist educators and how seriously we take this role.
Neurology has several very popular subspecialty fellowship programs. In 2015-16 there were 10 fellows in stroke, four in multiple sclerosis/neuroimmunology, two in neuromuscular/EMG, and one each in epilepsy/EEG, cognitive neurology, and neuro-oncology.
Other Individual Highlights
There have also been changes to our team. This year we said goodbye to Ranjit Ranawaya who retired in December 2015 after 36 years of practising neurology in Calgary. He recently led our Movement Disorders Clinic. Werner Becker and Neelan Pillay also semi-retired but continued to provide outpatient care in headache and epilepsy respectively. We welcomed Colin Josephson, who joined us as a clinician scientist and has a research focus on population health aspects of epilepsy.