Facebook Pixel Code
Banner image
About the Institute

Profile of Ivan Diamond

Photo of Dr Ivan Diamond
Dr. Ivan Diamond

Dr. Ivan Diamond, MD

  • Research Fellow, General Surgery/Group for Improvement of Intestinal Function and Treatment (GIFT)/ Child Health Evaluative Sciences (CHES)

1. Where are you from?/Where did you study?
I grew up in South Africa. I came to Canada right after high school and did my undergraduate degree at the University of Toronto in psychology and physiology.  I actually worked part-time at SickKids for a year in psychology with Dr. Joanne Rovet as a research assistant. I then went to medical school at Queens University and during my summers, I did research with the paediatric and transplant surgeons at SickKids, Dr. Jacob Langer, Dr. Paul Wales, Dr. Annie Fecteau and Dr. David Grant. It was then that I realized I wanted to do surgery. 

After medical school, I came to Toronto for my general surgery residency and completed half of that residency prior to starting my research training. There is a program called the surgeon-scientist program which allows you to integrate formal research training into your residency. I am currently working on a PhD in clinical epidemiology, supervised by Dr. Wales in surgery and Dr. Brian Feldman from Rheumatology.  Once I have completed my PhD I will complete the remainder of my residency.

2. What are you researching right now?
My research is in a disease called intestinal failure. It is a condition where the child is unable to get their nutrition by mouth and requires intravenous (directly into the veins) nutrition. While there are a number of diseases that lead to intestinal failure, most of the problems are surgical and usually start in infancy. The baby is either born with too little intestine or something happens soon after birth where there is significant intestinal injury. These children are looked after by a multi-disciplinary team called GIFT (Group for Improvement of Intestinal Function and Treatment) led by Dr. Wales. Historically, the biggest problem that these children face is that they develop what can be life-threatening liver disease from the intravenous feeds. This can lead to the need for liver and intestinal transplantation and often these infants die from this disease due to the unavailability of organs for transplant.

The main focus of my research is determining whether a different type of intravenous feed will reduce the risk of liver disease in these children. The type of intravenous fat that is available at the moment is made from soy bean oil. While soy-beans are not unhealthy for you, when used as the only type of fat intravenously, we believe that they are a major contributor to the liver disease that our patients develop. We are doing a multi-centre randomized controlled trial looking at a new type of intravenous feeds that contains, in addition to less soy bean oil, fish oil. We believe that a reduction in the amount of soy-based oil together with the addition of the fish-oil and its anti-inflammatory effects may reduce the risk of liver disease in these infants.

3. What in your opinion is the single most important scientific breakthrough, and why?
I think that the discovery of DNA is the most significant biomedical breakthrough of this century. We’re only just starting to recognize the potential that understanding genetic variability means for the care of patients. I think that in the next ten years we are going to see more personalized medicine coming to the forefront that takes into account genetic differences.

4. What are your major interests outside the lab?
I’m a news and politics junkie and spend quite a bit of time on the web reading about current events and politics. I also like spending time with friends. Since I spend a lot of time at work I like to try and get to the gym as much as I can. I also enjoy travelling. The best place I’ve been so far is Fiji. I love seeing new places and experiencing different cultures. One of the things my research has allowed me to do is travel and meet colleagues all over the world and that’s been great.

5. Why science?
During my undergrad I had an opportunity to do research. I participated in the SickKids Summer Research Program and worked in psychiatry with Dr. Russell Schachar. This was really my first exposure to clinical research. I just loved doing the research and being able to see the potential impact that this research could have on patients. At that point, while I knew I wanted to go to medical school, I also realized I wanted a large part of my career to be focused on clinical research. I believe that as a doctor you are able to help the patient across the bed from you but in clinical research you are able to help a greater number of people even more broadly.

During the first year of my residency, I spent quite a bit of time considering what type of research I wanted to do. I think that fundamental science research is very interesting and has the potential for huge benefit in the future. However, I wanted to be able to see a more immediate impact at the patient level. I am interested in assessing novel therapies with the understanding that the randomized controlled trial provides the best evidence for a particular treatment but it is often difficult to do. I want to consider what therapies should be evaluated through clinical trials and then design those studies to ensure that patients get the best possible care.

6. Why SickKids?
SickKids is a great place to work and train. My first exposure to research was here at SickKids and I’ve had great mentors here starting in my undergrad and continuing through medical school and my residency. I also recognize that the type of research that I do is a team effort. We have a fantastic and dedicated team of people who make up the GIFT program and provide excellent care to our complex patients and make it possible to run what is a fairly challenging clinical trial. Doing clinical trials also requires a lot of institutional support. The Clinical Research Office at SickKids has been instrumental in facilitating our research, both here and at the other centres across Canada participating in our study.

7. What is the most controversial question in your field right now?
There are other research groups who are looking at fish oils for the prevention of liver disease in patients with intestinal failure. There is an ongoing debate about the optimal approach, primarily whether you need to eliminate the soy-oil altogether. In our view this results in an inability to give the infant sufficient fat for growth and development. We believe that we get very similar clinical outcomes with our strategy of limiting but not eliminating soy-bean oil in terms of improvement in the liver disease. Ultimately, as the babies who are treated grow up we will be able to answer the question as to the impact that these alternate approaches have on growth and development.

8. What are you reading right now?
I am reading Obama’s Wars by Bob Woodward. As I said before, I’m a news and political junkie. I just finished The Unforgiving Minute by Craig Mullaney, which was about a soldier who was a commander in Afghanistan after being a Rhodes Scholar at Oxford University. Having read about the soldier’s perspective on the Afghan conflict, I wanted to learn more about the political context.

9. If you could give one piece of advice to someone considering a research career, what would it be?
Being a doctor is an incredibly rewarding experience. However, the opportunity to do research as well, adds a superb aspect to your career. Research is quite different from clinical medicine. Medicine requires focused thinking but as a researcher you have the opportunity to think more broadly and not only realize where you are at now but where you can be and the best way to get there.

10. What will the new Research & Learning Tower mean to you?
I’m sorry that I will probably be working elsewhere when the Tower is complete. The Child Health Evaluative Sciences offices are presently off campus at 123 Edward Street and having seen the plans for the Tower I think it will be a fantastic place to work and learn. I like the idea of being closer and connected to the Hospital. Right now the CHES staff are in offices across three floors in our current building but the open space concept of the Tower will be great in facilitating collaboration both at the scientist level but also at the trainee level.

November 2010