Clinics & Inpatient Care Units

Rheumatology

Faculty

Dr. Louise Perlin - Associate Professor of Medicine
Dr. Perlin is a clinician-teacher recognized for her outstanding teaching skills at the bedside both in the clinic and on the consultation service. She has six-half days of clinics per week, which are attended by house staff. She has won numerous teaching awards at the undergraduate and postgraduate levels and is responsible for the overall education program in the division of rheumatology. She is also program director for rheumatology and a member of the departmental executive committee. Dr. Perlin's practice encompasses the broad spectrum of rheumatic disease with a strong emphasis on inflammatory disorders.

Dr. Robert Rottapel - Professor of Medicine
Dr. Rottapel is a clinician-scientist (CIHR scholar) whose clinical base is at St. Michael's Hospital. He spends each Tuesday at the Hospital, running a clinic in the Martin Family Clinic and teaching residents in rheumatology. He attends weekly rheumatology noon seminars and gives morning reports to core residents on rotation. His teaching focus is on utilizing basic science principles to elucidate the pathophysiology and rationale for treatment of rheumatic disorders. He has a special interest in the rheumatic manifestations of Hepatitis C.

Dr. Laurence Rubin - Division Head, Professor of Medicine
Dr. Rubin is a clinician-scientist who combines research in genetics of metabolic bone disease/osteoporosis and rheumatic inflammatory disorders with a broad-based clinical practice in rheumatology (Martin Family Clinic) and metabolic bone disease/osteoporosis (61 Queen Street, seventh floor). Fellows attend the metabolic bone disease/osteoporosis program weekly (Monday morning) and rheumatology clinics are scheduled on Monday afternoons and Tuesdays with fellows and core residents in medicine. He is also a participant in the inpatient consult service. A unique experience is "Outpatient Needle Arthroscopy". The procedures are scheduled monthly, and provide trainees with the novel opportunity to visualize the internal "architecture" of the knee joint in patients with either degenerative or inflammatory disorders.

Dr. Rachel Shupak - Associate Professor of Medicine
Dr. Shupak is a clinician-educator. She has half-day clinics each week attended by undergraduate students, core residents and fellows. Her interests span a range of issues, but her particular interests include myopathies and a unique hemophilia/arthritis program which she developed at the hospital. As part of this latter program, Dr. Shupak is the only rheumatologist in Toronto offering radiation synovectomies of a variety of affected joints. Dr. Shupak has been the referral source for adolescents with inflammatory muscle disease in transition from the HSC. She is also a consultant on the inpatient service. She has won three outstanding teaching awards at the hospital.

Shahin Jamal - Clinical Associate July 2006 (full-time staff as of January 2007)
Dr. Jamal is a new staff member in the division of rheumatology. She will complete her master’s program in clinical epidemiology in December 2006 and will join full-time thereafter. Her interest is in early RA, access to care as well as clinical trials, and she is an opinion leader in the development of web software for clinical data collection and analysis. She currently holds one day of clinic per week and will increase to two days by the beginning of 2007.

Dr. Millicent Stone - Assistant Professor of Medicine
Dr. Stone is a clinician investigator who joined the division of rheumatology in July 2003. Her main clinical and research interests are in the investigation and treatment of spondyloarthropathy, specifically ankylosing spondylitis. Dr. Stone has gained an international reputation for her work assessing the utility and outcomes of biologic therapy in AS. She has recently relocated to Bath, England but will continue these efforts at St. Michael's Hospital through regular visits, and in particular will be establishing clinical trials of these agents, analyzing measures of outcome and predictors of response.

There are three part-time rheumatologists:

Dr. Syd Gershon
Dr. Julie Kovacs
Dr. Doreen Campbell

Both Dr. Gershon and Dr. Kovacs teach predominantly undergraduate students although it is possible that Dr. Kovacs will teach core residents as well.

Educational Activities

The formal educational fellowship activities include the bi-weekly intercity, the journal club and the rheumatology division's formal and informal rounds. The residents present regularly at our Tuesday noon seminar (lunch provided), with a focus on using clinical cases as a starting point for a discussion on pathophysiology and epidemiology of the disease. There is also an interactive session in the metabolic bone clinic (Mondays at noon) with all the MBC staff (lunch provided).

As part of our multi-disciplinary approach to arthritis, you may interact with a number of other specialty staff.

Orthopedics

Dr. E. Schemitsch, Division Head
Clinical interest: knee surgery
Research interest: biomechanics of fractures

Dr. Michael McKee
Clinical/research interest: upper extremities

Dr. Tim Daniels
Clinical interest: foot and ankle disorders

Dr. Jim Waddell
Clinical interest: hip disorders

Dr. Earl Bogoch
Clinic interest: joint diseases

Dr. Jeremy Hall
Clinical interest: upper extremities

Dr. Henry Ahn
Clinical interest: spine

Dr. Daniel Whalen
Clinical interest: upper extremities

Plastic Surgery

Dr. Jim Mahoney
Plastics, trauma, hand and wound care clinics

Dr. Melinda Musgrave
Plastics, trauma

Dr. Mohammad Elahi
Plastics, trauma

Radiology

Dr. Dawn Pearce
MSK radiologist: half-day sessions

Dr. Jim Dowdell
MSK radiologist: half day sessions

Number and types of patients seen

  • Dr. Louise Perlin, 60 per week, general rheumatology/80 per cent inflammatory
  • Dr. Rob Rottapel, 10 per week, general rheumatology/80 per cent inflammatory, Hepatitis C
  • Dr. Laurence Rubin, 30 per week, general rheumatology/50 per cent inflammatory, 25 per cent osteoporosis
  • Dr. Rachel Shupak, 60 per week, general rheumatology/80 per cent inflammatory, PM/DM, hemophilia, transition junior rheumatoid arthritis DM
  • Dr. Shahin Jamal, 10 per week, general rheumatology/early RA
  • Dr. Joanne Lewtas, SpA Clinic
  • Dr. Millicent Stone, quarterly visits, SpA Clinic

Number and types of consults

On average, there are five to ten consults per week, although this number fluctuates. These can be divided into:

  • Acute monoarthritis (gout, pseudogout, septic arthritis)
  • Inflammatory disorders (vasculitis, SLE, reactive arthritis)
  • Regional pain syndrome

Ambulatory multidisciplinary clinics

  • Hemophilic arthopathy clinics and radiation synovectomy (Shupak)
  • Remicade clinic weekly
  • Needle arthroscopy (monthly - two to three cases/Rubin)
  • Eearly RA (weekly)