University of Toronto Medical Journal

UTMJ University of Toronto Medical Journal Volume 82, Number 3/May 2005 A student-run scientific publication. Established in 1923. Table of Contents 157 Preface 199 158 Infectious Disease The Impact of the 2003 SARS Outbreak on Medical Students at the University of Toronto Mark S. Landis and Dr. John W. Bradley Technology Review Percutaneous Heart Valves: The Emergence of a Disruptive Technology Ran Gilad and Ron Somogyi The Free Future of General Medical Software Michael Bonert and Bradley MacIntosh Complementary and Alternative Medicine Modern Midwifery in Ontario: An Effective Model of Health Care Heather L. Cameron Economics and Health Policy Fixing Family Medicine in Ontario: Is Increasing the Number of Residency Positions Enough? James J Laughren Philosophy and Medicine Trials by Fire: The Case of Unethical Clinical Trials in the Countries of the South Behzad Hassani Historical Review War and Medicine: The Origins of Plastic Surgery Richard Backstein and Anna Hinek Book Review Eye of the Beholder Review of Glaucoma: A Patient’s Guide to the Disease, 3rd Edition Shefali Davé Survivor: Residency Review of Staying Human During Residency Training, 3rd Edition Shefali Davé 202 166 News and Views In the Literature Daniel Saul, Konstantinos Gus Sidiropoulos and Peter Tanuseputro Medical Murmurs 2005: A New Controversial Chapter in the use of FOBT in Primary Care Colorectal Cancer Screening Ariel Eric Klevan, Eran Shlomovitz and Andrew J. Smith Medical Education Diversity in Medicine – Diversity and Equity Issues in Medical Education, Part I Louie Chan and Yusra Ahmad 207 169 210 172 212 176 Current Medical Perspectives Kevin C Kain, MD, FRCPC Lorenne Doucet and Evan Kwong 217 179 Morning Report For Whom The Belly Tolls Devon McDonald, Kevin Schwartz, Althea Barthos and Dr. Doreen Chung 220 183 Clinicopathological Correlation Mucosal Melanoma of the Hypopharynx Teresa Pun, David Goldstein, Bayardo Perez-Ordonez, Mark Rafferty and Jonathan Irish Quick Diagnosis Ariel Eric Klevan, Alireza Zahirieh and Sean Symons Justina Sam and David F. Tang-Wai Jennifer MacIsaac Dominica Gidrewicz 221 191 Front cover illustration by Andrew Deonarine, MD program, University of Toronto (OT7) volume 82, number 3, May 2005 153 UTMJ University of Toronto Medical Journal Room 2171A, Medical Sciences Building, 1 King’s College Circle, Toronto, Ontario M5S 1A8 A student-run scientific publication. Established in 1923. UTMJ Staff EDITORS-IN-CHIEF Andrew Deonarine, M.Sc. (0T7) Andrea Rowe, B.Sc. (0T7) SENIOR ASSOCIATE EDITORS Annisa Chang, Ph.D. (0T7) Michael Loreto, M.Sc. (0T7) Varinder Randhawa, M.Sc., M.D./Ph.D.3 JUNIOR ASSOCIATE EDITORS Peter Ceponis, Ph.D. (0T8) Joanne Yu, Ph.D. (0T8) SENIOR MANAGING EDITORS Teresa Pun, B.Sc. (0T7) JUNIOR MANAGING EDITORS Ripudaman Minhas, B.Sc. (0T8) Mona Moosavian, B.Sc. (0T8) Lilly Teng, B.Sc. (0T8) SENIOR COPY EDITORS Tola Afolabi, M.A. (0T7) Chris Feng, B.ASc. (0T7) Mark Sinyor, M.Sc. (0T7) JUNIOR COPY EDITORS Cynthia Chan, B.Sc. (0T8) Eric Morgen, B.Sc. (0T8) Naomi Shupak, M.Sc. (0T8) SENIOR NEWS & VIEWS EDITORS Woganee Filate, M.HSc. (0T7) Emily Kovacs, M.Sc. (0T7) Daniel Saul, B.Sc. (0T7) Michael Sidiropoulos, M.Sc. (0T7) JUNIOR NEWS & VIEWS EDITORS Martin Betts, B.Sc. (0T8) Peter Tanuseputro, M.HSc. (0T8) SENIOR MORNING REPORT EDITORS Althea Barthos, B.ASc. (0T7) Devon McDonald, B.Sc. (0T7) Kevin Schwartz, B.Sc. (0T7) SENIOR CLINICOPATHOLOGICAL CORRELATION EDITORS Joe Lai, M.Sc. (0T7) Alipasha Rassouli, B.Sc. (0T7) JUNIOR CLINICOPATHOLOGICAL CORRELATION EDITOR Janice Wong, M.Sc. (0T8) SENIOR ECONOMICS & HEALTH POLICY EDITORS Michael Detsky, B.Sc. (0T7) James Pencharz, M.Sc. (0T7) JUNIOR ECONOMICS & HEALTH POLICY EDITORS Jed Laughren, B.Sc. (0T8) SENIOR HISTORICAL REVIEW EDITORS Rich Backstein, B.Sc. (0T7) Anna Hinek, M.Sc. (0T7) JUNIOR HISTORICAL REVIEW EDITORS Bilal Ahmed, B.Sc. (0T8) SENIOR MEDICAL EDUCATION EDITORS Louie Chan, B.Sc. (0T7) SENIOR INTERNATIONAL HEALTH EDITORS Yusra Ahmad, B.A. (0T7) Ophelia Yeboah, B.Sc. (0T7) JUNIOR INTERNATIONAL HEALTH EDITORS Brie Banks, B.Sc. (0T8) Deana Hathout, B.Sc. (0T8) SENIOR QUICK DIAGNOSIS EDITORS Justina Sam, B.HSc. (0T7) Amparo Wolf, M.Sc., M.D./Ph.D.2 JUNIOR QUICK DIAGNOSIS EDITORS Kalam Chan, M.Sc. (0T8) Andrew Lui, B.Sc. (0T8) SENIOR REHAB SCIENCES EDITORS Janine Pakulis, B.Sc. Ken Tang, B.Sc. SENIOR CURRENT MEDICAL PERSPECTIVES Lorenne Doucet, B.Sc., B.ASc. (0T7) JUNIOR CURRENT MEDICAL PERSPECTIVES Evan Kwong, M.Sc. (0T8) SENIOR PHILOSOPHY AND MEDICINE Ari Greenwald, B.Sc. (0T7) Susan Lee, B.Sc. (0T7) JUNIOR PHILOSOPHY AND MEDICINE Behzad Hassani, H.B.A. (0T8) Jai Shah (0T8) SENIOR TECHNOLOGY REVIEW EDITORS David Holt, B.Sc. (0T7) Ali Zaidi, B.Sc. (0T7) JUNIOR TECHNOLOGY REVIEW EDITORS Joy Abramson, B.Sc., M.D./Ph.D.1 Ron Somogyi, M.Sc. (0T8) SENIOR ALTERNATIVE MEDICINE EDITORS Michele Zysman, M.Sc. (0T7) JUNIOR ALTERNATIVE MEDICINE EDITORS Kathryn Howe, Ph.D. (0T8) SENIOR BOOK REVIEW EDITORS Shefali Davé, B.Sc. (0T7) JUNIOR BOOK REVIEW EDITORS Andrew Perrin, M.Res. (0T8) FINANCIAL OFFICER Vivian Yin, B.A. (0T7) WEBMASTER Michael Bonert, M.ASc. (0T7) EDITORIAL BOARD Hamideh Alasti, CCPM Judith Balogh, M.D. Stephanie J. Brister, M.D. Janet Craik, M.Sc., OT Reg. (Ont.) Ian Crandall, D.Phil. Marko Duic, M.D. Kymm Feldman, M.D. Philip Hébert, M.D., Ph.D. Maggie Lee Huckabee, Ph.D. Cheryl Jaigobin, M.D. Richard J. Moulton, M.D. Richard Pittini, M.D. Patrick Tang, M.D., Ph.D. James P. Waddell, M.D. V. Wee Yong, Ph.D. FACULTY ADVISORY BOARD Chair, Allan Detsky, M.D., Ph.D. Shabbir Alibhai, M.D. Jane Aubin, Ph.D. Michael Baker, M.D. John M. A. Bohnen, M.D. Wendy Levinson, M.D. Irv Lipton, M.D. John F. MacDonald, Ph.D. David Naylor, M.D., D.Phil. Donald Redelmeier, M.D. Duncan Stewart, M.D. Sharon E. Straus, M.D. Donald Stuss, Ph.D. Donald Wasylenki, M.D. TYPESETTING Type and Graphics Inc. E-mail: editors.utmj@utoronto.ca • http://www.utmj.org • Phone: 416-946-3047 • Fax: 416-978-8730 154 University of Toronto Medical Journal UTMJ Subscribers The University of Toronto Medical Journal is funded in part by its subscribers and the Medical Society. Patronage to the Journal is subdivided into five categories. 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Gordon Dr. Gordon Greenberg Dr. Tony Hanley Dr. Jacqueline James Dr. Armand Keating Dr. Ralph Kern Dr. Ed Keystone Dr. Stephen Lapinsky Dr. Peter Lee Dr. Gary Lewis Dr. Ken Locke Dr. Alexander Logan Dr. Heather McDonald-Blumer Dr. Susanna Mak Dr. Sangeeta Mehta Dr. Melita Mezody Dr. Alvin Newman Dr. Gary Newton Dr. Mitra Niroumand Dr. John Parker Dr. Yash Patel Dr. Sue Quaggin Dr. Cheryl Rosen Dr. Douglas Ryan Dr. Zion Sasson Dr. James Shaw Dr. Maureen Shandling Dr. Mark Silverberg Dr. Katherine Siminovitch Dr. Hillary Steinhart Dr. Thomas Stewart Dr. Nicolas Szecket Dr. Jerry Tenenbaum Dr. Hillar Velland Dr. Robert Wald Dr. Randy Wax Dr. Catherine Zahn Dr. Noe Zamel Dr. Bernard Zinman 156 University of Toronto Medical Journal Preface from the Editors Welcome to the third and final edition of the UTMJ for the 2004-05 academic year. We are pleased to bring you another impressive compilation of medical literature from the students of the University of Toronto and beyond. Our lead article is particularly significant to the medical community of Toronto in both its scientific and emotional relevance. The SARS outbreak of 2003 affected all health care professionals in Canada’s largest urban centre, even claiming the lives of some. Landis and Bradley investigate the impact of SARS on the medical trainees of the time, with respect to their education as well as their outlook on medicine. Several timely articles highlight the changing face of medicine from a variety of perspectives. Our Economics and Health Policy article by Laughren addresses the recent initiative by the Ontario government to combat the shortage in primary care physicians by increasing the number of family medicine residency positions. In the Complementary and Alternative Medicine section, Cameron explores the rising popularity of midwives in Ontario and discusses the advantages for both the patient and the health care system. In light of the changing demographics of Canadian medical trainees as well as the patients they will be serving, our Medical Education article by Ahmad and Chan highlights new initiatives to recognize and celebrate diversity. In Technology Review, Gilad and Somogyi feature the emerging technology of percutaneous heart valves and Bonert offers insight into the future of medical software. At the opposite end of the spectrum, Backstein and Hinek provide a fascinating Historical Review of the origins of one of the most technologically advanced medical disciplines. Of course, our regular array of clinical pieces contain valuable lessons for both the student and the seasoned practitioner. In Clinicopathological Correlation, Pun et al. review a very rare case of melanoma. Our Morning Report section features a presentation of acute abdominal pain. Finally, a variety of Quick Diagnosis cases cover a range of pathologies from neurology, dermatology, and cardiology. We would like to acknowledge our editorial board for their dedication in overseeing another year of UTMJ. We must also thank our editors for all of their superb contributions and congratulate them on a very successful year. Most importantly, we offer our deepest thanks to you, our faithful patrons, for your continuing support of the UTMJ and the students whom it serves. With much thanks, Andrew Deonarine and Andrea Rowe, Editors-in-chief volume 82, number 3, May 2005 157