North York General Hospital SIC Lloyd Smith
Lloyd Smith grew up and attended medical school in
Saskatchewan. He completed general surgery training
in the Gallie Program, including a rotation at Joe’s, a
favourite experience. Postsurgical residency he did fellowship
training in Hepatobiliary surgery in London,
England, and Surgical Nutrition at the University of
Pennsylvania. He also spent time as Richard Reznick’s
first surgical education fellow. He joined the staff at St.
Joseph’s Health Centre in 1990 where he developed an
interest in the new field of Minimally Invasive Surgery.
He credits Steve Strasberg who, after starting to do laparoscopic
cholecystectomies, offered to teach one surgeon
from each of the U of T Hospitals as a way of disseminating
the technique.
In 2000 Lloyd was recruited by Ori Rotstein to the
Toronto Western Hospital to help develop a UHN
Minimally Invasive Surgery program along with David
Urbach. He and David started a fellowship program
in MIS surgery. He also had the opportunity to help
push the envelope in laparoscopic procedures with Mike
Jewett, Richard Reznick, Paul Greig and others.
In 2002 Lloyd moved back to St. Josephs to become
Surgeon-in- Chief. During the next 10 years, he was a
big part of the MIS fellowship program which spread
across most of the University of Toronto teaching hospitals
and became a model for collaboration between
hospitals. He also helped to design the University of
Toronto Collaborative Bariatric Surgery Program, which
was originally headed by John Hagen and Richard
Reznick.
In 2012, Lloyd finished as Surgeon-in-Chief at St.
Joseph’s. He then completed a Health Administration
Program at the Schulich Business School. Avery Nathens
and Lloyd were asked to review North York General
Hospital in preparation for a search for a Surgeon-in-
Chief. Lloyd was impressed with the hospital, applied
and was selected for the position. He has been there 2
years as of this interview.
North York General Hospital
Lloyd likes the culture of the hospital and the focus
on being an outstanding community teaching hospital.
He and the group there have developed a focus
on “acute care surgery” modelled on the Orthopaedic
Division’s long established program. The hospital now
has acute care programs in Orthopaedics, General
Surgery, Plastics, Urology and Gynecology. Each division
does it a bit differently depending on their needs. The
overlying principle is to give emergency patients better
access to the OR and to do it in daytime hours. “It is
good for everyone - doctors, patients, and the hospital”.
He thinks it improves overall quality of care.
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“Residency training in Surgery at North York General
is primarily in General Surgery. The Hospital has
become a favorite choice for general surgery residents
because of the apprenticeship model (one resident with
several staff ) instead of a team model (chief, senior and
junior in ranked order). The surgeons try very hard
to put educational needs ahead of service. We tend to
develop a close personal relationship with our residents.
“The Division of General Surgery has become very
closely aligned with the University. Stan Feinberg is the
associate program director, Peter Stotland is our division
rep for education and Nancy Down is the Division
Head. They and the entire division have put lots of
thought into how we develop our educational program.”
Lloyd would like to see the other Divisions of
Surgery get more involved in resident teaching. “We
have extremely busy Orthopaedic, Plastics and Urology
divisions who do a mix of what most surgeons will see
and do if they go into community practice.” He thinks
that North York is well positioned to contribute to a
Competency –Based Curriculum at the University of
Toronto.
COLLABORATIONS
“We have a great relationship with Sunnybrook which
we would like to develop further. Currently we partner
for vascular services and most recently colorectal surgery.
Avery Nathans (Surgeon- in- Chief at Sunnybrook) and
I have committed to meet on a regular basis to look at
ways of collaborating further. Gone are the days when
every hospital can offer all services. We all need to focus
on what we are best at.
“We also partner with the Hospital for Sick Children.
Pediatric general surgeons from Sick Kids come up to do
a clinic two days a week, and operate two days a week,
enough that we are able to train residents in paediatric
anesthesia. Donna McRitchie, our Vice President for
Medical Affairs, has helped orchestrate these partnerships.”
Lloyd’s wife Mary Ann is a nurse who is active as a
volunteer at a hospice and the Gardiner Museum. They
have three children; Adam (28) is in finance, April (26)
is completing a Master’s Degree in Public Health, and
Claire (23) is a teacher. Lloyd is active in cycling, tennis,
golf, and skiing. He most recently read “Boys in the Boat”
by Daniel James Brown, a study of team efforts. He has
always enjoyed teaching and seeing the impact of teaching
in the eyes of the residents and students. “It’s great to
pass the privilege of being a surgeon on”. Lloyd’s favorite
quote is: “It’s amazing what you can accomplish if it doesn’t
matter who gets the credit”.
Lloyd Smith and his wife Mary Ann
M.M.
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