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University of Toronto Medical Journal

Publisher:
—
ISSN:
0833-2207
Category:
MEDICINE, GENERAL & INTERNAL
Impact factor:
0.9

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2 parsed articles

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Latest articles

Regional Analgesia in Sickle Cell Knee Pain: A case report using the interspace between the popliteal artery and capsule of the knee (iPACK) and genicular nerve block techniques

2026-01-05

Gurjap Deol, Shivaani Segar Pillai, Viththeagan Yohathasan, Hassan Ibrahim, Michael Polischuk

While nerve blocks have proven effective in managing pre- and postoperative knee pain, their application in managing sickle cell vaso-occlusive crises is not widely explored. This case presents a novel application of a motor-sparing combination of knee nerve blocks including the iPACK, genicular blocks, and a block to the vastus intermedius to treat debilitating knee pain in a 21-year-old male who was opioid-refractory. This intervention provided improved analgesia leading to a notable improvement in the patient’s functional ability. This case highlights the potential of this specific regional anesthetic technique as an effective and safe alternative to systemic opioid therapy for regional sickle cell-related pain.

There is a Doctor in the House: Physicians in the Canadian Parliament (1867–2025)

2026-01-05

Farah Qaiser, Ariel Gershon, Dan Petrescu

Background Physician advocacy—recognized as a desired competency by both the CanMEDS framework and the Medical Council of Canada—can play a role in prioritizing health in public policy. However, there are clashing perspectives regarding physicians’ political participation, and the level of physician participation in Canadian politics remains unclear. The purpose of this retrospective descriptive review was to carry out historical documentation of the Canadian physicians elected as Members of Parliament (MPs) or appointed as Senators and identify trends in sociodemographic characteristics and political participation. Methods We identified Canadian physician parliamentarians and collected sociodemographic characteristics using publicly available data sources—specifically, the Library of Parliament’s Parliamentarians database, Canadian newspaper archives, biographies available on the parliamentarians’ official websites, and public registers for licensed physicians. Findings were tabulated and summarized using descriptive statistics and graphical presentation. Results We found that to date, 220 of 4,695 (4.69%) MPs, and 64 of 1,006 (6.4%) Senators have been physicians. Most physician decision-makers are men (96.8%), represent a riding in Ontario (38.6%) or Quebec (27.7%), and tend to run for office more than once (90%). We also found that since the first Parliament in 1867, there has consistently been at least one physician in the House of Commons, though there has been a steep decline in political participation since the 17 th Parliament. Discussion Our study is the first to present a complete list of Canadian physicians elected to serve as MPs, or appointed to serve as Senators. We found that there has always been a physician in the House of Commons and the Senate: in fact, physicians are over-represented in Parliament compared to the general population. Despite over-representation, we note a decline in physician political participation, likely due to the increased rigor of standards to qualify as a physician and the challenges faced in political participation. This suggests a need to continue sustaining interest in pursuing political participation and advocacy among the current and next generation of physicians.