The University of Alberta Department of Obstetrics & Gynecology was formally established in 1922. The first chair was Dr. Leighton C. Conn. Gynecological patients were admitted and treated at the University Hospital, also known as the Strathcona Hospital, which had no obstetrical service. Obstetrical patients were admitted to the Misericordia Hospital. Outpatients were seen in the “Old Potter House” in downtown Edmonton, on 103 Avenue between 99 and 100 Streets.
Start of Obstetrical Service
The University Hospital got into the obstetrics business in 1933. The presence of an obstetrical service brought an increase in gynecological admissions, and new facilities were provided to accommodate this. The gynecology unit had 56 beds (including one private room) and was shared with Urology. Subsequently, the obstetrical unit was increased with the addition of “premature and isolation cubicles.” There was even “a doctor’s room and a student’s room.”
The obstetrical service, though growing, remained quite small. There were 500 to 700 deliveries per year with a Cesarean-section rate of 1.6 per cent. The maternal death rate was five per 1,000, mostly due to hemorrhage, sepsis and pre-eclampsia.
The Vant years
After the passing of Dr. Leighton C. Conn in 1941, he was succeeded by Dr. J. Ross Vant. During the “Vant years” the steady growth of both the obstetrics and gynecology services continued. Dr. Vant was one of the first Canadians to gain membership to the Royal College of Obstetricians and Gynaecologists of London, England.
In the early 1930s. Dr. Conn had been one of the first ‘Obstetrician-Gynecologists” recognized by the American College of Surgeons. The formal attire that Dr. Conn wore at the time of his investiture into the American College of Surgery was passed down to Dr. Vant, then to Dr. Ron Horner who donated it to the department. The cap and gown remain proudly displayed in a special cabinet in our resident seminar room.
Move to U of A Hospital
The department underwent a major transition with the move into the new University of Alberta Hospital in 1951. With brand-new facilities, the growth of the clinical services increased at an even greater rate. Over the next decade, service volumes more than doubled in the 81 beds allotted to the department. At the end of Dr. Vant’s term in 1962, the unit performed 2,211 deliveries with a Cesarean-section rate that, in keeping with the rest of the country, had “soared” to 4.9 per cent. The rate had remained stable over the previous decade, “despite the increased number of necessary repeat sections.”
In his final report, Dr. Vant noted the great increase in both scope and content of gynecological surgery. This was due to the availability of better anesthetic routines, blood and blood substitutes, and a closer liaison with members of other hospital departments. Perhaps prophetically, his last words to the board were: "I feel that more public beds are absolutely necessary if we are to meet the demand imposed by an expected and necessary increase in OPD admissions and, as well, to satisfy the requirements of our staff men irrevocably committed to this hospital."
In his final report, Dr. Vant noted the great increase in both scope and content of gynecological surgery. This was due to the availability of better anesthetic routines, blood and blood substitutes, and a closer liaison with members of other hospital departments.
Chairmanship of Dr. Paul
In 1962, Dr. William Paul was recruited from Toronto to become the third chair of the Department of Obstetrics & Gynecology, replacing Dr. J. Ross Vant. Dr. Paul was the first “geographic full time” (GFT) chair of the department, which meant that he actually received a salary for his combined roles as university department chair and university hospital chief. His tenure would not be as long as that of his predecessors.
Dr. Paul was an internationally recognized researcher in the area of fetal physiology. He introduced basic and applied research to the fabric of the department. He recruited another clinician-researcher, Dr. Jim Goodwin, and formed important relationships with the departments of Pharmacology and Physiology in the Faculty of Medicine.Unfortunately, this first adventure into research was short-lived. Dr. Paul was recruited back to the University of Toronto in 1965 to become chair of obstetrics and gynecology. Dr. Goodwin left a short time later.
The Beck Years
Dr. Peter Beck was recruited from McGill University to replace Dr. William Paul as chair of the Department of Obstetrics & Gynecology in 1965. Dr. Beck’s era was one where sub-specialization grew within the specialty of obstetrics & gynecology. The Royal College of Physicians and Surgeons of Canada did not formally recognize obstetrics & gynecology as a specialty until 1957, even though Dr. J. Ross Vant – who served as department chair from 1941 to 1962 – had been a member of the British Royal College for more than 20 years.
Within a decade, the trend to sub-specialization had begun. Dr. Beck was a pioneer in the area of urogynecology. He also had the reputation as an outstanding educator (and a tough examiner!).
Expansion of the Department
Once there was formal RCPSC recognition of the specialty, more attention was paid to postgraduate training programs. With increasing demands for both undergraduate and postgraduate educational programs, there was increased demand for “geographic full time” (GFT) appointments. These GFT appointees would receive remuneration for time spent in “non-clinical” activities such as teaching and research.
As in almost all North American medical schools, GFT positions were used almost exclusively to recruit faculty members with extra sub-specialty training. In a uniquely Canadian fashion, these GFT funds became a replacement for “fee-for-service” income for sub-specialists who often were required to spend more time on complex problems than the fee schedule would recognize. This meant that the funding intended for teaching and research actually was more commonly used to provide sub-specialist services. This dichotomy continues to exist and only in the last few years have governments and physicians come together to remedy this problem by establishment of “alternate funding plans” and other creative solutions.
Though the department had faculty members with “extra” training, such as Dr. Doug Ritchie in gynecological pathology and Dr. Leigh Brown in gynecological oncology, in the Beck era it was expected that the new GFT faculty members would have some formal sub-specialty credentials.
Advent of Perinatal Care
An important event in the department’s history occurred in 1980. The provincial Department of Health agreed to fund a new program that would focus on specialized care for high-risk pregnancies and newborns. This program would provide salaries for perinatologists and neonatologists as well as specialized nursing units. There was intense competition for the location of this unit between the University of Alberta Hospital and the Royal Alexandra Hospital, which had the busiest obstetrical service. Amidst undoubted political lobbying and maneuvering, the decision was made to split this fledgling program between the two sites.
The introduction of GFT faculty positions was not without some difficulties. Job descriptions often were vague, remuneration low and there were strict limitations on ability to earn supplementary clinical income. As a result, many of the new recruits had short GFT careers and opted for “private practice” positions in Edmonton or elsewhere.
Chairmanship of Dr. Mitchell
A new chair was recruited in 1986. Dr. Peter Mitchell arrived from the University of Western Ontario to become department chair and chief of the University of Alberta Hospital department. During the previous year, the University Hospital department had been relocated into the new, state-of-the-art facilities of the Walter C. Mackenzie Health Sciences Centre.
The vision of the new chair was to build on the strong clinical foundation by replenishing the depleted GFT sub-specialty ranks and developing a “bench-to-bedside” research program. The presence of a very supportive dean, the heightened enthusiasm generated by the new building and the presence of the Alberta Heritage Foundation for Medical Research would facilitate these goals. During his chairmanship, Dr. Mitchell oversaw a widespread expansion of both clinical services and research output.
Move to Royal Alexandra Hospital
In February 1995 the department took a major change in direction while under the chairmanship of Dr. Peter Mitchell. The regional health authority announced that, due to “health-care restructuring,” the decision had been made to close the Department of Obstetrics & Gynecology at the University Hospital and relocate its clinical and academic sub-specialty programs to the Royal Alexandra Hospital.
The Perinatal Research Centre’s basic science program remained in the Heritage Medical Research Centre on the U of A campus. But to facilitate perinatal study on a now “relocated” patient population, the health authority provided the PRC with lab and office space at the Royal Alexandra Hospital.
This was the establishment of the Perinatal Clinical Research Centre.Transition to an “off-campus” university department required major adjustments – both for the staff members who were relocated and to the Royal Alex hospital staffs that accepted former members of the University Hospital. The undergraduate and postgraduate training programs have remained strong, and there is an increasing volume of translational and clinical research activity.
Dr. Faught becomes new chair
In 2002, a new chair was appointed to the Department of Obstetrics & Gynecology. Dr. Wylam Faught, a University of Alberta graduate, was recruited from the University of Ottawa to become university department chair, as well as department chief at the Royal Alexandra Hospital. Dr. Faught became the third member of the Gynecologic Oncology team.
In late 2002, two additional sub-specialists in Maternal-Fetal Medicine were recruited. Dr. Sue Chandra graduated from Memorial University and attended Dalhousie University for her sub-specialty training. Dr. Roger Turnell graduated from his residency at McMaster, and received his sub-specialty training at the University of British Columbia. Before coming to Edmonton, Dr. Turnell was chair of obstetrics & gynecology at the University of Saskatchewan.
In a strangely ironic twist, our priorities today have come full circle and echo the words of the department’s second chair, Dr. J. Ross Vant, more than 60 years ago, when he spoke of the need to obtain more resources (beds, outpatient space, nurses and equipment) to look after our increasingly large and complex clinical responsibilities.
After Dr. Faught’s term ended in 2007, Dr. David Cumming served as acting chair from 2007 to 2009. Dr. Margaret (Peggy) Sagle was appointed interim chair in 2009.
In 2010, the department moved into the new Lois Hole Hospital for Women, the only women's hospital in Alberta. The Lois Hole Hospital is located at the Royal Alexandra Hospital site.
1922 - 1941 Dr. Leighton C. Conn
1941 - 1962 Dr. J. Ross Vant
1962 - 1965 Dr. William Paul
1965 - 1981 Dr. R. Peter Beck
1981 - 1982 Dr. Thomas R. Nelson (Acting)
1982 - 1986 Dr. Donald L. Dunlop (Acting)
1986 - 2002 Dr. Bryan F. (Peter) Mitchell
2002 - 2007 Dr. J. Wylam Faught
2007 - 2009 Dr. David Cumming (Acting)
2009 - 2014 Dr. Peggy Sagle
2014 - Present Dr. Radha Chari