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Respiratory Medicine
Respiratory Medicine

Our history

During the early years, clinical and laboratory research performed by the Chest (led by Peter Turner) and Respiratory Physiology (led by A. Charles Bryan) Divisions and their colleagues in other sub-specialties led to a rationalization of mechanical ventilation for acute lung disease, mechanisms and management of respiratory complications during anaesthesia, and the cause and treatment of neonatal apnea. Subsequently, there was a major expansion in the respiratory physiology programme within the Department of Internal Medicine. Close collaborative links resulted in a training programme almost unique in its breadth and depth.

The Chest Division rapidly developed an interest and focus on the management of the inpatient and ambulatory asthmatic child. This laid the ground work for the Division’s selection as the only Canadian Centre in an NIH funded multicentre North American asthma research project (Childhood Asthma Management Program) from 1991 to 1999 under the local leadership of Henry Levison (1991-97), Joe Reisman (1991-99), Ian MacLusky (1997-2006) and Padmaja Subbarao (2006-present).

Levison succeeded Turner as Chief of the Division in 1985 and broadened its focus by developing an expanded interest in unusual and complicated respiratory diseases. A new dimension was added in 1986 with the recruitment of Hugh O’Brodovich, who brought to the Division an interest in the cellular and molecular mechanisms of lung disease, as well as both training and experience from other renown centers. Together with members of the Division of Neonatology, he helped establish the MRC Group in Lung Development. Following Bryan’s retirement in 1990, O’Brodovich became Head of Respiratory Research Division within the Research Institute. Recruitment of additional fundamental scientists was completed and in 1994, O’Brodovich established and became the Director of SickKids' Lung Gene-Based Therapy research programme.

For over three decades, numerous trainees coming from all over the globe have graduated from the Division’s active postgraduate education programme. We continue to prepare both Canadian and foreign subspecialty residents (formerly known as “Fellows”) for careers in paediatric respiratory medicine. Since the mid-1980s, special expertise in paediatric respiratory medicine has been recognized by subspecialty qualifications in both Canada (1988) and the United States (1986). O’Brodovich served as Chair of the Sub-board of Pediatric Pulmonology of the American Board of Pediatrics (1992-95), and Vice-Chair, respiratory medicine examinations, of the Royal College of Physicians and Surgeons of Canada (1996-98). The Royal College has consistently given its full endorsement to the Division’s training programme, in 1989 (under Levison), again in 1995 (under Reisman, who was appointed Vice-Chair of paediatric respiratory medicine examinations in 1998) and most recently in 2001 (under Melinda Solomon).

In 1994, O’Brodovich succeeded Levison as the Division Chief, and the Chest Division became known as the Division of Respiratory Medicine. O’Brodovich continued to expand the scope of research expertise within the Division until he became Chairman of the Department of Paediatrics at the University of Toronto and Paediatrician in Chief at SickKids in 1996. Martin Post, an internationally recognized scientist investigating early lung development, became the Head of Respiratory Research at the same time. Subsequent to the restructuring of the SickKids Research Institute, Post became the Director of the Lung Biology Programme. In 1996, Dr Canny left to lead the paediatric respiratory group in Dublin, Ireland. In 2000, Reisman left to become the Chairman of Paediatrics at the University of Ottawa. Those hired both to replace Canny and Reisman, as well as to expand the scope of the clinical practice, resulted in a group of young dynamic and well-trained individuals who added a new dimension to the group.

Allan Coates, formerly Director of Respiratory Medicine at the Montreal Children’s Hospital of McGill University, was recruited to Toronto in 1997 to assume the position of Division Chief of Respiratory Medicine. A recognized leader in integrative physiology and clinical research, he focuses on enhancing the bedside “half” of the “bench to bedside” research focus that has become part of the Research Institute’s vision of the future for The Hospital for Sick Children. Coates retired from the Division in July 2010.

Over the past five years, the Division has joined with Respiratory Therapy and has greatly expanded the services of the latter in the Division of Emergency Medicine and on the general hospital wards. The Division has embraced the role of Clinical Nurse Specialist-Nurse Practitioners and several are fully integrated into the group. The Division has expanded its training commitments, its clinical service and its volume of work, establishing itself as the leading Division in Canada and one of the best in North America.

In April 2005, Felix Ratjen, Professor of Pediatrics, University of Essen, assumed the position of Division Chief of Respiratory Medicine and he holds the Sellers Chair in Cystic Fibrosis. Ratjen obtained most of his medical training in Germany. After a research fellowship at the Children’s Hospital in Boston, he worked at the University of Essen, where he was appointed Deputy Chief of the Department of Pediatrics in 1998 and Professor of Paediatrics in 2001. He assumed the position of Chief Executive of the Scientific Board of the German Cystic Fibrosis Foundation in 2002-05 and was actively involved in activities of the European Respiratory Society activities including paediatric Task Forces on Bronchoscopy, Bronchoalveolar Lavage, Nitric Oxide and Interstitial Lung Diseases, and also founded the Journal of Cystic Fibrosis.