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North York General Hospital SIC Lloyd Smith

Lloyd Smith grew up and attended medical school in Saskatchewan. He completed general surgery training in the Gallie Program, including a rotation at Joe’s, a favourite experience. Postsurgical residency he did fellowship training in Hepatobiliary surgery in London, England, and Surgical Nutrition at the University of Pennsylvania. He also spent time as Richard Reznick’s first surgical education fellow. He joined the staff at St. Joseph’s Health Centre in 1990 where he developed an interest in the new field of Minimally Invasive Surgery. He credits Steve Strasberg who, after starting to do laparoscopic cholecystectomies, offered to teach one surgeon from each of the U of T Hospitals as a way of disseminating the technique.

In 2000 Lloyd was recruited by Ori Rotstein to the Toronto Western Hospital to help develop a UHN Minimally Invasive Surgery program along with David Urbach. He and David started a fellowship program in MIS surgery. He also had the opportunity to help push the envelope in laparoscopic procedures with Mike Jewett, Richard Reznick, Paul Greig and others.

In 2002 Lloyd moved back to St. Josephs to become Surgeon-in- Chief. During the next 10 years, he was a big part of the MIS fellowship program which spread across most of the University of Toronto teaching hospitals and became a model for collaboration between hospitals. He also helped to design the University of Toronto Collaborative Bariatric Surgery Program, which was originally headed by John Hagen and Richard Reznick.

In 2012, Lloyd finished as Surgeon-in-Chief at St. Joseph’s. He then completed a Health Administration Program at the Schulich Business School. Avery Nathens and Lloyd were asked to review North York General Hospital in preparation for a search for a Surgeon-in- Chief. Lloyd was impressed with the hospital, applied and was selected for the position. He has been there 2 years as of this interview.

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North York General Hospital

Lloyd likes the culture of the hospital and the focus on being an outstanding community teaching hospital. He and the group there have developed a focus on “acute care surgery” modelled on the Orthopaedic Division’s long established program. The hospital now has acute care programs in Orthopaedics, General Surgery, Plastics, Urology and Gynecology. Each division does it a bit differently depending on their needs. The overlying principle is to give emergency patients better access to the OR and to do it in daytime hours. “It is good for everyone - doctors, patients, and the hospital”. He thinks it improves overall quality of care.

“Residency training in Surgery at North York General is primarily in General Surgery. The Hospital has become a favorite choice for general surgery residents because of the apprenticeship model (one resident with several staff ) instead of a team model (chief, senior and junior in ranked order). The surgeons try very hard to put educational needs ahead of service. We tend to develop a close personal relationship with our residents.

“The Division of General Surgery has become very closely aligned with the University. Stan Feinberg is the associate program director, Peter Stotland is our division rep for education and Nancy Down is the Division Head. They and the entire division have put lots of thought into how we develop our educational program.”

Lloyd would like to see the other Divisions of Surgery get more involved in resident teaching. “We have extremely busy Orthopaedic, Plastics and Urology divisions who do a mix of what most surgeons will see and do if they go into community practice.” He thinks that North York is well positioned to contribute to a Competency –Based Curriculum at the University of Toronto.

COLLABORATIONS

“We have a great relationship with Sunnybrook which we would like to develop further. Currently we partner for vascular services and most recently colorectal surgery. Avery Nathans (Surgeon- in- Chief at Sunnybrook) and I have committed to meet on a regular basis to look at ways of collaborating further. Gone are the days when every hospital can offer all services. We all need to focus on what we are best at.

“We also partner with the Hospital for Sick Children. Pediatric general surgeons from Sick Kids come up to do a clinic two days a week, and operate two days a week, enough that we are able to train residents in paediatric anesthesia. Donna McRitchie, our Vice President for Medical Affairs, has helped orchestrate these partnerships.”

Lloyd’s wife Mary Ann is a nurse who is active as a volunteer at a hospice and the Gardiner Museum. They have three children; Adam (28) is in finance, April (26) is completing a Master’s Degree in Public Health, and Claire (23) is a teacher. Lloyd is active in cycling, tennis, golf, and skiing. He most recently read “Boys in the Boat” by Daniel James Brown, a study of team efforts. He has always enjoyed teaching and seeing the impact of teaching in the eyes of the residents and students. “It’s great to pass the privilege of being a surgeon on”. Lloyd’s favorite quote is: “It’s amazing what you can accomplish if it doesn’t matter who gets the credit”.

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Lloyd Smith and his wife Mary Ann

M.M.




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