History of the CSEM

David A. Hanley, MD, FRCPC — 2007 update

The Canadian Society of Endocrinology and Metabolism (CSEM) came into being as a result of the efforts of a number of prominent members of the Canadian Society for Clinical Investigation (CSCI). Endocrinologists had always played a very important role in that society and it was from the CSCI that the CSEM drew its membership initially.

The society executive was formed a year earlier at a meeting of the Endocrine Society in Washington, D.C., in June of 1972. The executive referred to itself as the Ad Hoc Council of the CSEM. At that meeting plans to bring the Society into existence were laid and the following key steps were taken:

1. Membership was recruited, largely from the CSCI, and by the time the society had its first official meeting in Edmonton, 24 January 1973 — there were 238 paid-up members.
2. A constitution and application for incorporation under the Canada Corporations Act had been generated through a directors’ meeting of the CSEM on 18 January 1973. This meeting was held at the office of Ogilvy, Cope, Porteous, Hansard, Marler, Montgomery, and Renault, in Montreal. The society was officially recognized as a corporation on 19 February 1973.
3. The leadership of the new society was proposed as follows:
   Executive:
   
   • President: Robert Volpé, University of Toronto
   • President-Elect: Henry Friesen, McGill University
   • Secretary-Treasurer: Keith Dawson, McGill University
   • Honorary President: J.S.L. Browne
4. The first official general meeting of the CSEM occurred during the Annual Meeting of the CSCI and the Royal College of Physicians and Surgeons of Canada at the Hotel MacDonald, Edmonton, Alberta, Wednesday 24 January 1973 at 5:15 p.m. At this meeting the constitution was ratified with some minor changes and the society began its existence with a reasonable bank account of $3,884.58. Annual dues were set at $10.00 for renewal and $15.00 for new memberships.
5. The first Council Meeting of the CSEM was held the following day on 25 January 1973 at the Edmonton Club. The term of office was established for the various offices of the council. A special meeting of the general membership of the CSEM was held at the same time to ratify these decisions and compose the membership of the various committees. The following executive committees were established:
   
   • Drs. Mo Watanabe and Aubie Angel chaired a committee on the Society's constitution
   • Dr. Carl Abbott chaired a nominating committee
   • Dr. Henry Friesen chaired a liaison committee for interactions with other societies (Endocrine Society, International Society of Endocrinology, etc.)
   • Dr. John Moorhouse chaired an education committee.

Although the brief history as outlined above relates the formal establishment of the CSEM, earlier informal meetings of the membership had occurred. Several members have pointed out the key roles played by early council members such as Aubie Angel, Mo Watanabe, and Robert Volpé in the initial establishment of the society. Our first Secretary-Treasurer, Keith Dawson, states that "Bob Volpé and Aubie Angel...were the real ‘'ring-leaders'’ in its organization...and even from the beginning, it was a success". Dr. Volpé remembers a particular day in 1971 when "...Dr. Angel met me on the street (in Toronto ), and in discussing random matters of the day he proposed that we start a CSEM and that I should take the initiative. With his urging we did plan to organize... and had the (first) informal meeting in June 1972 (in Washington )". He says, "Had it not been for the constant harassment by Dr. Angel, l doubt that I would have pushed myself to get this early meeting organized."

It should also be noted that the creation of a Canadian society of endocrinologists was not uniformly endorsed or encouraged. Dr. Charles Hollenberg (who was at McGill at the time) recalls that "...the majority of McGill endocrinologists, many of whom were international leaders, were opposed to the formation of a Canadian society since they felt that Canadian needs were adequately met through the American Endocrine Society. However, when it became clear that representation of Canada in international meetings and congresses was going to be dependent upon the development of a Canadian endocrine society, and when endocrinologists in other parts of Canada demonstrated a significant interest in forming a Canadian organization, a number of us changed our minds and worked actively towards the establishment of the Society."

The rapid establishment of the CSEM as a prominent force representing the discipline of Endocrinology and Metabolism in working with government, the Royal College of Physicians and Surgeons of Canada, the CSCI, and international endocrine groups, soon convinced Canadian endocrinologists that the CSEM had a significant role to play. During the first decade of its existence the society rapidly developed into its present form, with council members representing the regions of the country elected for three year terms.

In 1974 the CSEM began negotiations with the Royal College to examine the issue of certification examinations in the subspecialty of Endocrinology and Metabolism. Former president, Dr. Sonia Salisbury, played a major role in the development of this certification process, and Dr. Keith Dawson recalls that the development of a Royal College specialty in endocrinology was a major reason for the founding of the CSEM.

In 1974 and 1975, Dr. Michel Chrétien served as the delegate of the CSEM as part of a team negotiating for increased medical research funding. These efforts met with some success at the time and the society has continued a strong role as an advocate for more funding for the Medical Research Council of Canada, and the successor to the MRC, the Canadian Institutes of Health Research.

As former president Dr. Harvey Guyda points out, Endocrinology and Metabolism has traditionally been Canada’s strongest discipline in academic medicine and the CSEM has always had a very prominent role in the Annual Meeting of the Royal College and the CSCI. Dr. Guyda notes that because so many of our proposals for the meeting program were accepted, we "created a problem for our membership because it meant that our program was spread out over the full 4 to 5 days". In the mid-1970s, up to one-third of all abstracts accepted at the CSCI Royal College Annual Meeting were from the members of the CSEM. Our society members became discouraged by the high rejection rate which naturally befell to the greater proportion of submitted abstracts.

Another major CSEM contribution to the medical science-education field was the establishment of the Sandoz Lectureship in 1975. Sandoz Canada (now Novartis Canada) contributed significantly over the years to the education programs of our society. Our second president, Dr. Henry Friesen, underscores the critical role played by Tony Nalecz who was Medical Director of Sandoz at the time. Dr. Friesen recalls, "I proposed to Tony Nalecz of Sandoz that he should consider sponsorship of a high profile lectureship which would enable the Society to bring in outstanding talent and thus enrich the program. It was gratifying to me how quickly he supported the idea and, as I remember, he agreed it should be a regular feature by making an initial 3 to 5 year commitment. Sandoz not only honoured that initial goal but, as we all knew, the Sandoz Lecture is one of the highlights of the Annual Meeting." The Sandoz Lectureship has been awarded to some of the most prominent endocrinologists in the world (including number of Canadians). Sandoz has also supported the society's newsletter which is published twice a year, and recently established the Antoni Nalecz Memorial Award for the best abstract submitted to the CSEM annual program.

In 1995 the CSEM established the D. Harold Copp Young Investigator-in-Training Award for the best abstract at the Annual Meeting by a trainee in an educational program. This award was personally presented by Dr. Copp at its inauguration in Montreal and at the 1997 Vancouver Annual Meeting. To support endocrine research by students the CSEM created in 1994 five annual Student Travel Awards for scientific presentations at the Annual Meeting.

Through the late 1970s and early 1980s negotiations continued with the Royal College of Physicians and Surgeons of Canada to provide guidelines for establishment of training programs in Endocrinology and Metabolism and certification for the subspecialty. In 1982 the membership was polled and the proposal for the establishment of a certificate of special competence in Endocrinology and Metabolism was approved. A committee was formed to communicate with the Royal College. In 1983 the Royal College Council approved the establishment of a new subspecialty qualification in Endocrinology and Metabolism based on prior certification in internal medicine or pediatrics. The first Royal College examination for qualification for this certificate was held in 1985. The standards for training programs were accepted, and universities across the country have received Royal College approval.

A number of major international educational and scientific programs have been held in Canada with the assistance of the CSEM. Probably the most notable was the International Society of Endocrinology's World Congress held in Québec City in 1984. There were 2,781 abstracts presented at this congress in addition to 200 symposia, 10 plenary lectures, and 20 meet-the-professor speakers. At the time, this was the largest meeting held by the International Society of Endocrinology. Dr. Fernand Labrie played a critical role in bringing this meeting to Canada and he and a large number of CSEM members were prominent in organizing the program and ancillary symposia.

Other CSEM collaborations with international organizations have brought important conferences to Canada. The University of Toronto Endocrine Division hosted the Endocrine Society's Post-Graduate Assembly (now called Clinical Endocrinology Update) in Toronto in 1977 and 1994. Dr. David Goltzman played a key role in Montreal hosting of the 10th Meeting of the International Conference on Calcium Regulating Hormones (now the International Bone and Mineral Society) which was held in conjunction with the American Society of Bone and Mineral Research’s Annual Meeting held in 1989 in Montreal. The IBMS meeting is held every three years, and it returned to Montreal in 2007.

During its short history the CSEM has fostered cross-Canada communication in our academic discipline rather than the north-south (U.S.A.) links which had previously been the major source of interaction among Canadian endocrinologists. As past-president Sonia Salisbury points out, the specialty exam has actually been a unifying influence for Canadian clinical endocrinology, and this influence will undoubtedly increase with time. The Merck Canada Visiting Professorship was established to finance travel of a Canadian endocrinologist to another center for teaching and meeting with local physicians and scientists. This award is administered by the CSEM Education Committee.

Canadian Endocrinologists have been pioneers in the introduction of growth hormone treatment for children with short stature. This therapy was overseen for many years by the Canadian Growth Hormone Advisory Committee which evolved in the mid 1990s into the Canadian Pediatric Endocrinology Group. Recognizing the prominent national status of pediatric endocrinology, the CSEM council in 1996 incorporated a representative of the Canadian Pediatric Endocrinology Group in its membership.

In addition to its scientific and educational roles, the CSEM represents Canadian endocrinologists on national issues of clinical policy and workforce planning. Dr. M. Watanabe chaired the 1986 Canadian workforce study of Endocrinologists which surveyed adult and pediatric endocrinologists and reported its findings to the Royal College of Physicians and Surgeons of Canada. The workforce survey was updated in 1994 and has assisted efforts to maintain an adequate cadre of endocrinologists for the needs of the Canadian public.

The CSEM, after considerable deliberation, decided to join the Canadian Diabetes Association (now Diabetes Canada) in removing the Annual Meeting from the aegis of the Annual Meeting of the Royal College of Physicians and Surgeons of Canada. The first separate meeting with the Canadian Diabetes Association was held in the Fall of 1999. The migration of specialty societies’ scientific programs away from the Royal College/Canadian Society for Clinical Investigation's Annual Meetings has obvious implications for those organizations. Nevertheless, the CSEM membership felt that for our Society to survive and grow, we needed a stronger national meeting than what we had been able to develop within the confines of the Royal College Annual Meeting.

Another major issue facing the CSEM is the division of its membership base into a number of other societies such as the Canadian Hypertension Society, the Diabetes Canada, and the Canadian Society of Atherosclerosis, Thromboisis and Vascular Biology. Recent CSEM executives have addressed this issue, and there are increasing interactions among the executives of these related societies resulting in smoother coordination of scientific programs, business meetings and social functions. The crucial issue facing all Canadian specialty societies is the proportionately reduced level of government funding of research in this country in comparison with other G8 countries. It is hoped that our Society as well as all societies involved in education and research will actively work with government to ensure continued growth in this area. The outlook is bright for our Society as a leader in academic medicine and the field of Endocrinology and Metabolism.

ACKNOWLEDGMENTS

This brief history is dedicated to the memory of Daniel Roncari and Harold Copp, Otto Rorstad reviewed the manuscript and made helpful suggestions. The following individuals deserve special mention for sending me information and their recollection of the early days of the CSEM: Bob Volpé, Charles Hollenberg, Daniel Roncari, Harvey Guyda, Fernand Labrie, Keith Dawson, Jack Laidlaw, Henry Friesen, Mo Watanabe, and Sonia Salisbury. The secretarial assistance of Teresa Williams is gratefully appreciated.

The first edition of this history was published in "Medical Specialty Societies of Canada: Affiliates of the Royal College of Physicians and Surgeons of Canada", T.P. Morley (ed.) Boston Mills Press, Erin Ontario, pages 261–270.