65th Annual Clinical Meeting

 

June 18

Breakfast Symposium 1: The Role of Contraceptive Progestins: Clinical Impact and its Contribution to Overall Hormonal Impact

WTCC - Room 200DE
07:00 - 08:30

Learning Objectives

At the end of the session, participants will be able to:

  • Understand the role of progestins and how progestins may differ;
  • Address patient concerns with respect to overall hormonal impact and how this may effect compliance.

Faculty

  • Margaret Burnett, MD (Moderator), Winnipeg, MB
  • J. Kell Williams, MD, Tampa, FL

Unrestricted Educational Grants

  • Janssen-Ortho Inc.

PG 1: Society of Canadian Colposcopists

WTCC - Suite 204
08:30 - 15:30

Learning Objectives

At the end of the session, participants will be able to:

  • Make practical applications of recent knowledge of HPV disease to colposcopy management for patients;
  • Recognize and manage typical colposcopy patterns;
  • Evaluate and treat some unusual colposcopic problems such as graft versus host disease.

Faculty

  • Lizabeth Brydon, MD (Course Director), Regina, SK
  • James Bentley, MD, Halifax, NS
  • R. Patricia Power, MD, St. John's, NL
  • Alexandra Schepansky, MD, Edmonton, AB
  • Jeffrey Dempster, MD, Halifax, NS
  • Helene Gagne, MD, Ottawa, ON
  • George Sawaya, MD, San Francisco, CA
  • Sam Ratnam, MSc, PhD, St. John's, NL
  • Monique Bertrand, MD, London, ON

Unrestricted Educational Grants

  • Society of Canadian Colposcopists (SCC)
  • Society of Obstetricians and Gynaecologists of Canada (SOGC)

PG 2: Urogynaecology - A Pilot Project in Education

WTCC - Suite 201
08:30 - 15:30

Limited to 40 participants

This interactive course will pilot a new approach to education. Keep an eye on the latest developments — Visit us often!

Faculty

  • Scott Farrell, MD (Course Director), Halifax, NS
  • Marianne Pierce, MD, Halifax, NS
  • Baharak Amir, MD, Halifax, NS

Unrestricted Educational Grants

  • Society of Obstetricians and Gynaecologists of Canada (SOGC)

PG 3: Inauguration of New CSMFM President • Update on Fetal Therapy CHD in Pregnancy

Delta Halifax - Baronet 1 & 2
08:30 - 15:30

Learning Objectives

At the end of the session, participants will be able to:

  • Better understand research in Maternal Fetal Medicine and the need for collaboration;
  • Better understand the framework of practice in Maternal Fetal Medicine;
  • Better understand the national databases pertinent to Maternal Fetal Medicine;
  • Review women/manpower issues: Why choose MFM as a career?
  • Review the fetal therapy update: tracheal occlusion for diaphragmatic hernia;
  • Better understand prevention and in-utero therapy of open neural tube defect;
  • Better understand the impact of obesity.

Faculty

  • Dan Farine, MD (Course Director), Toronto, ON
  • Francois Audibert, MD (Course Director), Montreal, QC
  • Robert Liston, MD, Vancouver, BC
  • R. Wilson, MD, Calgary, AB
  • Greg Ryan, MB, Toronto, ON
  • Hayley Bos, MD, London, ON
  • Mark Walker, MD, Ottawa, ON
  • Gregory Davies, MD, Kingston, ON
  • Lynn Murphy-Kaulbeck, MD, Moncton, NB

Unrestricted Educational Grants

  • Society of Obstetricians and Gynaecologists of Canada (SOGC)

PG 4: Fetal Health Surveillance - Antepartum Intrapartum

WTCC - Suite 303
08:30 - 12:00

Learning Objectives

At the end of the session, participants will be able to:

  • Have reviewed the 2007 SOGC Fetal Health Surveillance Consensus Guidelines;
  • Know the important changes from the prior SOGC Guidelines;
  • Have used the new Fetal Health Surveillance terminology in clinical care scenarios.

Faculty

  • David Young, MD (Course Director), Halifax, NS
  • N. Lynne McLeod, MD, Halifax, NS
  • Ann Sprague, RN,PhD, Ottawa, ON

Unrestricted Educational Grants

  • Society of Obstetricians and Gynaecologists of Canada (SOGC)

PG 5: REI - Endocrinology Problems in Gynaecology

WTCC - Suite 203
08:30 - 12:00

Learning Objectives

At the end of the session, participants will be able to:

  • Manage hirsutism, amenorrhea, define the condition and evaluate potential health risks;
  • Update of current management of Ovarian Hyperstimulation Syndrome clarify the pathology, prevention, risks and management;
  • Review role of exercise, obesity and diet in infertility;
  • Review key issues in infertility diagnosis and management eg; ovarian reserve tests, methods to assess uterine cavity, tubal patency and choose evidence based therapy.

Faculty

  • Gillian Graves, MD (Course Director), Halifax, NS
  • Heather Cockwell, MD, Oakville, ON
  • Renda Bouzayen, MD, Halifax, NS
  • Thomas Ransom, MD, Halifax, NS

Unrestricted Educational Grants

  • Society of Obstetricians and Gynaecologists of Canada (SOGC)

PG 11: SMIG - Laparoscopic Hysterectomy: Principles & Practice (Didactic Session)

WTCC - Suite 205
08:30 - 12:00

Learning Objectives

At the end of the session, participants will be able to:

  • Review the current evidence and practice patterns for laparoscopic hysterectomy;
  • Review the clinically relevant anatomy for laparoscopic hysterectomy;
  • Provide practical tips for using electrosurgery and alternative energy sources in operative laparoscopy;
  • Review an approach to the various types of laparoscopic hysterectomy;
  • Provide strategies for reducing complications at laparoscopy.

Faculty

  • Sukhbir Singh, MD,FRCSC (Course Director), Ottawa, ON
  • Philippe-Yves Laberge, MD, FRCSC, ACGE, Ste-Foy, QC
  • Krisztina Bajzak, MD, St. John's, NL
  • Nicholas Leyland, MD, North York, ON

Unrestricted Educational Grants

  • Johnson & Johnson Medical Products - Ethicon Endo-Surgery Division
  • Karl Storz Endoscopy Canada Ltd.
  • Society of Obstetricians and Gynaecologists of Canada (SOGC)

PG 13: CSPM - Surgical Pelvic Floor Anatomy: Prosections (Didactic Session)

WTCC - Suite 202
08:30 - 12:00

Learning Objectives

At the end of the session, participants will be able to:

  • Review surgically relevant pelvic floor anatomy for both the gynaecologic surgeon and the urogynaecologist;
  • Become familiar with a variety of pelvic floor procedures available, including some novel "mesh" procedures;
  • Recognize the potential pitfalls of pelvic floor procedures for pelvic organ prolapse and urinary incontinence;
  • Utilize prosected cadaver specimens and hands-on cadaver dissections to demonstrate and enhance the above learning objectives.

Faculty

  • Queena Chou, MD (Course Director), London, ON
  • Alfred Bent, MD, Brookfield, NS
  • Geoffrey Cundiff, MD, Vancouver, BC

Unrestricted Educational Grants

  • Bard Canada Inc.
  • Society of Obstetricians and Gynaecologists of Canada (SOGC)

PG 15: CANPAGO - Unique Challenges in Providing Care to Adolescents in Obstetrics and Gynaecology

WTCC - Suite 306
08:30 - 12:00

Learning Objectives

At the end of the session, participants will be able to:

  • Understand some of the unique challenges faced by health care professionals in providing high quality ethical care to mature minors, with particular attention to issues of consent and confidentiality;
  • Review various forms of illicit drugs and how they may impact young women's gynaecologic and reproductive care;
  • Discuss contraceptive options for adolescent women and strategies to minimize contraception failures;
  • Explore issues around adolescent pregnancy including pregnancy rates, pregnancy risks and recommendations for surveillance.

Faculty

  • Nancy Van Eyk, MD (Course Director), Halifax, NS
  • Françoise Baylis, PhD, Halifax, NS
  • Sari Kives, MD, North York, ON
  • Joan Wenning, MD, Halifax, NS

Unrestricted Educational Grants

  • Society of Obstetricians and Gynaecologists of Canada (SOGC)

PG 17: SIGMA - Menopause - Osteoporosis in the Aging Woman

Delta - Baronet 4 & 5
08:30 - 12:00

Learning Objectives

At the end of the session, participants will be able to:

  • Manage an early postmenopausal patient who is symptomatic; has concerns about breast cancer; and has a low bone mass;
  • Manage a Premenopausal patient with a low BMD who has fertility concerns;
  • Manage a perimenopausal patient with low BMD and abnormal uterine bleeding;
  • Manage an older postmenopausal patient on long term hormonal therapy with a prior fracture;
  • Manage a patient with Premature Ovarian Failure who has a very low BMD referred to you from the Fertility Clinic.

Faculty

  • Elaine Jolly, OC,MD,FRCSC (Course Director), Ottawa, ON
  • Aliya Khan, MD, Oakville, ON
  • Chui Yuen, MD, Vancouver, BC
  • David Kendler, MD, Vancouver, BC
  • Christine Derzko, MD, Toronto, ON

Unrestricted Educational Grants

  • Society of Obstetricians and Gynaecologists of Canada (SOGC)

Luncheon Symposium 1: A New OC Dosing Regimen 24-4: What does it Mean?

Room 200DE
12:00 - 13:00

Learning Objectives

At the end of the session, participants will be able to:

  • Understand the drawbacks of 21/7 regimens: incomplete pituitary-ovarian suppression, follicular development and hormone withdrawal symptoms;
  • Understand modifications in current 21/7 regimens to provide greater pituitary-ovarian suppression with potential for improved contraceptive efficacy and side effect profile;
  • Understand how 24/4 dosing may impact your practice.

Faculty

  • Donald Davis, MD (Moderator), Medicine Hat, AB
  • Lee Shulman, MD, Northbrook, IL

Unrestricted Educational Grants

  • Bayer HealthCare Pharmaceuticals

PG 6: Preterm Labour A to Z

WTCC - Suite 303
13:00 - 15:30

Learning Objectives

At the end of the session, participants will be able to:

  • Describe the importance of preterm labour, the cost to the health care system and the outcome of premature babies;
  • Learn the mechanisms involved in preterm labour and the implications for clinical practice;
  • Learn the predictors and diagnostic criteria for premature labour;
  • List the strategies for prevention and treatment of premature labour.

Faculty

  • Robert Gagnon, MD (Course Director), Montreal, QC
  • John Challis, PhD,DSc,FRCOG,FRSC, Vancouver, BC
  • Anthony Armson, MD, Halifax, NS
  • Alan Bocking, MD, Toronto, ON

Unrestricted Educational Grants

  • Society of Obstetricians and Gynaecologists of Canada (SOGC)

PG 7: PIH - Preeclampsia

WTCC - Suite 205
13:00 - 15:30

Learning Objectives

At the end of the session, participants will be able to:

  • Review the new classification for hypertensive disorders in pregnancy;
  • Understand the potential use of predictive tools in the context of preeclampsia;
  • Be aware of the more recent therapeutic developments.

Faculty

  • Andree Gruslin, MD (Course Director), Ottawa, ON
  • Amira El-Messidi, MD, Mount-Royal, QC
  • Douglas Woelkers, MD, La Jolla, CA

Unrestricted Educational Grants

  • Society of Obstetricians and Gynaecologists of Canada (SOGC)

PG 8: Prenatal Screening

WTCC - Suite 305
13:00 - 15:30

Learning Objectives

At the end of the session, participants will be able to:

  • Review the current Canadian guidelines on prenatal screening;
  • Be aware of legal obligations for prenatal screening;
  • Discuss the 18-20 week genetic sonogram - an underutilized prenatal screen;
  • Review new prenatal screening technology.

Faculty

  • Michiel Van den Hof, MD (Course Director), Halifax, NS
  • Douglas Bell, MD, Ottawa, ON
  • R. Wilson, MD, Calgary, AB
  • Jo - Ann Brock, MD, Halifax, NS

Unrestricted Educational Grants

  • Duchesnay Inc.
  • Society of Obstetricians and Gynaecologists of Canada (SOGC)

PG 9: Emergencies in Obstetrics

WTCC - Suite 302
13:00 - 15:30

Learning Objectives

At the end of the session, participants will be able to:

  • Consider the approach of a pregnant woman with respiratory complications;
  • Review the management of a pregnant woman with septic shock;
  • Discuss the anesthetic considerations of a patient with severe preeclampsia, morbid obesity or at risk of bleeding;
  • Review the steps of the cardiopulmonary resuscitation during pregnancy;
  • Understand the acute management of a patient with amniotic fluid embolism.

Faculty

  • Line Leduc, MD (Course Director), Outremont, QC
  • Chantal Crochetiere, MD, Montreal, QC
  • Francine Morin, MD, Montreal, QC

Unrestricted Educational Grants

  • Society of Obstetricians and Gynaecologists of Canada (SOGC)

PG 10: Reproductive Mental Health in Obstetrics and Gynaecology

WTCC - Suite 306
13:00 - 15:30

Learning Objectives

At the end of the session, participants will be able to:

  • Have advanced awareness of the role of a reproductive mental health service in providing care to women and their children;
  • Receive updated information about psychiatric medications in pregnancy;
  • Gain an understanding of the importance of mother-infant attachment as it relates to a mental health population.

Faculty

  • N. Lynne McLeod, MD (Course Director), Halifax, NS
  • Coleen Flynn, Halifax, NS
  • Mary-Ann Hudec, MD, Halifax, NS

Unrestricted Educational Grants

  • Society of Obstetricians and Gynaecologists of Canada (SOGC)

PG 12: SMIG "Hands On" Lab and Demonstrations (Laboratory Session) - Hysteroscopy and Laparoscopy

Skills Centre for Health Sciences, Salle B04, Basement Bethune Bldg, 1276, rue South Park, Halifax
13:00 - 15:30

Learning Objectives

At the end of the session, participants will be able to:

  • Demonstrate OR set up essentials including equipment troubleshooting;
  • Provide a "hands-on" experience with various alternative energy sources;
  • Provide a "hands-on" experience with office hysteroscopy equipment;
  • Demonstrate and practice using various options for tissue extraction in benign gynaecology.

Faculty

  • Sukhbir Singh, MD,FRCSC (Course Director), Ottawa, ON
  • Claude Fortin, MD, Lachine, QC
  • Barry Sanders, MD, Vancouver, BC
  • Donna Gilmour, MD, Halifax, NS
  • Krisztina Bajzak, MD, St. John's, NL
  • David Rittenberg, MD, Halifax, NS
  • Philippe-Yves Laberge, MD, FRCSC, ACGE, Ste-Foy, QC

Unrestricted Educational Grants

  • Johnson & Johnson Medical Products - Ethicon Endo-Surgey Division
  • Karl Storz Endoscopy Canada Ltd.
  • Society of Obstetricians and Gynaecologists of Canada (SOGC)

PG 14: CSPM - Off-Site Specimens

Dalhousie University Sir Charles Tupper Medical Building 5850, rue College 14th étage, salle 14G Halifax
13:00 - 15:30

Learning Objectives

At the end of the session, participants will be able to:

  • Review surgically relevant pelvic floor anatomy for both the gynaecologic surgeon and the urogynaecologist;
  • Become familiar with a variety of pelvic floor procedures available, including some novel "mesh" procedures;
  • Recognize the potential pitfalls of pelvic floor procedures for pelvic organ prolapse and urinary incontinence;
  • Utilize prosected cadaver specimens and hands-on cadaver dissections to demonstrate and enhance the above learning objectives.

Faculty

  • Queena Chou, MD (Course Director), London, ON
  • Alfred Bent, MD, Brookfield, NS
  • Geoffrey Cundiff, MD, Vancouver, BC

Unrestricted Educational Grants

  • Bard Canada Inc.
  • Society of Obstetricians and Gynaecologists of Canada (SOGC)

PG 16: CANPAGO - Menstrual Problems in the Adolescent Patient

WTCC - Suite 202
13:00 - 15:30

Learning Objectives

At the end of the session, participants will be able to:

  • Review the etiology of menorrhagia in adolescent patients and discuss possible management options;
  • Discuss menstrual suppression for challenging young women, including those on chemotherapy or with developmental delay;
  • Explore when mullerian anomalies should be suspected, and how to diagnose and manage them.

Faculty

  • Nancy Van Eyk, MD (Course Director), Halifax, NS
  • Melanie Ornstein, MD, Toronto, ON
  • Sari Kives, MD, North York, ON

Unrestricted Educational Grants

  • Society of Obstetricians and Gynaecologists of Canada (SOGC)

Sub-Specialty Sessions (SS)

SS 1: Midwifery - Midwives and the Rest of the Community

Delta Halifax - Baronet 4 & 5
13:00 - 15:30

Learning Objectives

At the end of the session, participants will be able to:

  • Understand the challenges faced by midwives in the various health care systems across Canada;
  • Understand midwives' relationship with the health care team throughout Canada;
  • Identify barriers for midwifery regionally, provincially, territorially and nationally;
  • Develop strategies for where we go now as midwives working in our communities and Canada.

Faculty

  • Michelle Kryzanauskas, RM (Course Director), Kimberley, ON
  • Kathi Wilson, RM, Ilderton, ON

Unrestricted Educational Grants

  • Society of Obstetricians and Gynaecologists of Canada (SOGC)

SS 2: Nursing - Labor Support: What is it and How do We Know When it is Provided?

WTCC - Suite 304
13:00 - 15:30

Learning Objectives

At the end of the session, participants will be able to:

  • Identify and review five elements of labor support;
  • Describe techniques of labor support that work depending on a woman's phase of labor. During this portion of the presentation, we will enable a "hands on" opportunity to practice several of these supportive techniques;
  • Discuss the evidence associated with supportive care in labor;
  • Develop methods of documentation that "showcase" labor support provision.

Faculty

  • Kate Lively, RN (Course Director), Halifax, NS
  • Erna Snelgrove-Clarke, RN, Halifax, NS
  • Margaret Quance, RN, PhD, Calgary, AB

Unrestricted Educational Grants

  • Society of Obstetricians and Gynaecologists of Canada (SOGC)

Concurrent Session: Sex in the City

WTCC - Suite 203
13:00 - 15:30

Learning Objectives

At the end of the session, participants will be able to:

  • Appreciate how sexual health is expressed and changes over the lifespan;
  • Gain a deeper understanding of their role in discussing and promoting sexual health with their patients;
  • Advocate for effective sexual health interventions;
  • Identify and counsel around common sexual problems;
  • Gain an understanding of the safety and efficacy of testosterone in female sexual dysfunction, based on international evidence from the world's leading authority.

Faculty

  • Jennifer Blake, MD (Course Director), Toronto, ON
  • Susan Davis, MD, Prahran, Australia
  • John Lamont, MD, Hamilton, ON
  • William Fisher, PhD, London, ON
  • Donald Langille, MD, Halifax, NS

Unrestricted Educational Grants

  • Society of Obstetricians and Gynaecologists of Canada (SOGC)

Research & Innovation - Oral Abstract Presentations

WTCC - Suite 302 (OBS) & Suite 303 (GYN)
16:00 - 18:00

For more details, please consult the schedule on-site.

BPS 1: CMPA - Medico-Legal: Gynaecology

WTCC - Suite 304
16:00 - 17:30

Learning Objectives

At the end of the session, participants will be able to:

  • Identify common complications of hysteroscopic surgery;
  • Outline the best techniques for prevention of hysteroscopic complications;
  • Discuss management of the common complications of hysteroscopic surgery;
  • Identify common causes of gynaecologic litigation.

Faculty

  • Douglas Bell, MD (Course Director), Ottawa, ON
  • Paul Martyn, MD, Calgary, AB

BPS 2: VBAC - Is it Still an Option?

WTCC - Suite 203
16:00 - 17:30

Learning Objectives

At the end of the session, participants will be able to:

  • Describe a VBAC counselling session for patients with a previous caesarean section;
  • Discuss the risk factors for uterine rupture;
  • Describe the usefulness of ultrasound measurement of the lower uterine segment;
  • Describe the technique used for the measurement of the lower uterine segment.

Faculty

  • Lynda Hudon, MD (Course Director), Montreal, QC
  • Robert Gauthier, MD, Montreal, QC
  • Nicole Jastrow, MD, Montreal, QC

BPS 3: Routine Prenatal Testing - New Standards

WTCC - Suite 205
16:00 - 17:30

Learning Objectives

At the end of the session, participants will be able to:

  • Explore the rationale and evidence for and against a number of tests performed in pregnancy including
  • Routine urine culture with first prenatal visit;
  • Routine urine dip with each subsequent visit;
  • Thyroid function tests at first prenatal visit;
  • Screening for syphilis;
  • Universal screening for diabetes at 24-28 weeks;
  • Routine cervical swabs for GC and Chlamydia;
  • Dating ultrasound;
  • Varicella serology.

Faculty

  • Heather Scott, MD (Course Director), Halifax, NS
  • Martina Delaney, MD, St. John's, NL

BPS 4: Normalizing Birth

WTCC - Suite 202
16:00 - 17:30

Learning Objectives

At the end of the session, participants will be able to:

  • Understand a definition of "Normal Birth" and why it matters;
  • Discuss the SOGC Joint Policy Statement on Normal Childbirth (12/08) and whether this fits within your current practice model;
  • Understand the principles and practices that promote, protect and support "Normal Birth";
  • Understand some of the barriers and enablers for a culture of "Normal Birth".

Faculty

  • William Ehman, MD (Course Director), Nanaimo, BC
  • Kathi Wilson, RM, Ilderton, ON
  • Ann Sprague, RN,PhD, Ottawa, ON

BPS 5: Coagulation Disorders in Obstetrics and Gynaecology

Delta Halifax - Baronet 4 & 5
16:00 - 17:30

Learning Objectives

At the end of the session, participants will be able to:

  • Recognize which women should be screened for blood disorders;
  • Discuss and recommend the limit of investigation for blood disorders;
  • Review the clinical recommendation in obstetrical care and gynaecology for women with blood disorders;
  • Recommend an algorithm for delivery for women with bleeding disorders.

Faculty

  • Diane Francoeur, MD (Course Director), Montreal, QC
  • Rochelle Winikoff, MD, Montreal, QC

BPS 6: When a Hysterectomy is Required, How Should the Uterus be Removed? Challenges, Tips and Tricks

WTCC - Suite 204
16:00 - 17:30

Learning Objectives

At the end of the session, participants will be able to:

  • Review current guidelines for hysterectomy in terms of surgical approach;
  • Identify most common challenges for vaginal hysterectomy;
  • Discuss tips and tricks for increasing minimally invasive approaches to hysterectomy.

Faculty

  • Guylaine Lefebvre, MD (Course Director), Toronto, ON
  • Kirsten Smith, MD, North York, ON

BPS 7: Options for Managing Overactive Bladder

Delta Halifax - MacDonald
16:00 - 17:30

Learning Objectives

At the end of the session, participants will be able to:

  • Understand the basic diagnostic evaluation required for patients presenting with symptoms of overactive bladder;
  • Understand the indications for invasive testing (urodynamics, cystoscopy) in patients presenting with symptoms of overactive bladder;
  • Understand the therapeutic and side effect profiles of pharmacological agents used to treat overactive bladder;
  • Understand the options for non-pharmacological (i.e. conservative treatment) for overactive bladder.

Faculty

  • Danny Lovatsis, MD (Course Director), Toronto, ON
  • Jens-Erik Walter, MD, Westmount, QC

BPS 8: Medical Abortion - Update (in association with The National Abortion Federation)

WTCC - Suite 305
16:00 - 17:30

Learning Objectives

At the end of the session, participants will be able to:

  • Counsel women on the advantages and disadvantages of medical versus surgical abortion;
  • Describe the important components of medical abortion practice including counselling, effects and follow-up;
  • Safely provide medical abortions in their practices using agents and regimens available in Canada.

Faculty

  • Edith Guilbert, MD (Course Director), Sainte Foy, QC
  • Sheila Dunn, MD, Toronto, ON

BPS 9: Impact of Food-Borne Infectious Diseases in Pregnancy- Listeria Hysteria

WTCC - Suite 306
16:00 - 17:30

Learning Objectives

At the end of the session, participants will be able to:

  • Review the impact of listeria infection in pregnancy;
  • Discuss other food-borne infections in pregnancy;
  • Develop an approach to emerging infectious diseases in pregnancy.

Faculty

  • Mark Yudin, MD (Course Director), Toronto, ON

BPS 10: Vulvovaginal Abnormalities

Delta Halifax - Baronet 1 & 2
16:00 - 17:30

Learning Objectives

At the end of the session, participants will be able to:

  • Recognize and diagnose the common vulvar dermatoses;
  • Learn the current treatment options for the vulvar dermatoses;
  • Develop an approach to the diagnosis and treatment of vulvodynia.

Faculty

  • Jeffrey Dempster, MD (Course Director), Halifax, NS
  • Mary Louise Baxter, MD, Dartmouth, NS