Approved Minutes – CASEM Board Meeting
Delta Okanagan Kelowna, Columbia Room
June 19-20, 2012
Present:
Dr. Bruce Davidson, President
Dr. Renata Frankovich, President Elect
Dr. Janice Harvey, Past President
Dr. Jennifer Fletcher, Director, NB
Dr. Ed Pilat, Director, MB
Dr. Alan Vernec, Director, QC
Dr. Pierre Frémont, Director, QC
Dr. Laura Cruz, Director, ON
Dr. Richard Goudie, Director, ON
Dr. Victor Lun, Director AB
Dawn Haworth, Executive Director
Barbara Falardeau, Administrative Assistant
Jaime McLean, Communications Officer
1.
Opening Remarks and Welcome
Dr. Bruce Davidson welcomed the Board Directors to the CASEM Board Meeting in Kelowna BC.
2.
Review and Approval of Minutes
The minutes of the Board meeting held in Kelowna October 28-30th 2011 were reviewed and
approved. The conference call minutes from April 3, 2012 were reviewed and accepted as
standing.
MOTION: Janice Harvey/Pierre Fremont: That the minutes from CASEM Board Meeting,
October 28-30, 2011 and April 3, 2012 be approved. Carried.
3.
Approval of Agenda
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Additions to the Agenda under Other Business:
4.
Applications for Centre of Excellence (Laura Cruz)
Hit Count Initiative (Pierre Fremont)
Presidential Report

Dr. Anthony Galea (Update and Appeal Decision)
Dr. Bruce Davidson updated the Board on the recent appeal panel hearing held on May 10 th
2012. He applauded the work of the appeal panel (Drs. Wilkinson, Shrier and Jeff Palamar) for
their thoroughness and professional approach. The decision of the appeal panel, agreed by
both parties ahead of time, was final. A full appeal submission document outlining decision
making process was provided by the appeal panel. They did uphold the original decision of the
CASEM board with the following amendments:
1. Membership with CASEM is revoked for 3 years from October 24 2011.
2. Dip. Sport Med. designation cannot be used (as it requires continuous membership
within CASEM).
3. Dr. Galea can re-apply for membership in CASEM as of October 24, 2014 under the
condition that he has attended a CASEM or CPSO recognized training program in ethics.
4. Dr. Galea, should he re-join CASEM, would have to re-sit the Diploma in Sport Medicine
examination after October 24 2014 in order to be considered to have the Dip. Sport
Med.
The Board discussed at length next steps which included:
-
Does CASEM inform the CSPO of its revocation of Dr. Gale’s membership;
Do we inform the membership and if so, how? Can we do it at the AGM which is a
closed door meeting?
Do we make a public announcement? Do we include information on the public side of
the website?
Do we inform other relevant bodies of the CASEM decision?
Whilst the Board reach consensus to not to make the decision public, they requested further
guidance and it was suggested that Dawn Haworth contact the CASEM lawyer for further
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direction and input in terms of a) informing the membership at the AGM and b) whether
CASEM informs the College.
Post discussion note: The lawyer responded whilst there is nothing in the CASEM Bylaws which
prevents disclosure of the results of the Galea appeal to the membership (he would not
disclose a copy of the decision), CASEM should be aware that communicating the result could
lead to a potential claim of defamation and/or slander.
Given the lawyer’s response, the Board agreed that they would not inform the membership at
the AGM or, at this point in time, inform the College. They would, however, respond openly to
any member’s questions or queries on the matter with only facts (of process and decision
making).
 Canadian Concussion Collaborative (CCC)
The Quick Scat or “Five Things to Know about Concussion” was approved by the Canadian
Concussion Collaborative and is presently going through peer review. The approved Quick Scat
will be published in the Clinical Journal of Sport Medicine. The next CCC meeting is planned for
fall 2012.
 CME Module (CMA) – Update
CASEM had originally approached CMA (Dr. Sam Shortt) with regard to the development of an
online CME module on Concussion Awareness. A joint proposal was established and CMA and
CASEM and approached the NHL, Trillium Funds and IIHF among others but the response was
luke warm with no financial support forthcoming. CMA did have some funds available and were
willing to support the project with joint funding from CASEM but CASEM could not contribute
the amount required ($70k) to move the project forward. Subsequently, Dr. Shortt proceeded
with the initiative in collaboration with the Ontario Neurotrauma Foundation who funded the
project in its entirety. The CCC will endorse the project if found suitable and Dr. Shortt will
present at the upcoming CCC meeting in the fall of 2012.
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5.
Secretary-Treasurer’s Report – Dr. Pierre Fremont

Audited Financial Statements 2011
The audited financial statements for 2011 were previously approved by the Board.
Pierre will present at the AGM to update members on the CASEM financial picture for
2011.

Investment Portfolio
Dr. Pierre Fremont presented the secretary report and an update on the investments.
The auditor suggested with the new Not-for-Profit Act coming into play, financial
statements should be reviewed by the Secretary Treasurer monthly and then bi-monthly
by the Executive Committee.
MOTION: Pierre Fremont/Bruce Davidson: That the financial Statements will be reviewed as
following: Monthly review by the Secretary/Treasurer; bi-monthly review by the Executive
Members of the CASEM Board; Three times yearly by the CASEM Board - Carried
CASEM has a nice balance of mutual funds and GICS. The balanced Sunwise portfolio
has rallied and is only now up to the original amount invested and that figure continues
to vacillate depending on market forces. This is a guaranteed investment account so
CASEM will be guaranteed our initial investment amount at the end of maturation (10
years). The GIC interest levels are still very low and therefore GICs that are coming up to
maturation will be kept in short term 90 day GICs so when the rates increase the money
can be invested longer term.
CASEM continues to use the services of Kronish Financial Services. The Board
questioned if CASEM is getting a good deal with the present investment company and
suggested comparing investment fees with other financial institutions. Dr. Jennifer
Fletcher offered that her husband take a look at the investments and give an evaluation
on the investment fees.
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6.
National Office Report – Dawn Haworth
CASEM received a large influx of new membership applications in the first half of this year. The
goal is for 800 members by the end of 2012. The Board reviewed the list of Dip. Sport Med
members who have yet to renew their membership and an effort will be made to contact
individually those members and encourage them to remain with CASEM.
JCSMS - Janice Harvey and Dawn were invited to the Joint Commission Meeting in Portland in
the spring. Renata Frankovich supersedes Janice Harvey as JCSMS rep and will attend to the
next meeting in Alabama in 2013. Dawn Haworth will notify JCSMS staff of the change in
representation.
Jaime McLean joined the CASEM office in March 2012 as the new communications officer on a
part-time basis. This appointment is a one-year contract and will be reviewed by the Board at
the 2012 fall meeting following a recommendation from the Executive Director and 2013
operating budget projections.
7.
Advisory Board – Update
James Penman, strategic planning consultant and Jeff Palamar, lawyer, were invited to join the
CASEM Advisory Board and both have agreed. The Board is still looking for a
Marketing/Communications expert to join the Advisory Board and have received an application
from Allison Seymour. The Board needs to discuss the role of the advisory board at the fall
meeting. It was suggested that advisory board members join the CASEM Board for one day
where the Board will discuss the Communication and Marketing Plan for 2013.
8.
Committee Reports:
Professional Services (Ed Pilat)

Communications/Membership
The annual sponsorship contribution from Industry was somewhat lighter in 2012
however CASEM still managed to secure 40K in corporate sponsorship money. Jaime
and Dawn, along with Dr. Marshall, will continue to seek out new sponsorship
opportunities. Jaime took over the production of the CASEM Newsletter from Barbara.
The idea is to update the newsletter with more scientific input from the Publications
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Committee and publish bi-monthly. Dr. Andrew Marshall will continue to chair of the
Timely Topics Series. The workshop on Running Injuries in Hamilton and Ottawa were a
great success and another course is planned for the fall. Dr. Marshall is also interested
in holding another Anti-Doping Course probably as preconference to Whistler. Jaime
and Pierre Fremont will be working on revamping the CASEM website during the
summer months. The CASEM facebook page is regularly visited and posted on by
CASEM members with updates on sport and CASEM events. CASEM has now a twitter
account and Jaime is sending out regular tweets.
 Selection
The Selections Committee sent out emails to potential candidates for the Olympics and there
were large number of applications to review. The application form had to be slightly modified
to match the ranking grid criteria. Games applications stay in general low though. CASEM needs
to assess motivations and hesitations of members to apply for major games. The Head Office
will develop a survey and send out to members to get their feedback. The Chair suggested that
the committee asks for an evaluation or character reference for Game applicants. This is to help
teams to be more cohesive and effective during game coverage. Another solution is that the
Ad-hoc committee invites the CMO provides input on the Selection calls.
ACTION: Richard Goudie to bring forward suggestions as to either have the CMO on the call or
get a reference letter from the past CMO regarding Games applicants .
 Publications
Dr. Margaret Burghadt accepted the position of Chair of the Publications Committee. As per an
earlier decision by the CASEM Board, all position papers on the CASEM website are reviewed
after three years by the primary author and if not reviewed and updated, the papers will be
pulled after five years. The committee suggested that a deadline for the review be given to the
authors and if by the deadline no update has been done, the paper will be pulled from the
CASEM website. Margaret is tweaking the CASEM Guidelines to match the guidelines published
by the Clinical Journal. The Board gave the Chair approval to go ahead with the guidelines.
Another neglected document is the Selected Readings for candidates who want to prepare for
the CASEM exam. It was suggested to the Board that the reading list from the sport medicine
fellowship programs could be posted on the CASEM website. The Board decided that the Core
Competencies from the fellowships are on the CASEM website and can be Goggled or obtained
through SIRC services. The Publications Committee will continue to encourage sport medicine
fellows to contribute to the newsletter under the direction of the fellowship director. The
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credentials committee was asked to look at the Core Competencies and align the CASEM exam
to the competencies.
ACTION: update the Credentials Committee that only Core Competencies should be examined

Team Physician Coordination Committee
Dr. Watson did not submit a report as there were no new activities. Dr. Paul Watson stepped
down as Chair and Dr. Janet McKeown took over the Committee Chair position.

Accreditation (Jennifer Fletcher)
Credentials
The Board received the report from Credentials. The next exam will be held in Calgary
in November and at the time of writing, 48 candidates have confirmed places making
the exam full.
New Appeal Policy - The committee had recently changed two policies with respect to
the exam that had unforeseen consequences. First, the committee voted that
candidates will only be informed that they Passed or Failed, but would not receive any
other information. Second, the committee voted to increase the Appeal fee to $300,
and that this would apply to all appeals. After the last exam, there were six appeals and
in some of them, the candidate outlined potential process errors on a station but that
station had no relevance to the candidate passing or failing the exam. Had the candidate
known the criteria by which they failed, the candidate would not have submitted such
an appeal. Evaluating this appeal required only a couple of minutes. The committee
decided to maintain the $300 fee to file the appeal. However, if the appeal itself is
clearly not relevant, the candidate will be given a $200 credit toward the upcoming
exam. If the appeal is considered potentially relevant and has to be evaluated, the $300
fee will be applied. This fee is reimbursed if the appeal is considered to have merit (i.e.
either the decision is reversed or the candidate passes, or the candidate is allowed to rewrite the examination for free). All other appeal processes remain the same.
The Board approved the new Appeal Policy and this will come into effect for the 2012
exam.
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-
Specialty Status
RCPSC Update (Merrilee Zetaruk)
Following CASEM’s application last spring for recognition by the Royal College as an Area
of Focused Competence, a nationwide consultation with various stakeholders (e.g.
medical licensing bodies, Post-gradual Medical Education Deans, medical students, etc.)
was carried out. The results of this consultation along with our application were
reviewed by the Committee on Specialties at the Royal College in October, 2011. The
COS supported the application and recommended that it proceed to the Education
Committee for final approval.
The Education Committee reviewed the application in November 2011 and approved
our application to recognize Sport and Exercise Medicine as an AFC Diploma discipline
with the proviso that the Competency Training Requirements and portfolio documents
be simplified to make implementation more feasible by programs.
A working group has been created as a new Specialty Committee (AFC) in Sport and
Exercise Medicine. The members of this group are: Bob Foxford (EM); Anita Pozgay
(EM); Bob McCormack (Ortho); Mark Roberts (Int Med); Claire Leblanc (Rheum); Deirdre
McLean (PM&R); Merrilee Zetaruk (Peds)
The primary task of this group in the shorter term will be to review the documents I
submitted as part of the application and simplify them / modify them according to new
templates that the Royal College has developed. We are scheduled to meet in Ottawa,
Sept. 13 and 14th for a workshop to begin the implementation of Sport and Exercise
Medicine as a Royal College AFC Discipline.
CFPC Update (Lisa Fischer)
The process has been a long one however Dr. Lisa Fischer reported that the CFPC has
approved "SD programs", (much like the Royal College has approved "Diplomas") and
SEM is one of those programs that has been approved for review. Next steps include:
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
A working group from the CFPC will contact each group above, to move forward with
program development, accreditation, etc (the SOT will require each program to develop
competencies, evaluation, etc.)

Need to determine criteria for “practice eligible routes “for special designation within
our focused practice area. Dr. Fischer has put forth the idea of a portfolio grid with
points assigned for each category (Diploma would be a mandatory point).

Establish a system to ensure ongoing competency through CPD, etc

the CASEM fellowship committee will need to discuss the current competency
framework, discuss evaluative tools, CPD requirements, grand parenting - this should
be done within the next 3 months in order for SEM to have a solid plan to move forward
with the CFPC review, to be discussed at fellowship committee meeting in Kelowna

The goal is for everything to be completed by Jan 2013 for awarding special designation
(though Dr. Fischer noted that her experience with the College to date would suggest
that this date is overly optimistic!)
-
Fellowship Committee
The Fellowship Committee is currently preparing for modifications to Core Competencies to
fit within CANMEDS and Triple C curriculum pending direction from CFPC.
They also continue to align primary care PGY3 programs with common deadline for
applications to PGY-3 program

-
Academic (Alan Vernec)
Research
Dr. Victor Lun’s 7 year term as committee chair will end in June, 2012. Dr. Michael
Koehle has agreed to chair the committee beginning in June, 2012.
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The committee reviewed applications for the CASM Research Grant (RG) and New
Investigator Grant (NIG). Dr. Lun noted that with the NIG award, two recipients were within
a fraction of scored points from each other and requested an additional $7500 from the
Board so that both applicants could be given the opportunity to receive a grant. The Board
discussed however given the current fiscal constraints CASEM is working in, they turned
down Dr. Lun’s request.
-
Annual Symposium
2012 Kelowna
The 2012 Kelowna meeting has not been without its challenges and the roles and
responsibilities of the key players (scientific chair versus overall chair) need some
discussion by the Board. The new model of day one caused difficulties in
planning/finances. The Board agreed that the meeting is a collaborative effort between
CASEM Head Office and the Program Chair and the Program Chair should be responsible
for all details associated with running an annual conference in consultation with the
Executive Director.
2013 Whistler - “Sport Medicine on the Western Edge”
The conference is being chaired by Dr. Dory Boyer and planning is going well. The 2013
organizing committee will present a projected budget to the Board at their fall meeting.
It is anticipated that attendance and therefore projected profit expectations will be
similar to that of Newfoundland.
2014 FIMS World Conference – Quebec City
The organizing committee for this world conference is comprised of both FIMS and
CASEM members. The organizing committee is chaired by Dr. Preston Wiley and Dr.
Julia Alleyne represents FIMS in her role as Chair of the Education Commission. Dr.
Pierre Frémont will jointly represent CASEM as the President alongside Dr. Lyle Michelli
who will be President of FIMS in 2014.
The Board reviewed a letter received by Dr. Jean Doré – Dr. Doré is requesting the Board
consider his request for a lead-role and title in this conference organizing committee.
The Board discussed his request and whilst they were appreciative of allof his efforts in
the part he played with regard to brining the meeting to Quebec, his role would remain
that of a member of the organizing committee.
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2015 PAN AM
A meeting was be held in Kelowna between Julia Alleyne, Renata Frankovich, Bruce
Davidson and Tatiana Jevremovic to look at finding common ground to move forward
with the PAN AM after PAN AM rejected two proposals submitted by CASEM. After
that meeting, Dr. Alleyne submitted a new proposal however this was not accepted by
the CASEM Board in principle as the Board believe strongly that CASEM should retain
financial control of the meeting. Renata Frankovich will relay Board comments back to
Dr. Alleyne and suggest a further meeting to see if a compromise can be reached.
-
Team Physician Course Development Committee
This committee will meet in Kelowna and review the schedule of upcoming courses for
the next 3 year cycle as they relate to future CASEM meetings and locations. These
include: Advanced Course in Sport Medicine; FIMS Team Physician Course; Emergency
Sideline Course and new endurance sport medicine Course in conjunction with Ironman
Canada.
-
Timely Topics/Other CME
The Running Injuries Timely Topics has been given successful twice, once in Hamilton
immediately prior to Around the Bay and again in Ottawa in conjunction with the
Ottawa Race Weekend organizing committee. Both courses were very well evaluated.
A third course may be offered in the fall of 2012 or spring of 2013.
 Clinical Issues I (Richard Goudie)
- Athletes with a Disability
Dr. Russell O’Connor took over the Chair position for this committee and is motivated to get the
committee members involved again. The Committee will have a meeting in Kelowna and
establish one and three year goals.
- Wilderness Medicine
The new co-chairs are Dr. Ivy Chen and Dr. Michael Koehle. The committee did not report any
new activities. The committee is working on a pronouncement on Altitude Implications for
Sports and Exercise Medicine.
- Performing Arts Medicine
No new activities and no report were submitted for the Board Meeting in Kelowna 2012.
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Clinical Issues II (Laura Cruz)
- Sport Safety
The Chair of the Sport Safety Committee did not submit a new report. The committee will
continue to work on the outstanding issues from the last board report. The committee did not
get a new submission date for the publication of bicycle helmet paper. The committee
proposed last year to submit an article on Sport Safety for the CASEM Newsletter but nothing
has been submitted so far. Jennifer Fletcher chaired a committee meeting in Kelowna and will
report back to the Board
- WIISM
The WIISM breakfast talk was rolled into the main session on Friday morning this year. Connie
Lebrun presented an update on concussion. The Abuse, Harassment and Bullying in Sport Paper
was published in the Journal last September. Manon Cote attended CS4L with a poster
presentation on the CASEM Exercise in Pregnancy Guidelines in Ottawa in January. The WIISM
committee was asked to provide a letter of support to Dr. Michelle Mottola who is applying for
a CIHR grant to update and test the Exercise Pregnancy Guidelines including Par Med Ex Tool.
Mary Jane Desouza, president of FAT Coalition asked for support from WIISM to convince the
editors to exclude the planned point- counter-point debate regarding the existence of the
Female Athlete Triad in the April JACSM Health and Fitness journal. Manon Cote asked the
CASEM Board if there is a process for Board approval for support letters. The Board replied that
as the Chair of WIISM Dr. Cote has approval to write letters of support since there are no
position statements on these subjects. Dr. Jennifer Fletcher completed the position paper on
Osteoporosis.
ACTION: Laura Cruz: to let Manon Cote know that the Board approved the support letters.
ACTION: Laura to follow up on the status of the CIHR grant.
- Pediatric Exercise Medicine
The current Chair of the Pediatric Committee is Dr. Erika Persson. Dr. Laura Purcell took on a
lead in the pediatric concussion and is updating the CPS’s previous position papers. Laura
Purcell will represent CASEM at the Ontario Health School Head Injury Prevention with the
Ministry of Education. The committee decided after a debate with CPS that there are no
changes or updates to the current Backyard Trampoline Paper and reaffirmed the position
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statement as it was previously submitted and published by CASEM and CPS. Drs. Philpott, Luke,
and Zetaruk will have the draft of the needed revisions to the Physical Inactivity in Children and
Adolescents Position Statement (2004) completed in the fall 2012.
9.
Affiliated Representatives
-
EIM Update - Dr. Renata Frankovich
Dr Frankovich is representing CASEM on the EIM initiative which is projected to be
launched in Canada in October of 2012 at the CSEP conference. Dr. Pierre Frémont is
representing the CFPC SEM section.
An inaugural meeting was held in Victoria and a plan of execution is being developed by
Susan Yungblut, the national task force manager.
There will be a focus group meeting in Kelowna headed up by CSEP at which CASEM
Board members and EIM US founders (Bob Sallis and Steven Blair) have been invited.
10.
2012 Budget Development and Review of 2012 Budget
Dawn Haworth presented a revised budget for 2012 which looks at a balanced budget with
expectations that Kelowna will provide +/- $65K profit and the investments continue to
produce an average of 3% (portfolio and GIC). The MSK course, Sideline Emergency and
Injury Prevention are all projected to run at break even.
Income
Clinical Journal Sport Medicine
Donations
EXAM (fees & sponsorship)
Investment Income
Membership
Miscellaneous Income
Corporate Sponsorship
Symposium Revenue
Advanced Course in Sport Med
Team Physician Development Course
Injury Prevention
40,000
3,000
72,600
30,000
240,000
5,000
45,000
206,000
0
0
25,000
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Timely Topics, Pilot
Emergency Sidelines
MSK
Total Income
30,000
16,700
22,820
736,120
Expense
Board/Executive - 3 Meetings
Board plus Chairs/Ad. Board
Subscriptions (625 member subs)
National Office
FIMS Subscriptions
Credentials
Travelling Scholarships
Research Committee
Specialty Status/Fellowship Mtg
Team Physician Course Dev (Advanced Course in
Sport Med)
Translation
Committee Work
Annual Symposium
Advanced course in Sport Med
CASM/FIMS Team physician Development
Injury Prevention*
Timely Topics, Pilot
Timely Topics, (Running Injuries/endurance
medicine)
Emergency Sidelines
MSK
Special Projects
COC Representation
CMA Representation
FIMS
Expert Group Representation
Sportdiscus
Member Recruitment
FISU Sponsorship/Student Bursary
Sponsor Recognition
Total Expense
Net Income
35,000
0
70,000
270,000
3000
63,840
7,500
22,500
2,000
0
3000
10,000
137,500
0
0
24,640
25,000
12,900
18,000
10,000
1500
1500
10,000
1000
6,100
5,000
0
0
739,980
-3,860
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Motion: PF/JH – that the revised projected budget for 2012 be approved. Carried
11.
2012 Election Results
From 1st July 2012, Renata Frankovich will take over as President, Dr. Pierre Frémont as
President-Elect and Dr. Janice Harvey as Secretary-Treasurer.
Dr. Jennifer Fletcher will begin a 2nd 3-year term as Director for Atlantic Provinces.
All appointments will be ratified by CASEM members at the AGM.
12.
-
Any Other Business
Applications for Centre of Excellence (Laura Cruz)
Dr. Cruz asked the Board to consider supporting, in principle, the application of the Sport Care
unit in Toronto for the FIMS Centre of Excellence.
The FIMS Collaborating Centres of Excellence will facilitate regional and national educational
and research networks to promote best practice sport medicine principles for athlete care and
the promotion of active living on an international basis.
Goals:
1. To promote an international standard of excellence in clinical care through knowledge
transfer and exchange.
2. To develop and deliver accessible FIMS educational courses (TPC, Advanced, Instructors,
Rehabilitation and Emergency Sidelines) on a regular basis to Sport Medicine
professionals.
3. To promote a mentoring model applicable to developing countries and early career
professionals for advancement of sport medicine best practices.
4. To engage an international network of FIMS members in collaborative research efforts
promoting evidence-based sport medicine.
5. To promote the membership and participation in the FIMS organization for international
sport medicine.
-
Hit Count Initiative (Pierre Fremont)
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Dr. Fremont apprised the Board of a new concussion initiative out of the USA concentrating on
concussions in youth.
Whilst concussions have been making headlines in professional sports for the past five years,
youth sports organizations have not received the same public scrutiny, and therefore while
most programs have taken positive steps on the concussion issue, few if any are actively
working to limit exposure to sub-concussive brain trauma. Today, children are exposed to levels
of brain trauma that are considered dangerous and unacceptable for adults.
Hit Count is asking youth sports organizations to change the ways games are played and
practiced, with the goal of significantly reducing the number of head hits children incur during
sports participation. The next step will be to convene a meeting of experts, sports
organizations, thought leaders, and industry to explore the current state of knowledge and the
steps that would need to be taken to establish, adopt, and measure a Hit Count.
The CASEM Board agreed that there has been very little focus so far on concussion and subclinical head trauma prevention in the increasingly popular field of youth contact sports. The
board therefore felt that this initiative deserves CASEM’s attention and further understanding.
Pierre will contact Katerine Schock at the Sports Legacy Institute to determine next steps and
indicate CASEM’s interest.
13.
Adjournment
The next CASEM Board meeting is scheduled before the CASEM exam on November 8-9,
2012 in Calgary AB.
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