Introduction to the University Health Network Osteoporosis Clinic

The Osteoporosis Clinic for the University Health Network is based out of Toronto General Hospital. The aim of the clinic is to provide excellence in the diagnosis and management of osteoporosis. From an educational perspective, we hope to provide medical trainees of all levels with an improved understanding of the evidence based assessment of patients at risk for osteoporotic fractures and the spectrum of treatment options. Bone Density testing (DXA) is available at the clinical site.

Dr. Angela Cheung is the Director of the Osteoporosis Clinic. Drs. Rowena Ridout and Heather McDonald are the associate directors.

Clinics are run 4 days per week. Clinics start at 1:00 pm and continue until 5 pm approximately.
The clinic days and corresponding physicians are:

Monday: Dr. Lianne Tile General Internal Medicine
Tuesday: Dr. Rowena Ridout Endocrinology
Wednesday: Dr. Angela Cheung General Internal Medicine
Thursday: Dr. Heather McDonald Rheumatology
Dr. Moira Kapral General Internal Medicine

At each clinic, a mixture of new and follow up patients are seen. The patient population is varied. A significant proportion of our patients have secondary causes for their osteoporosis. In particular, our clinic sees many of the patients currently cared for by the UHN Transplant services. Men comprise approximately 20% of our population.

Students from a variety of levels can be accommodated in the Osteoporosis clinic setting. Undergraduate and Postgraduate trainees can have their learning objectives met at a level commensurate with their personal needs. (e.g. level of training, duration of time in the clinic, personal goals and objectives) The competencies suggested are consistent with the framework found throughout the Department of Medicine. The best learning environment for the student is available when there are a maximum of two students per staff.

Within the framework of the CanMEDS criteria, the following core areas of “Medical Expertise”
are suggested:

  1. To define and analyze key clinical states which potentially contribute to the development of abnormal bone density including concepts of peak bone mass, post menopausal bone loss, age related bone loss and altered bone metabolism (secondary causes of osteoporosis)
  2. To list risk factors which lead to the development of osteoporotic fractures and/or low bonemass and to gain familiarity/expertise in using these to assess the potential fracture risk for a given patient
  3. To establish familiarity with bone density assessment, specifically DEXA in order to beable to define the current role of this measurement technique and to be able to discuss itsstrengths and limitations
  4. To develop a framework and rationale for appropriate investigation of osteoporosis
  5. To define treatment options available and be able to provide a rationale for their use inthe clinical setting (non pharmacologic and pharmacologic)


  1. Please be punctual.
  2. Prior to attending the clinical session, please familiarize yourself with key risk factors
    for Osteoporosis and related fractures.
  3. Please review your particular learning needs with your assigned clinician at the
    beginning of your session.
  4. Notify the osteoporosis clinic secretary (416-340-3890) of any absence from
    scheduled clinics.
  5. Students are reminded to be respectful of all patients and staff in the Osteoporosis
  6. All patients must be reviewed with your individual supervisor in the osteoporosis clinic
    unless you are specifically notified otherwise.

The staff of the Osteoporosis Clinic hopes that you will find this a valuable experience. Please feel free to ask any of the staff for assistance to help you meet your own learning needs



© Osteoporosis Program 2008