Adolescent Medicine

Adolescent Medicine

The Division of Adolescent Medicine is currently housed in the Montreal Children’s Hospital legacy site at 1040 Atwater Avenue some two miles from the Glen hospital site but is fully integrated into the functioning of the larger hospital. Our separate location affords us the luxury of having a designated and welcoming space for teenagers and their families to receive comprehensive care by a multidisciplinary team that shares a large space that provides for a well integrated approach and promotes frequent interaction between various members of the Division of Adolescent Medicine both on a formal and informal basis. We work closely in the same space with the Pediatric Gynecologist and an Obstetrician who runs a teen pregnancy clinic. We evaluate and follow patients on a consultation basis sent to us from both hospital-based specialists and community based physicians or allied health care professionals. These consultations are conducted at the Atwater site as well as throughout the hospital Glen site for both outpatients and in-patients. In addition, we admit to in-patient services at the Glen Hospital site and follow directly under our care patients with eating disorders requiring hospitalization.

Our work is also conducted on an outreach basis to vulnerable teenagers at a variety of sites. We provide care for incarcerated teenagers, youth in placement and street involved youth. This work is undertaken mostly by our physicians in collaboration with allied health care professionals within the community networks. This allows for a more comprehensive experience of the needs of youth and broadens the experience of our trainees.

History

The first clinic for Adolescents in Canada was started by Dr. John Elder at the Montreal Children’s Hospital in 1959. With the support and encouragement of the Chairman of Paediatrics Dr. Alan Ross the program received financial backing from the hospital. This was a giant step forward in proper care for this vulnerable population at a time when little attention was being paid to the unique needs of teenagers who are at a critical stage of development. In 1968 Dr. Robert Kinch (later the Chairman of Obstetrics and Gynaecology at McGill) started a clinic in Paediatric and Adolescent Obstetrics and Gynaecology, which was then run for over a quarter of a century by Dr. Elsa Quiros-Calinou.

The Division of Adolescent Medicine has had a number of illustrious leaders over the years including Dr. Nicholas Steinmetz, Dr. Michael Malus and Dr. Allan Pavalanis. Under the leadership of Dr. Franziska Baltzer this service blossomed into a highly regarded multidisciplinary program providing care to an ever-increasing patient population. In 1995 the Division of Adolescent Medicine and the Gynaecology Program merged into one administrative entity under the leadership of Dr. Baltzer. During some 25 years Dr. Baltzer has transformed the Division from one with a few clinics a week with a paucity of patients to an extremely busy division with widely recognized expertise in Adolescent Medicine and Gynaecology.

The Division now has a Royal College-accredited subspecialty residnecy training program in adolescent medicine. We are one of only four such training centers in Canada and the only bilingual one in the world.

Mission, Vision and Values

Our Mission

The Division of Adolescent Medicine promotes the health and well-being of adolescents as an investment in the future of our society.

As members of a tertiary care interdisciplinary team, we contribute to this investment through:

  1. Providing consultation/guidance to other health professionals on managing adolescent health issues.
  2. Providing direct care for adolescents with complex health problems or high behavioral risk problems.
  3. Teaching colleagues and future colleagues (trainees in each of the disciplines represented by our team) about health issues specific to adolescents, and techniques for engaging with adolescent patients and their families.
  4. Training future adolescent medicine specialists.
  5. Contributing to the understanding of adolescent health and disease through research.

We are dedicated to providing our services in an ethical, innovative and caring manner. We are an accredited training institution mandated to train other health care professionals in the principles of Adolescent Medicine and to deliver high quality care.


Our Vision

In the tertiary care setting provide exemplary care with a specific commitment to treatment of adolescents with complex health problems or high behavioral risk.

  • To promote and facilitate the good health and well being of our patients.
  • To provide extended and accessible services for urgent medical needs.
  • To conduct a thorough history and physical examination in order to arrive at an accurate medical diagnosis and establish an appropriate treatment plan, emphasizing prevention whenever possible.
  • To address the psychological and social health needs of our patients, identifying areas of concern and providing referrals to appropriate professionals or facilities when necessary.
  • To educate our patients about current issues in Adolescent Medicine, their disease process and treatment modalities available.
  • To communicate on a regular basis with, and act as a liaison between other partners in the health community.
  • To participate in approved research studies designed to advance our knowledge of pediatric health care.

The Division of Adolescent Medicine will be a model for excellence in the care of adolescents and their families.

Each adolescent is a whole person – with physical, emotional, intellectual, cultural, ethnic, and spiritual dimensions – as well as part of a family system which itself has needs in all these realms. Through continuous quality improvement, our care will honor all those needs by providing care: 

  • Respectfully
  • Compassionately
  • Sensitively
  • Openly
  • Honestly
  • Confidentially
  • Promptly
  • Flexibly
  • Collaboratively

We will extend this same respect to all our team members, and ourselves, by respecting our individual contributions to the team, our time, and our needs as whole persons who themselves exist within the complex systems of our professional teams and our personal lives.

We will keep abreast of innovations in diagnosis, and in treatment and translate those to our system of care as soon as it is feasible within the limits of budgetary and staffing constraints.

We will provide a training milieu for medical students, residents, future adolescent medicine specialists, art therapists, social workers, nurses, and advanced practice nurses in order to increase the number of professionals capable of contributing to the health and well-being of adolescents in this and other settings. The trainee is a valued member of the team and is treated with the same respect we accord our colleagues. Our patients and their families are also valued and central members of the teaching team and are integral to fulfilling our teaching mission.

We will advocate for all adolescents by encouraging all providers of health care to adhere to these same principles.


Our Values

We believe in the dignity and well-being of our patients and their families.

We strive for excellence in care by using current practices that conform to accepted standards and apply the principles of evidence-based medicine.

We communicate with our patients in an open and honest, sensitive and confidential manner.

We respect a patient’s individual needs in our multicultural and multilingual community.

We provide a safe, comfortable environment where patients are treated in a respectful, dignified and friendly manner.

We respect personal and professional integrity, encourage staff input in decision-making and recognize their contributions to our common mission.

Hospital-based Specialty Clinics:

Eating Disorder Outpatient Assessment Clinic

Multidisciplinary clinic evaluating youth with a suspected eating disorder in order to make the diagnosis and propose treatment. Youth who are diagnosed with an eating disorder will be followed longitudinally by the resident who made the diagnosis. Follow-up visits are scheduled during the resident’s weekly outpatient clinic.

Center of Excellence in Adolescent Severe Obesity (CEASO)

Specialized multidisciplinary program within adolescent medicine for assessment and treatment of severe obesity in teenagers. The clinic provides comprehensive assessment, partners with community resources to provide behavior and lifestyle interventions, and provides a pathway towards bariatric surgery and a transition to adult care.

Pediatric and Adolescent Gynecology

Treatment for pediatric and adolescent gynecological problems. Services include obstetrics and other pregnancy-related gynecological issues as well as operative gynecology.

For the Adolescent Medicine Subspecialty Residency Program, in addition to seeing a broad range of patients with gynecologic complaints in their general adolescent medicine clinic, residents will have the opportunity to attend specialty clinics with a fellowship-trained pediatric and adolescent gynecologist.

Adolescent Obstetrics Clinic (AOC)

Adolescent-centered multidisciplinary obstetrical care is offered as one component of a comprehensive Adolescent Parent-Infant Program. The goal of the AOC is to optimize the health of the adolescent and her fetus in order to prevent adverse pregnancy and neonatal outcomes.

Adolescent Parent-Infant Program

The same multidisciplinary team members that offer prenatal care remain involved after adolescents give birth and a pediatrician/ adolescent medicine specialist joins the team to provide pediatric care to the children and the young parent simultaneously. The young parents benefit from psychosocial support to help them to meet their own developmental needs as they are learning to parent. The parent’s mental and physical health as well as gynecological needs are addressed during the same visit when the child is seen.

Sexual Abuse Clinic

Multidisciplinary clinic for the evaluation of children and adolescents who may have experienced sexual abuse. The resident will participate in the psychosocial and medical evaluation of youth under the supervision of an adolescent medicine physician.

Health Care for Youth with Developmental Disabilities

The youth with developmental disabilities [3/4 autistic spectrum, 1/4 intellectual impairment] followed at the adolescent clinic have a high rate of neurological comorbidity, gastrointestinal problems, and nutritional issues. They need specialized strategies to examine them and to discover the physical discomforts and medical conditions that may cause deterioration in behavior. Adolescent girls with developmental disabilities are often referred to manage their menstrual cycle when this is aggravating epilepsy or triggering behavior problems.

Cystic Fibrosis Multidisciplinary Clinic

Specialized multidisciplinary clinic (including pediatric respirologists, a pediatrician, an adolescent medicine physician, clinical nurse specialists, a dietician, a social worker and a psychologist). The adolescent medicine physician’s role within the clinic is to assess the youths for psychosocial risk and resilience factors, to provide gynecological care including consultation for complex contraception, to provide counselling re: future fertility in both female and male teenagers, to assist with adherence to medical regimens and to assess preparedness for transition to adult care.

Nephrology Transition Clinic

Specialized multidisciplinary clinic (including a pediatric nephrologist, an adolescent medicine physician, clinical nurse specialists, a social worker and a dietician). The adolescent medicine physician’s role within the clinic is to assess preparedness for transition to adult care of youth with active renal problems (including renal transplants) and enhance the transition process for youth and their families.

Community-based Youth Clinics and Experiences:

Head and Hands

This is a multiservice community agency serving marginalized youth between the ages of 14 and 25. The individuals seen in the clinic present with a variety of medical issues, such as STI screening and treatment, contraception, transgender care, mental health issues and other common medical problems.

Portage

For the Adolescent Medicine Subspecialty Residency Program, residents who are able to commute to the outlying community of Prevost, the possibility of a one or more day observation of this residential addictions treatment program can be arranged. https://portage.ca/en/services/adolescent-programs/

CAFÉ Program

Crise Ado- Famille-Enfance is an integrated mobile crisis program for youth and their families.

For the Adolescent Medicine Subspecialty Residency Program, residents join the crisis worker to observe the evaluation and interventions.

Fosters

The Centre de Réadaptation en Dependance (CRD) Foster is an organisation that is charged with youth and adult outpatient addiction treatment in the Greater Montreal Area. Counselors from Foster meet with youth in schools or in various community service points, to discuss and address addictions to drugs, alcohol, gambling, or the internet. They are also an access point for inpatient addiction treatment services.

For the Adolescent Medicine Subspecialty Residency Program, residents will join a counselor at one of the service points once or twice a week for 8 to 12 weeks to gain a longitudinal experience of addictions counseling and learn about the treatment options available for youth in Quebec. http://www.crdfoster.org/Youth-program

Meraki Health Center

This is a multidisciplinary clinic evaluating gender non-conforming children, adolescents, and adults. Residents will have the opportunity to observe the interventions of the various professionals on the team. Under the supervision of an adolescent medicine physician, residents will learn to evaluate youth expressing gender variance, assisting the youth and their family in developing a management plan, including puberty suppressing hormones and cross-sex hormones.

Dawson College

Dawson is one of Montreal‘s English language CEGEPs (Collège d’enseignement général et professionnel).

For the Adolescent Medicine Subspecialty Residency Program, residents will see patients under the supervision of an adolescent medicine physician.

McGill Student Health Services

McGill University is the academic home for 37,000 students from across Canada and around the world.

For the Adolescent Medicine Subspecialty Residency Program, residents may elect to spend a 4 week rotation delivering clinical care in the health services unit.

Indigenous Health

For the Adolescent Medicine Subspecialty Residency Program, residents will join an adolescent medicine physician during a week-long visit in the remote communities of Whapmagoostui and Kuujjuarapik. This is an opportunity for residents to learn about the challenges that youth face in remote communities; to address adolescent issues such as, identification and management of Type II diabetes, metabolic syndrome, polycystic ovary syndrome, contraception, school refusal, school truancy, drug or alcohol addiction, adherence to treatment; and to reflect on the impact of culture and socioeconomic factors on health and wellness.

Centre d'expertise Marie-Vincent

This is a multidisciplinary evaluation and treatment center for children and youth who are survivors of sexual abuse.

For the Adolescent Medicine Subspecialty Residency Program, residents will learn about the services provided by the center, and participate in the general health evaluation and the medical exam. (www.marie-vincent.org)

Carrefour sociomédical du Grand Longueuil

The Carrefour is a multidisciplinary center for the evaluation of children and adolescents facing neglect, physical or sexual abuse.

For the Adolescent Medicine Subspecialty Residency Program, residents will participate in the psycho-social and medical assessment of survivors of sexual abuse under the supervision of an adolescent medicine physician with expertise in sexual abuse.

Division Members

Dr. Holly Agostino
Dr. Francizka Baltzer
Dr. Jason Bond *
Dr. Ian Comeau *
Dr. Giuseppina Di Meglio
Dr. Julius Erdstein
Dr. Susan Finkelberg*
Dr. Vanessa Gadoury-Levesque
Dr. Robert Gagnon *
Dr. Samir Khalife *
Dr. Laurent Legault *
Dr. Suzanne MacDonald
Dr. David Martens
Dr. Katherine Maurer *
Dr. Diane Munz *
Dr. Julie St-Pierre *
Dr. Pierre-Paul Tellier *

*Associate Division Members

Dr. Angela Alberga, Kinesiologist
Peggy Alcindor, Nutritionist
David Archer, Certified Family Based coach, Social Worker
Nancy Berney, Art therapy
Abigail Brodovich, Nutritionist
Sally Cooke, Art therapy
Carla Farnesi, Research Program Coordinator
Julie Fortin, Nurse
Sue Mylonopoulos, Social worker
Justine Noiseux, Social worker
Monica O’Donohue, Nurse
Dr. Maeve O’Leary , Psychologist
Dr. Catherine Serra Poirier, Psychologist

Contact Us

Division Director

Dr. Julius Erdstein
 

Postgraduate Medical Education

Residency Program Director
Dr. Giuseppina Di Meglio
 

Administrative Staff

Residency Program Coordinator
programadmin.adomed [at] mcgill.ca (Angie Bentivegna)
514-412-4400 ext. 22396

For elective requests please contact Angie Bentivegna.

MUHC Administrative Assistant
adolmed [at] muhc.mcgill.ca (Natalie Der Arakelian)
514-412-4400 ext. 22533

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