During the mid-1960’s, the Director of the Clinical Sciences Division of the Faculty of Medicine, Dr. Jack Laidlaw, had become increasingly dissatisfied with the training of clinician investigators and felt that the existing apprenticeship model lacked rigor and did not provide adequate background preparation in medical research. Traditional basic sciences departments provided structured programs for graduate training, but were not considered to be a realistic solution because they were limited in terms of the scope of research that could be conducted and effectively excluded most postgraduate trainees in clinical medicine to their lack of basic science prerequisites. An additional concern of Dr. Laidlaw was that qualified faculty (clinician scientists) with a primary appointment in clinical departments had no place to hold a graduate appointment. There was a need for a new entity structured as a graduate program which could provide the rigor necessary to adequately train clinician investigators and yet have a more flexible and multidisciplinary approach to research than was possible within traditional basic science departments. Such a unit would also provide a graduate appointment home for faculty with primary appointments in the clinical departments.
Around the same time that Dr. Laidlaw was proposing a new multidisciplinary graduate unit to serve the needs of the clinical departments, administrators at the Ontario Cancer Institute/Princess Margaret Hospital(OCI/PMH) had begun to place more emphasis on clinical research. Dr. Ernest McCulloch, who at the time was working with Dr. Lou Siminovitch in the Division of Biological Research at OCI/PMH, was invited to implement this policy by supervising a stream of MD graduate students who would engage in clinical research. Dr. McCulloch, a friend and colleague of Dr. Laidlaw, shared the same dissatisfaction with the “rigidities and academic structure” of the basic science sector and, after talking with Dr. Laidlaw about the new IMS, they decided to join forces.
Laidlaw and McCulloch shared the view that their new creation needed to be multidisciplinary in nature and should involve collaboration among the existing clinical and basic science departments at the University. It was a bold initiative at the time and was met with skepticism from many quarters. Despite this, the Institute of Medical Science was established in the summer of 1967 as a graduate unit of the School of Graduate Studies at the University of Toronto, and received approval from the Ontario Council of Graduate Studies in September 1968. The first graduate of IMS was Dr. Claude Morin, who received his MSc in the spring of 1969.
During the first few years of the IMS, Drs. Laidlaw and McCulloch worked hard to disseminate their vision to senior clinicians and Chairs and, in conjunction with the Executive Committee, to establish and expand the faculty and student base of the IMS, obtain funding and establish guidelines. In a 1984 Hanna History of Medicine interview, Dr. McCulloch recalled that “those were interesting, strenuous days, because we were devising policies and procedures; doing everything from scratch”.
Dr. Laidlaw was Director of the IMS from its inception in 1967 to 1975, when he was appointed Chair of the Department of Medicine at McMaster University. Dr. McCulloch, who had previously been the Graduate Secretary, was appointed IMS Director in 1975. He continued to maintain the standards of the IMS and worked to slowly build up its reputation. McCulloch reported that one of his greatest challenges was convincing the Clinical Chairs about the importance of research and how much time it took to conduct first-rate scientific investigation. He repeatedly urged IMS students to strive to be the best in their fields. Under Dr. McCulloch, the IMS initiated an undergraduate summer program in medical science to increase awareness and interest of medical research among undergraduate medical and arts and science students. This program was highly successful and continues to the present date. Dr. McCulloch left the IMS in 1979 to become Associate Dean of the School of Graduate Studies. Following the departure of Dr. McCulloch, Dr. H.B. Kedward briefly stepped in as Acting Director, and was replaced by Dr. Daniel Roncari in 1980. Dr. Roncari was Director of the IMS for three years and left his position as Director of the IMS in 1983 to become the first Julia McFarlane Professor of Diabetes Research and Chair of the Research Unit at the University of Calgary.
The Director’s position was then filled by Dr. Aubie Angel until 1990. During this period, Dr. Angel and the Executive fostered development of a graduate program in nursing and a collaborative program in bioethics by hosting these programs until they established their own programs within the SGS. The IMS also assisted in the introduction of the Surgical Scientist Program. Dr. Angel left the IMS in 1990 to take up the position of Chair of Medicine at the University of Manitoba.
In 1991, Dr. Mel Silverman replaced Dr. John Wherrett, who had been Acting Director since Dr. Angel’s departure. As Director, Dr. Silverman raised the academic standards of the IMS, expanded the curriculum, increased student enrollment (particularly MD enrolment) and faculty appointments. During his tenure, the IMS added its first professional degree program – the Master of Science in Biomedical Communications. He was integral in encouraging clinical chairs to emulate the surgical scientist model and introduce their own departmental programs. This had led to the creation of clinician scientist streams within most clinical departments, including Medicine, psychiatry, Paediatrics, Anesthesia, Ophthalmology, Radiation Oncology, and Obstetrics and Gynaecology. Together with Bernie Langer he helped found the University of Toronto Royal College of Physicians and Surgeons Clinician Investigator Program (CIP), which has been instrumental in communicating standards of rigorous scholarly research to the clinical sector, and in highlighting the unique requirements of the training and career development of clinician investigators.
Dr. Ori Rotstein took on the Directorship of the IMS in 2000 and completed his tenure in 2011. During his Directorship, the IMS continued to expand dramatically, becoming the largest graduate unit in the Faculty of Medicine, and the fifth largest graduate unit at the University of Toronto. Two more professional programs (the Master of Health Science in Bioethics, and the Master of Health Science in Medical Radiation Science) were added to the roster of graduate degrees. The IMS continued to provide leadership in such areas as translational research, student policy (creation of the Statement of Agreement that outlines terms of the supervisor-student relationship, and the IMS Graduate Oath), and faculty development. Under Dr. Rotstein’s leadership, IMS took steps to address student and faculty interest in development of a formal translational research curriculum. The IMS remodelled the core departmental course, MSC1010Y Seminars in Translational Research, introducing more than 15 module short courses, spanning domains of enquiry from the basic sciences through clinical research and knowledge translation. IMS also dramatically expanded opportunities for students to participate in collaborative programs across the University.
In 2011, Dr. Allan Kaplan assumed the Directorship of the IMS. As Director, Dr. Kaplan has been instrumental leading the IMS further towards a strategic vision rooted in translational research. He played a central role in the creation of a Masters of Health Science Translational Research Degree Program proposal and in shepherding this proposal through the approval processes in the Faculty of Medicine and at the University of Toronto. He also oversaw the establishment of new collaborative programs in Musculoskeletal Health and in Resuscitation Science. In July 2014, Dr. Kaplan assumed the position of Vice-Dean of Education in the Graduate and Life Sciences Education Office in the Faculty of Medicine. Dr. Mingyao Liu stepped into the role of Interim Director of the IMS and was appointed Director in January, 2015.
At the University of Toronto, the IMS has made a substantial impact within the Faculty of Medicine by imparting the rigorous standards of graduate studies to research in the clinical departments. The cooperation of MD and PhD scientists has created exciting multidisciplinary graduate programs in translational research, with the result that (i) a large portion of the total research output of the clinical departments is now integrally linked to IMS graduate programs, and (ii) the University has produced a cohort of highly-skilled clinician scientists. An impressive example of this success is that, over the last 25 years, a significant number of academic leaders in the clinical departments at the University of Toronto are IMS graduates. Rather than “inbreeding”, this infusion of highly skilled clinician scientists has transformed departments with strong clinical programs into clinical departments with international academic stature.
At the national level, the IMS has assumed a leadership role in Canadian academic medicine. The number of MD clinician scientists currently enrolled in the IMS, is more than double that of all other clinician scientist training programs in Canada. Many of the Canadian medical schools are using the IMS model as a template for establishing their own health scientist training programs.
The IMS has been actively pursuing international collaboration dating back to 2002. The first international summer students from National Chiao Tung University of Taiwan arrived in 2003, to participate in the IMS Summer Undergraduate Research Program (SURP). Students from all over the globe continue to travel to Toronto to participate in this immersive course. The IMS is currently in partnership with National Chiao Tung University of Taiwan, Shandong University School of Medicine and Kyoto Prefectural University of Medicine. Our department also works with Science Abroad at Woodsworth College to help send 6 U of T students to renowned international research facilities.
The IMS success story is attributable to the quality of students and supervisor faculty and the commitment of clinical departments to support graduate studies. Despite significant clinical responsibilities, the IMS faculty is dedicated to graduate supervision and research, and has assumed an increasing voluntary administrative role in course direction, participation in thesis program and examination committees, and representation on IMS administrative committees. In a very real sense, the IMS “vision” reflects the goal of the clinical departments to achieve recognition for internationally significant scholarships.