Promotions

Academic promotion is one of the most important ways in which the University can recognize the excellence of its faculty in terms of teaching, research, creative professional activity (CPA) and other professional activities, both within and outside the University. 

There are three ways candidates can be put forward for senior promotion (promotion to the rank of Associate or Full Professor):

  • A review of CVs by the department Chair
  • Proposals made by their site Anesthesiologist-in-Chief to the Chair, or
  • Written self-nomination by the candidate, addressed to the Chair.
Faculty who feel they are strong candidates should first meet with their Site Chief to notify them of their intent to apply for promotion. Potential applicants are also encouraged to contact the Departmental Promotions Committee Chair, Dr. Frances Chung, early in the new year to conduct a preliminary review of their application documents prior to submission. 
 
Those considering applying for promotion should review the instructions and tips on the tabs below. 

Please note, the Department of Anesthesiology and Pain Medicine has established internal deadlines which might differ from those of the Temerty Faculty of Medicine. Typically applications are due in the Department (approximately) May 15th each year. If successful, the candidate's promotion will take effect on July 1st of the academic year following the application.

For a comprehensive review of the promotions process, please visit the Temerty Faculty of Medicine - Appointments & Promotions  webpage. 

Please contact the department at promotions.anesthesia@utoronto.ca if you have questions.

Please Note: Jr. Promotion (promotion from Lecturer to the rank of Assistant Professor) is a separate process where candidates are reviewed by the Department Appointments Committee (DAC). Applications for junior promotion are accepted on a quarterly basis. The DAC makes recommendations to the Chair, and in turn, the Chair forwards recommendations to the Dean, Temerty Faculty of Medicine. If approved by the Dean, the promotions are effective shortly after the date of recommendation. The process and timelines for junior promotions can be found here. Questions regarding Jr. Promotions should be addressed to appts.anesthesia@utoronto.ca.

Upcoming Virtual Event: Thinking about applying for Sr. Promotion in May 2022? Zoom details below

The Senior Promotions Committee will be hosting another talk aimed at assisting faculty on their journey toward promotion. Zoom information below. Please mark the following date on your calendar:

Thursday, October 28, 2021 – 5 p.m. to 6 p.m.

“How to be Promoted via Educational Track!”

Dr. Ameen Patel, William Walsh Chair in Medical Education - Endowed Research Chair - Faculty of Health Sciences, Department of Medicine - McMaster University

Objectives:

  1. Review of metrics for promotion to associate professor and professor (for clinical faculty educators) in the FHS at McMaster University
  2. Review of hurdles for successful promotion
  3. My success journey to Education Chair and Professor at Faculty of Medicine, McMaster University

Join Zoom Meeting
https://utoronto.zoom.us/j/85396811094

Meeting ID: 853 9681 1094
Passcode: 036593

 

Dr. Frances Chung, Chair, Sr. Promotions Committee (on behalf of the Sr. Promotions Committee)

Watch Dr. Lisa Allen's talk: "How to Achieve Promotion on Creative Professional Activity - Quality Improvement and Patient Safety May be One Way?"

Thank you to Dr. Lisa Allen - Mount Sinai Hospital - Professor, Obstetrics and Gynecology - Temerty Faculty of Medicine, University of Toronto for her well-received presentation.

Please visit the YouTube link below to watch the recording from Wednesday, October 6, 2021 – 5 p.m. to 6 p.m.

"How to Achieve Promotion on Creative Professional Activity - Quality Improvement and Patient Safety May be One Way?"

Objectives:

  1. To review CPA as an area of excellence in achieving senior promotion
  2. To discuss how departments can recognize quality improvement and patient safety as a pathway to senior promotion
  3. To understand how to structure a CPA dossier leading to successful promotion on excellence in QuIPS

Past Sr. Promotions Workshops and Presentations

Presentations from Workshops

Senior Promotion: Decanal Committee Point of View
by: Dr. George Djaiani
Feb 2020 Slides and presentation

 

Informatics and Innovation Technology - A Pathway to Academic Promotion
by: Dr. Clyde Matava
Feb 2020 Slides and presentation

 

Creative Professional Activities (CPA) - Feb 2019: Lead by Dr. Annette Vegas

General Promotions Guidelines: Associate and Full Professor 

Academic promotion at the University of Toronto is based on accomplishment in scholarship (research and/or creative professional activity), teaching and service to the University. We urge you to carefully consider completion of each of these dossiers, where applicable, but ALL candidates must submit a Teaching Dossier.

  • Research (Scholarship, as demonstrated by a Curriculum Vitae and supporting documents)
  • Creative Professional Activity (as demonstrated by a CPA Dossier and supporting appendices)
  • Teaching – a teaching dossier is mandatory for all applicants. One must be an effective teacher to achieve promotion (demonstrated by a Teaching Dossier, teaching evaluations, unsolicited teaching-related testimonials, etc.)
  • Administration / Service (if applicable, and as demonstrated through the Administrative Dossier and supporting documents)

Activities in the Scholarship category are given the greatest weight during the evaluations process, followed by the candidate's teaching ability and involvement in education, and, lastly, by their administrative contributions and leadership. Activities which fall under the Research category include, but are not limited to presence of funding, publications, patents, presentations at local, national, or international meetings, as well as participation, leadership, and mentorship in the research community. Creative Professional Activity (CPA) can fall under one or more of the following subheadings: professional innovation and creative excellence, development of professional practices, and exemplary professional practice. Teaching and education includes undergraduate, graduate, and postgraduate medical education, continuing education, faculty development, public education, etc. Lastly, Adminstration/service can take the form of outstanding leadership and administration contributions, such as involvement in leading change in program operations,or involvement in government / non-government organizations which impact your specialty, your site, the department and others. 

For promotion to Full Professor on the basis of Scholarship, the successful candidate will be expected to have established a wide reputation in his or her field of interest. The criteria are the same for promotion to Associate Professor, but with a lesser level of accomplishment.

Note that the greatest weight will be given to excellence in scholarly achievement (research and/or CPA), and to excellence in teaching:

“The successful candidate for promotion will be expected to have established a wide reputation in his or her field of interest, to be deeply engaged in scholarly work, and to show him/her-self to be an effective teacher. These are the main criteria. However, either excellent teaching alone or excellent scholarship alone, sustained over many years, could also in itself justify eventual promotion to the rank of Professor. Administrative or other service to the University and related activities will be taken into account in assessing candidates for promotion, but given less weight than the main criteria: promotion will not be based primarily on such service.” Policy and Procedures Governing Promotions, 1980, paragraph 7).

The term “wide reputation” is interpreted as meaning national recognition for promotion to the rank of Associate Professor, and international recognition for promotion to the rank of full Professor (FoM Manual for Academic Promotions, July 2018). Breadth of reputation is most clearly demonstrated through invited lectures, invitations to sit on journal editorial committees, and the strength, caliber and range of external referees. Note that promotion on a single criterion can be achieved in the Faculty of Medicine, however, this generally requires 'sustained excellence' in that aspect. “Sustained” as defined by the University, translates to at least 10 years (FoM Manual for Academic Promotions July 2018). 

A summary and timeline of the Sr. Promotions process will be emailed department-wide early in the new year to help prepare you for each step. The guide outlines the responsibilities and deadlines for candidates requesting promotion to Associate Professor or Full Professor. Please note that these deadlines are firm.

Contact Us

For information regarding the senior promotions process, please contact us at (416) 978-4306 or promotions.anesthesia@utoronto.ca.

Detailed Promotion Criteria for Each Category (Research / CPA / Teaching Effectiveness / Administrative Service)

As defined in the University of Toronto Policy and Procedures Governing Promotions,promotion is based on demonstrated excellence in one or more of researchcreative professional activity [CPA], or teaching and service to the University.

  • To be considered for the rank of associate professor, the candidate is required to have demonstrated a national reputation.
  • To be considered for the rank of full professor, the candidate is required to have demonstrated an international reputation.

All candidates are expected to be effective teachers

Academic achievement in teaching - demonstration of teaching excellence - that is sustained over many years can in itself justify promotion.  In this instance, proof of a national/international reputation is not required and the candidate is strongly encouraged to request a Waiver of External Review.

Excellence in Research
Excellence in CPA
Sustained Excellence in Teaching / Teaching Effectiveness
Administrative Service

 

Research

Successful research leads to the advancement of knowledge through contributions of an original nature. Promotion to associate or full professor based on research requires that the candidate have a record of sustained and current productivity in research and research-related activities.

For the criterion of excellent achievement in research to be met, the research should result in significant changes in the understanding of basic mechanisms of molecular or cellular function and disease, clinical care, health services delivery or health policy, or the social sciences and humanities as applied to health. The researcher’s work should present creative insights, ideas or concepts, and must have yielded a significant quantity of information leading to new understanding. The new information may derive from the invention and/or application of new techniques, novel experimental approaches and/or the identification and formulation of new questions or concepts.

It is expected that research advances will be communicated through the publication of papers, reviews, books and other scholarly works, and had a demonstrated impact on the field. The quality of the scholarship in research will be judged in comparison to peers in the Temerty Faculty of Medicine and to others in the same field at peer institutions.

Please see the Manual for Academic Promotion for a full description of requirements and criteria.

 

 

Creative Professional Activity (CPA)

Hollenberg Report - Definition of Creative Professional Activity

The Temerty Faculty of Medicine recognizes CPA under the following three broad categories:

Contributions to the Development of Professional Practices

Innovation and exemplary practice may be in the form of leadership in the profession, in professional societies, associations, or government and regulatory agencies, that has influenced standards or enhanced the effectiveness of the discipline. Membership or the holding of office in professional associations is not in itself considered evidence of CPA. Sustained leadership and setting of standards for the profession are the principle criteria to be evaluated. 

Examples of contributions to the development of professional practice may include (but are not limited to) guideline development, health policy development, government policy, community development, international health and development, consensus conference statements, regulatory committees, and setting of standards.

Exemplary Professional Practice

Exemplary practice is that which: is fit to be emulated; is illustrative to students and peers; establishes the professional as an exemplar or role model for the profession; or shows the individual to be a professional whose behaviour, style, ethics, standards, and method of practice are such that students and peers should be exposed to them and encouraged to emulate them.

To demonstrate exemplary professional practice, the candidate must show that his or her practice is recognized as exemplary by peers and has been emulated or otherwise had an impact on practice.

CPA under this category can include:

  • Teaching techniques
  • Educational innovations
  • Curriculum development,
  • Models of care innovations (role of EMR prompts, standardized pathways, pre-printed patient ‘order sets’, on quality and safety of inpatient care or resident experience)
  • Leadership in the development of professional practice (tools to enhance physician communication, professionalism)

Professional Innovation and Creative Excellence

Professional innovation may include the making or developing of an invention, use of digital technologies or other devices to improve care and outcomes, development of new techniques, conceptual innovations, or educational programs inside or outside the University (e.g. continuing medical education or patient education).

Creative excellence, in such forms as biomedical art, communications media, and video presentations, may be targeted at various audiences from the lay public to healthcare professionals.

In assessing CPA, the following should be kept in mind:

  • CPA does NOT need to be described under the above three headings. Rather, the University has provided these headings as examples of the types of activities that CPA would encompass.
  • Being a competent healthcare practitioner, while valuable to the public and profession, and for educational role-modelling, is not sufficient to meet the criterion of excellence in CPA
  • The Faculty expects that most candidates for promotion will be engaged to some degree of CPA as part of their scholarly life. Such baseline activity does not constitute grounds for promotion.
  • Contributions must be relevant to the candidate’s U of T appointment and may link to research and/or teaching and education.​

The impact of CPA outside of the local environment may be demonstrated many ways. These include awards and honours, invited presentations,  testimonials/letters of recognition provided by recognized leaders, invitations to consult/advise (e.g., with a quality improvement project or educational curriculum at another institution), appointment to decision making bodies, advisory committees, or task forces related to the focus of one’s CPA.  

Importantly, to have impact through CPA, an individual’s CPA activities should have a thematic connection. For example, if a faculty member has as his/her focus, “addressing low value care" (i.e., something related to Choosing Wisely he/she might list a publication describing a project on this theme, membership on a national committee for his/her specialty related to Choosing Wisely, teaching on this topic, and some invited presentations in other provinces). In total, these activities can provide a substantive picture of impact under CPA because they have a clear thematic connection. 

Resources:

CPA Checklist

CPA Workshops are periodically offered by the Centre for Faculty Development at St. Michael’s Hospital. Check their website for workshop listings.

 

Teaching and Education

While all candidates must demonstrate Teaching Effectiveness, academic achievement in teaching alone, sustained over many years (sustained excellence in teaching) may be grounds for promotion.

Excellence in Teaching

An outstanding teacher is a “master clinician-teacher” who has been recognized for their teaching excellence, leadership and/or innovation in education/teaching through honours and awards at the University/divisional, provincial and/or national levels. Candidates seeking promotion and other forms of recognition on the criteria of excellence in education and teaching must demonstrate significant and high quality contributions to teaching and/or other education related activities in at least one of the following areas:

  • Sustained excellence in teaching: Generally, a number of years are required to establish a noticeable presence and reputation as a teacher and as a valued contributor to other education activities. No minimum number of years at a specific rank is specified – however, ten years is an approximate benchmark.
  • Educational or curriculum development activities such as the planning and development of major curriculum or educational programs, and the production of new educational materials such as textbooks, syllabi, video materials or computer programs, and/or educational innovation.
  • Contribution to the field of health professional education. Evidence is required of a national/international reputation in the field of health professional education due to sustained participation in research in education, contributions to the medical/health professions educational literature or active leadership in professional associations dedicated to educational development.
  • Education leadership in faculty, department, division or hospital. This includes significant roles in educational administration where, under the candidate’s direct leadership, innovative programmes or curriculum have been developed.

A Waiver of External Review should be sought when the predominant criteria for promotion is sustained excellence in teaching unless the candidate has a clear national or international reputation in education.

Teaching Effectiveness

All candidates must demonstrate teaching effectiveness through the following:

  • Quantity of teaching/educational activity: documented hours, levels, formal and informal as per the candidate's academic position description.
  • Quality of teaching/educational contributions: demonstrated by teaching evaluations, student testimonials, and students’ achievements
  • Relative activity and evaluations in comparison to peers (of similar position description and stage of career)
  • Educational scholarship – e.g., curriculum development
  • Educational leadership

 

Administrative Service

All faculty members are expected to provide service in the form of committees and other roles and responsibilities to the University and/or their field. However, service in itself cannot be the main criteria for promotion.

Candidates should document administrative or committee work in their CVs, both within the University and to external agencies that further the scholarly and educational goals of the University. Where appropriate, quality and impact of such activities should be noted.

This may include:

  • Establishment of new programs within the Faculty or University
  • Successful fundraising activities that benefit the department, Faculty or University
  • Development of new or revised departmental, Faculty or University policies and procedures
  • Invitations to serve a leadership function in the Faculty or University
  • Representation and active involvement on boards and other organizational committees
  • Significant contributions while serving in a leadership role in discipline or professional organizations
  • Significant contributions to the development of policies or procedures within a discipline, profession or relevant organization

Documentation Checklist, Instructions & Templates

Promotion Dossier Requirements (Associate and Full Professor Rank)

Deadline for 2022: May 16, 2022 (to be confirmed)

Documents should be submitted to promotions.anesthesia@utoronto.ca.

1. Senior Promotion: Promotion Candidate Information Form

Complete the Promotion Candidate Information Form and submit it along with your dossier.

2. Cover Letter & Curriculum Vitae

Note: These two documents are the minimum required to be considered for promotion at the initial Departmental Promotions Committee (DPC) meeting.

Cover Letter

Cover letters should be addressed to the Deptartment Chair, Dr. Beverley Orser.

Please address the following points in your letter:

  • the rank you are applying for
  • your current academic job description and the percentage time allocated for clinical, research, teaching, and service activities
  • your basis for seeking promotion (e.g.,excellence in research and competence in teaching)
  • a brief summary of your major contributions under each of the following categories:
    • scholarship / research, if applicable
    • creative professional activity, if applicable
    • teaching (all candidates)
    • administration, if applicable

Curriculum Vitae

Must be in Unversity of Toronto format in accordance with University Policy (Manual of Staff Policies Academic Librarian, Number 3.01.05, paragraph 16) found here

A template can be downloaded here

3. Research Documentation, if applicable

Research Statement

4. Most Significant Publications

  • List the FIVE most significant publications since last promotion and include a short paragraph for each describing the significance and your contribution.
  • Copies of each publication, in .pdf format, sent as separate documents.

5. Teaching Dossier and Evidence of Teaching Effectiveness

Note: Every applicant needs to provide a Teaching Dossier and teaching evaluations regardless of the primary focus of your promotion dossier.

  • Teaching and Education Report
  • Data Summary Sheets – Teaching
  • Add, in separate Appendices:
    • Student evaluations of teaching
    • Unsolicited testimonial letters (Please do not request reference letters.)
    • Peer evaluations (Please do not request reference letters.)
    • Formal assessments, both internal and external (e.g., any departmental, divisional, or clinical assessments or evaluations.) 

6. Creative Professional Activity Documentation

7. Administrative Dossier, if applicable

  • Write a brief outline of your service activities.
  • Include a statement of the nature and impact of your service achievements on the department, the Temerty Faculty of Medicine, the University, your discipline, the professional community, or other targeted communities.
  • Attach supporting documentation that demonstrates the nature and impact of your service achievements. 

8. Referee / Student Testimonial Information

  • Names, Rank, and CURRENT Emails of 5 External Referees *see Things to Consider When Selecting Referees
  • Names and Current Emails of 5 - 10 Student Referees *see Things to Consider when Selecting Referees

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Notes

Please send your completed documents to promotions.anesthesia@utoronto.ca. We regret that hard copies or faxes cannot be accepted.     

Do not combine the documents noted above into one file. Separate PDF files for each category, clearly labeled, must be provided. 

              Required file naming:
                        Lastname_Firstname_DocumentName(Type)_Month Year.pdf 
                        Smith_John_CV_June2020.pdf
                        Smith_John_CVSummaryTable_Publications_June2020.pdf
                        Smith_John_Teaching Dossier_June2020.pdf

Files are reviewed in an electronic format. Please be certain that all pages in a document are in the same orientation. Documents are to be submitted electronically, preferably in PDF format, by the mid-May deadline. The Department will upload the required documentation to the LaserFiche file management system on your behalf.

Tips for Compiling Your Dossier

  • Sample promotions dossiers of previous successful candidates are available on request.
  • Keep all of your teaching evaluations to demonstrate effectiveness / competence in teaching.
  • If you develop a website, monitor number of links to your site to demonstrate impact.
  • Keep an accolades file (e.g.  letters, testimonials, invitations to lecture) to demonstrate recognition for work done. Letters of thanks from patients should not be included.
  • Routinely assess which activities will strengthen your promotion dossier.
  • Avoid clustering when considering potential referees and provide names of individuals from different institutions / countries.
  • Tell your story – remember that individuals assessing your application may not be experts in your field. Emphasize why your contributions are significant.
  • Before submitting your referee names to the Department, do a quick “search and find” in your CV to ensure that the individual’s name does not show up anywhere in the previous 5 years of your work or publications. If it does, it will automatically be negated as a potential referee by the Decanal Committee. This could hold up your promotion.
  • Don’t assume that you know what someone’s Professorial Rank is – a referee name at an inappropriate rank cannot be used towards the reference letters that need to be submitted.
  • If there are gaps in your history, address them. (e.g., fewer publications / reduced funding due to parental leave taken).
  • Be specific about what your individual contributions are in collaborative efforts. It is not enough to say you led an investigation; stipulate how you led the investigation and why you were an instrumental part of the group. Indicate the signifcance of your work on patient care, safety, quality improvement etc.
  • When considering your significant publications, consider where your name is – are you Senior Responsible Author? First Author? Somewhere in the middle?
  • Not all publications have high impact factors. Some journals pertain to a small group of readers but may well be the preeminent journal in a particular field. If that is the case for your publications, address this issue.

Things to Consider When Selecting Referees

External Referees

Choosing referees is perhaps one of the most critical aspects (and least controllable) of the promotions process. External referees establish the candidate’s reputation nationally or internationally, help to frame the value-add of his/her work, and place the candidate in context of their peers and the expectations for promotion at other universities.

Applicants are asked to provide the Department with the names of 3 external referees along with their current email address, the institution with which they are associated (including country) and their professorial rank. Failure to provide this information can significantly hinder one’s promotion application.

Please keep in mind, the University of Toronto's conflict of interest protocols are very strict and adhered to rigidly. In order to write on a candidate’s behalf, external referees:

  • should be at arm's length - no collaboration (e.g. publications or research grants) in the past five years
  • must never have been a supervisor or student of the candidate
  • should not have a personal relationship with the candidate
  • should be senior experts in the academic field or specialty
  • must be at or above the aspired rank

If you need to ask if the relationship is too close, it likely is.

Need help finding eligible referees?

  • conduct PubMed search
  • ask international colleagues for names

Note: The Department Chair and the Promotions Committee will also be compiling names of potential referees for each candidate.

Student Testimonials

Applicants are also asked to provide the names and current email address of at least 5-10 trainees who can be contacted for testimonial letters. These students should be:

  • current or former trainees, taught/trained/supervised and/or mentored by the candidate since the candidate's last promotion.
  • representative of multiple levels of training, e.g. undergraduate to postgraduate to graduate depending on the scope of the candidate’s teaching activities.
  • able to attest to the candidate’s attributes as an effective teacher, educational scholar and mentor.

Please Do Not Solicit Referee Letters / Student Testimonials on Your Own Behalf ~ The Department of Anesthesiology and Pain Medicine is responsible for soliciting all letters of reference from external referees, trainees/students, cross-appointed chairs etc. Please make no effort to contact your chosen referees. Any letters that are solicited by the candidate can be added to the candidate’s file as 'colleague letters' but WILL NOT count towards the required letters of reference that need to be obtained.

What to Expect Once You Have Submitted Your Application

  • The Departmental Promotions Committee reviews each candidate's dossier thoroughly and advises about any areas in their documents which do not conform with the Promotions Manual guidelines.
  • The Committee might recommend changes to enhance a candidate's chances at the next stage of the process.
  • Mentors are assigned to assist the candidates in building their dossiers and presenting them in the best possible way.
  • Candidates are also free to contact any of the Committee members for advice pertaining to their documentation and the promotions process.
  • Based on a timeline provided at the outset of the process, candidates will amend their submissions drawing upon the suggestions of their mentor and/or other committee members and submit the updated documentation for final review.
  • The committee then makes their recommendations to the Department Chair whether to move forward with the submission to the Decanal Committee.
  • Candidates not recommended for promotion by the DPC are provided reasons, along with feedback on how to improve their chances of promotion in the future. This is an important part of the Committee's role in Faculty Development.

Promotion Timeline 2021 - 2022

2021

JANUARY - APRIL 

Potential promotions candidates meet with their site chiefs to discuss their intention to apply for promotion

Potential promotions candidates contact Frances Chung 

APRIL After consultation with Dr. Chung, candidates declare their intent to apply by submitting CV / Cover Letter / Candidate Information Form to promotions.anesthesia@utoronto.ca
MAY Upon invitation from Promotion Committee Chair, candidates submit their promotion dossier
JUNE

Department Promotions Committee reviews preliminary promotions dossiers

Candidates are notified of committee decision (to move forward or to defer)

For those moving forward, a mentor will be assigned to assist in the augmentation of the candidate's portfolio

For those being deferred, feedback is provided

AUGUST Final revisions of dossiers to be submitted
SEPTEMBER - NOVEMBER Department solicits external referee letters
DECEMBER Promotions Committee conducts a final review of promtions dossiers

2022

 
FEBRUARY February - Department submits confidential promotion dossiers and accompanying documentation to the Temerty Faculty of Medicine Decanal Promotion Committee
APRIL Temerty Faculty of Medicine Decanal Promotion Committee review
MAY - JUNE

Candidates are notified of final recommendation

Promotions announced

JULY 1st Effective date of promotions

Department of Anesthesiology and Pain Medicine Promotions Committee Members (as of July 2021)

  • Beverley Orser, Professor & Chair
  • Frances Chung (Chair of Commitee), Professor, Toronto Western Hospital
  • Annette Vegas, Professor, Toronto General Hospital
  • Vincent Chan, Professor, Toronto Western Hospital
  • George Djaiani, Professor, Toronto General Hospital
  • Jeffrey Wassermann, Associate Professor, St. Michael’s Hospital
  • Tobias Everett, Associate Professor, Hospital for Sick Children
  • Fiona Campbell, Professor, Hospital for Sick Children
  • Stephen Choi, Associate Professor, Sunnybrook Health Science Centre
  • Duminda Wijeysundera, Professor, St. Michael's Hospital
  • Ki Jinn Chin, Professor, Toronto Western Hospital
  • Simon Abrahamson, Professor, St. Michael's Hospital
  • Mrinalini Balki, Professor, Mount Sinai Hospital
  • Matteo Parotto, Associate Professor, Toronto General Hospital