Local News
Another ex-Winnipeg physician chimes in on Canadian and American health care systems
By BERNIE BELLAN Elsewhere on this website we have a piece by Dr. Elisa Flaybush who, although she received her medical training at the University of Manitoba medical school, went to the US for specialized training in gastroenterology – and chose to remain in the US. You can read Elisa’s commentary on our Canadian medical system at “Manitoba trained Jewish physician now living in US laments state of medical care in Canada.”
That piece elicited quite a few views. Unfortunately, we do not allow comments on our website. (We get inundated with spam comments and it’s too time consuming to wade through them to find legitimate comments.) Interestingly though, we received a very thoughtful email sent to us through our “Contact Us” link from another former Winnipegger, Dr. Martin Koyle – who also chose to go elsewhere for specialized training – in his case, in urologoy, following his graduation from the U of M medical school. In Dr. Koyle’s case, however, after spending most of his career in the US, he did return to Canada – to teach and work first in Montreal and latterly in Toronto.
(We might also note that Dr. Koyle has been the recipient of many awards throughout his career, most recently having been selected as one of the American Urological Assocation’s 2026 Distinguished Award Winners.)
Following is Dr. Koyle’s piece, written in response to Dr. Flaybush’s piece:
Bernie: I enjoyed your dialogue with Elisa, whom I do not know. I must admit that my training and education in Manitoba more than prepared me for subsequent specialist training and spending the majority of my career in the USA, but returned to spend the last 10 years of my full-time career as Professor of Surgery at the University of Toronto Temerity Faculty of Medicine and Women’s Auxiliary Endowed Chair in Urology and Regenerative Medicine at SickKids. Like Elisa, I was not mentioned in Eva (Wiseman)’s book because, like Elisa, I never returned to Winnipeg to practice, but have returned multiple times to operate and serve as visiting professor.
Much of my 40-year career and success was because of the education and mentorship I received from Eva’s husband, Nathan, also Dr. Alan Decter, Dr. Luis Oppenheimer, and Dr. Harvey Chochinov, all Jewish. Certainly, many of my non-Jewish educators had major impacts on my development as well and I feel fortunate to have been lucky. Before I accepted a postgraduate residency training position at Harvard I had long discussions with Nathan and Alan, and looked at all alternatives. One of them said that the 3 most overrated things in the world were “homecoming, sex and Harvard Medical School!” After a few months back I replied to that comment, agreeing with the latter insight, but fervently disagreeing with comments regarding homecoming and sex! However, the Harvard reputation and networking opportunities paid dividends that I likely would not have garnered had I stayed in Manitoba to train and then eventually sought to seek other opportunities.
I too believe that the Canadian healthcare system is broken despite best intentions. Reality is reality. From the time of William Osler until my starting practice in 1984, medical knowledge was doubling in a linear fashion roughly every 7 years. Over the past few decades, with all the innovations and disruptions, biomedical knowledge now grows exponentially, every 2.5 months! Moreover, the number of medical specialties and subspecialties has gone from 40 to 150 over the past 4 decades. Moreover, in my parent specialty of urology, within 5 years of my subspecializing in pediatric urology, I had become a dinosaur, as urology over that short period had changed so dramatically. Routine x-rays were replaced by ultrasound, then CT scans, and then MRI was added. Hands on surgery became largely replaced by laparoscopy and now robotic surgery. New drugs, new guidelines, new metrics, litigation, peer pressure, the electronic medical record, and much more have increased the complexity even more… and the costs to boot! Since the system is based on taxpayer dollars, it is always playing catch up.
Elisa and I are proceduralists that cost the system money and much of what we do is therefore elective. In Canada, in order to see a specialist like her or me, you most often need a referral from a primary care provider, usually using an archaic methodology of FAXing a referral form and hoping a response ultimately reaches the patient. In the USA, if we don’t address a call or referral immediately and appropriately, whether in private practice like Elisa, or in an academic environment like me, we are quite likely to lose that referral base and even that entire practice. So, customer service in our competitive model is essential.
In my practice, I am salaried and see insured and indigent patients, who are all treated equally. In semi-retirement, we are constantly attempting to improve access in the hospital where I work. During my 10 years in Toronto – and I assume it’s similar in Manitoba, my practice felt like an impersonal, never-ending conveyer belt, with very little relationship with the referring provider or, sadly, the patient. The physician also was the one who bore the brunt of patient complaints for any delay or cancellation, despite having no control of the system in which I worked.
Elisa, being in private practice, likely has more control over flow than I do. I use allied health providers, nurse practitioners and physicians as a team to improve flow. They are underutilized in Canada and too much reliance is placed on the gatekeeper, the family doctor. Canada tries to play nice in the sandbox, so to speak, by thinking that all inhabitants of a given province or territory have equal access and equal care. However, many patients in Canada need supplemental insurance – which can be costly if not offered by an employer.
So healthcare is challenging. We are living longer, with more chronic conditions that can now be treated better and hence, prolong life. In the US as much as 25% of healthcare dollars are spent on prolonging the inevitable. In Canada there is far more emphasis on palliative care and hospice, far reducing end of life costs. There is much waste in both systems – with a lot of over management (mismanagement?). In the US it is as challenging as the Canadian system, but for different reasons. There is a profit motive in an open market system, whether that be the insurance company, the hospitals themselves, or the provider. Whether the government provides the dollars through taxes (Canada) or all those pieces that don’t necessarily fit perfectly in the American system, the bottom line needs to finish in the black.
So healthcare is broken, and while fair and equitable is a laudable human-focused goal, it is challenging to achieve in a never-ending playing field. Similarly, an open market system – as Elisa has suggested, works in many instances, but in order to provide for all, it is reliant on government (tax) dollars as well. With the changes in administration in the US, where there is fear that the Social Security and Medicare (federal care dollars for those over age 65 and those with significant conditions like kidney failure) pots are not being replenished as the population ages, and state support has diminished for Medicaid (support for low income), the system also faces mounting challenges as well.
Martin A. Koyle MD, MSc, MMgmt, MBA(cert.), FAAP, FACS, FRCSC, FRCS (Eng.), FRSM
Professor Emeritus, University of Toronto, Temerity Faculty of Medicine & Institute of Health Policy, Management, & Evaluation (IHPME)
Adjunct Professor, University of Minnesota School of Medicine
Faculty, IMHL & GCHM programs, McGill University, Desautels Faculty of Management
Email: marttch@me.com; marty.koyle@gmail.com.
Twitter:@MakMarttch
Local News
Young Winnipegger Dr. Yale Michaels receives $550,000 Canadian Cancer Society research grant
By MYRON LOVE It has been shown on many occasions that a teacher can have an outsized role in shaping a young person’s life. Dr. Yale Michaels’ life story is one example.
During a recent interview with the young cancer researcher – the son of John Michaels and Karen Stern – Yale recounted how a Grade 7 teacher at Grant Park High School was largely responsible for his decision to pursue a medical career in medicine.
The young Michaels attended Brock Corydon Elementary School and was a long time Massad camper. In junior high school at Grant Park, however, he recounts, “I was having a tough time staying on task. Thankfully, my Grade 7 science teacher suggested that I might find it interesting volunteering to help in a cancer research lab. He had a contact and got me in. I loved it. It was a good fit for me. I never looked back.”
Michaels (whose zaida, Leon Michaels, was a leading cardiologist here) spent much of his free time during his high school years volunteering in the lab. After graduation, he enrolled in Harvard –with help from the university’s financial aid program – where he earned his Bachelor’s degree. He followed that up with a Ph.D. from Oxford in 2019, followed by three years as a post-doctoral Fellow – before returning to Winnipeg in 2023 to work at Cancer Care Manitoba, as well as teach at the University of Manitoba.
“I enjoyed my time both at Harvard and Oxford,” he says. “What made England even more enjoyable is that Yale has family there. His grandparents – Leon and Joan Michaels – were born and raised in London and Yale’s time there overlapped for a few months with his brother Jamie (about whom there was a story in a July issue of the Post), who earned his Master’s Degree in Creative Writing at the University of London.
This past June, the young researcher learned that he was to be the recipient of a $550,000 Canadian Cancer Society Emerging Scholar Research Grant, covering five years of research.
Michaels’ field of research focuses on new ways of combating blood cancers – specifically in the new area of immunotherapy. He is being aided in his research by lab tech Dana Segal and graduate student Serena Dembowksi.
Michaels adds that he is collaborating with a number of other researchers from Winnipeg – and throughout Canada, including Drs. Harinad Maganti, David Szwajcer, Jody Haigh, Versha Banerji, and David Knapp.
Using the patient’s own immune cells – specifically CAR T cells -to treat blood cancers was first approved in 2017, Michaelsreports. “The treatment has shown itself to be really successful. Many patients go into remission and some may have the potential to be cured.”
One of the drawbacks, he explains, is that the treatment is prohibitively expensive. Each dose costs about $500,000 U.S.
“What we are trying to do in my lab and elsewhere is find a way to greatly reduce the cost,” he explains. “It becomes a matter of scale. Other drugs used in treating cancer can be produced in amounts of 1,000 doses per production run. But right now CAR T therapy is made on a one-off basis with an individual manufacturing run for each patient. We are attempting to instead make CAR T cells from stem cells – which can be grown in large quantities. We are trying to use genetic engineering to manipulate them so that they can be administered safely to patients.
“We (Michaels and fellow researchers) are making good progress in this area,” he adds.
He cautions that the research is still in the formative stages and that clinical trials are still several years away. “Our research so far though has shown that our treatment would seem to be effective at killing cancer cells,” he reports. “This grant from the Canadian Cancer Society will help us to further that research.”
Outside of work, Michaels notes, much of his time is spent with his family – Dr. Allison Marmel and their two-year-old daughter, Rose.
(Ed. note: We should note that Yale Michaels was also the punter for the Harvard University football team – by far his greatest achievement.)
Local News
Rabbi Kliel Rose, Etz Chayim’s spiritual leader, taking a new position in Ottawa
By MYRON LOVE It is with mixed feelings that Rabbi Kliel Rose, the spiritual leader of Congregation Etz Chayim for the past eight years, is once again leaving the community in which he grew up. Immediately after Yom Kippur, he, his wife, Dorit Kosmin, and three of their five children are moving to Ottawa, where Rabbi Rose is to become the spiritual leader of Congregation Kehillat Beth Israel (popularly known as KBI).
“My time in Winnipeg has been wonderful,” Rabbi Rose says. “It has been a privilege to have served as Etz Chayim’s rabbi and be part of the Jewish community here. Our Jewish community has a sense of solidarity that is unlike any other Jewish community in North America.”
He wasn’t actually looking to leave, Rabbi Rose explains. “Last spring, I was just having a cursory look at postings for Conservative rabbis and KBI stood out. What attracted me was not simply the opportunity to serve a larger congregation, but the chance to lead a community with such a rich history and such a strong commitment to egalitarian Conservative Judaism, Jewish learning, inclusion and community engagement. KBI is a relatively young congregation that brings together more than a century of Jewish history in Ottawa, and I was very drawn to the opportunity to help shape its next chapter.”
KBI, Rabbi Rose reports, was created in July 2016 through the amalgamation of two long-standing and storied Ottawa congregations: Agudath Israel and Congregation Beth Shalom. The merger brought together the rich traditions of both communities to create a modern, egalitarian Conservative congregation. Today, KBI is the largest Jewish congregation in Ottawa, serving more than 500 families, with a strong emphasis on Jewish learning, inclusion, community engagement and youth and family programming.
“There is a tremendous amount of energy and possibility at KBI,” Rabbi Rose says. “It is a community with deep roots, but also a very strong desire to think about what Jewish life should look like in the future. That is exciting to me as a rabbi.”
As with many rabbis, Kliel Rose’s career path has been a long and winding road. The son of the revered Carol and Rabbi Neal Rose, he first left Winnipeg after graduating from Grant Park High School.
In an interview with the Jewish Post & News in 2018, shortly after he returned here to serve Congregation Etz Chayim, Rabbi Rose credited his parents with being tremendous role models. “They are a dynamic team,” he commented, “but they never pushed any of us (Kliel Rose is the middle child in a family of four brothers and one sister) in any particular direction. They were really nurturing. They were okay with anything we decided as long as we were passionate about it.”
For the longest time as a young man, he noted, he fought against going into “the family business”. But, he said, working in Jewish summer camps, people in leadership positions in the camps saw something in him and convinced him to pursue rabbinic ordination.
Thus, after graduating with a Judaic Studies degree from Gratz College in Philadelphia, Kliel Rose enrolled in the Jewish Theological Seminary.
He noted that the most important piece of advice his father gave him before he enrolled in a rabbinic studies program was the suggestion that he should work for a time in a large congregation to see what it is like – “both the joy and the underbelly,” as he put it.
“I took his advice,” Rabbi Rose said. “For two years, I worked under the umbrella of a special fellowship at Bnai Jeshurun Congregation in Manhattan. The congregation had 4,000 members at that time. It had been a dying congregation which had been revitalized by Rabbi Marshall Meyer, who had previously helped revive Jewish life in Argentina. Rabbi Meyer, with his vision of social justice, was an inspiration for me.”
Rabbi Rose also spent a year at an Orthodox yeshiva in Israel and a couple of years as a youth director at a large Conservative congregation on Long Island.
Before coming to Winnipeg, Rabbi Rose served congregations in Miami Beach (for three years), Nashville (for five years), and Edmonton (for five years).
The past eight years at Etz Chayim have certainly brought their share of challenges, but Rabbi Rose says they have also been deeply meaningful. Just two years after arriving, the COVID pandemic transformed congregational life. Then there was the congregation’s decision to sell its 70-year-old building on Matheson Avenue and move to a smaller facility in south Winnipeg – a process that was completed just over two years ago.
“It has been really challenging these past few years,” he recounts. “It was difficult leaving behind our old building with so much history. But I think Etz Chayim made the right decision, and I am proud of how our community came together to navigate these challenges and build a new future for the congregation.”
Rabbi Rose says he is particularly grateful for the relationships he has built during his eight years at Etz Chayim and throughout Winnipeg’s Jewish community. “There have been so many meaningful relationships and experiences during my time here. I feel very fortunate to have had the opportunity to serve this community and to have been part of Etz Chayim’s story during such an important period of transition.”
“I’m leaving with an enormous amount of gratitude,” he adds. “Etz Chayim has given me the opportunity to grow as a rabbi and as a leader, and I hope that I have been able to contribute something meaningful to the congregation and to the wider Winnipeg Jewish community in return.”
Another factor that made Rabbi Rose’s decision to leave difficult is that his parents moved back here two years ago and his older brother, Carnie, returned about 18 months ago to become Shaarey Zedek’s senior rabbi.
“It has been wonderful having my parents and brother here,” Kliel says. “This has been the first time that my children have had grandparents and an uncle and aunt in the same city.”
The Rose family will also miss the many friendships and connections they have made in Winnipeg.
Our community will also miss Kliel’s wife, Dorit. “My wife is a talented and caring individual who has worked in different areas of the community,” he notes. “Most recently, she was working in spiritual care at the Simkin Centre. She has made a tremendous contribution to the community and will certainly be missed.”
For Rabbi Rose, the decision to leave Winnipeg is less about leaving something behind than about embracing a new opportunity. After eight years of helping Etz Chayim navigate a period of profound change, he says he feels ready to take on a new leadership challenge while carrying with him the lessons and relationships he has gained here.
The Rose family will be leaving two days after Yom Kippur. Kliel reports that they have sold their house and have just a few things to wind up.
Local News
Temple Shalom, Etz Chayim Yom Tov Services to be Held in Different Locations this Fall
By MYR0N LOVE In 2025, one of the most interesting aspects of Yom Tov in Winnipeg was the official debut of new rabbis Carnie Rose and Myriam Saitman, at the Shaarey Zedek Synagogue and Temple Shalom respectively – also the imminent departure of Rabbi Yossi Benarroch, since 2016 the Adas Yeshrun Herzlia congregation’s spiritual leader.
This year, The Jewish Post’s pre-Yom Tov story has a different focus. Due to water damage caused by heavy rain in June (see story in previous issue of The Jewish Post) Temple Shalom’s congregation has had to move out of their building until renovations are complete and will be holding Yom Tov services at the Berney Theatre. Also, Congregation Etz Chayim will be returning to its building on Wilkes for Yom Tov after holding services in a larger facility last year and having Yom Kippur services at a Holiday Inn the year before.
“This year,” says Morissa Granove, Congregation Etz Chayim’s COO, “we are very happy to be bringing the High Holy Days home to 1155 Wilkes Avenue. We will be hosting two services each day and have had an overwhelming response to our ticket sales. Our daytime morning services have already sold out, and we expect to have a full house at each of our services this year. We are excited for everything to come.”.
It was about two-and-a-half years ago that Etz Chayim members relocated to Wilkes from their 70-year-old building on Matheson in the North End. Granove reported last year that the move south has “proven to be a great success in many ways. Operational expenses are greatly reduced in the newer and more efficient space, and our congregation is seeing an increase in attendance at services, programs, and events due to their new, convenient location”.
Etz Chayim’s services’ will be led once again by Rabbi Kliel Rose (see related story about his departure for Ottawa immediately after Yom Kippur) and Cantor Tracy Kasner, while newly anointed Cantor Kevin McIntyre will be reading the Torah. There will also be a youth and family service with activities for kids of all ages.
For further information about Etz Chayim’s High holiday services, phone 204 589-6305 or email info@etzchayim.ca.
Congregation Shaarey Zedek, our community’s oldest and largest synagogue, would like to invite members of the community to join and experience “a season of Unity, Enlightenment, Invigoration, and Renewal with services in the Sanctuary,” says Dr. Rena Secter Elbaze, the congregation’s executive director.
“We anticipate that our services – featuring Senior Rabbi Carnie Shalom Rose, Rabbi Anibal Mass, and Cantor Leslie Emery – accompanied by the Shaarey Zedek Quartet and Ruach Choir with piano accompaniment – will be spiritually uplifting,” Elbaze says.
“Due to high demand, we are also delighted to offer two Family Services for Young Families, one in the morning and one in the afternoon, in the Tova Vickar Family Childcare Centre. These engaging services will be led by Rabbi Anibal Mass, with support from our Youth Band, Shinshinim – Israeli Youth Ambassadors, and dedicated volunteers.”
Looking back over the past year, Elbaze reports that Shabbat morning and weekday services have been attracting “a widening circle for prayer, learning, and breaking bread under the leadership of our dedicated clergy team”.
“Our Tova Vickar and Family Childcare Centre is fully operational,” she continues, “and is already recognized provincially for achievement and excellence and connecting childcare families to synagogue life.”
She adds that the congregation’s membership base is growing, with 98 families/ households having joined since July of last year – including new members and those who have re-joined – for a total of 228 people of all ages.
As well, she notes, the congregation’s sisterhood and the Hebros Men’s Group are thriving, drawing a broad demographic of participants seeking Jewish learning, camaraderie, and connection. As well, Elbaze adds, the Young Adult Group is engaging in synagogue life and gathering regularly for Shabbat dinners and Jewish holiday celebrations.
“Our Israeli Youth Ambassador program, the Shinshinim, is infusing youth programming with dynamism, creativity, and a meaningful connection to Israel” she points out.
Readers who want to contact the Shaarey Zedek about Yom Tov tickets can call the office at 204 452-3711 or email Rena at rena@szwinnipeg.ca.
As mentioned above, Temple Shalom will be holding High Holy Day services in the Berney Theatre at the Asper Campus. Rabbi Myriam Saitman, who received her ordination last year, noted in last year’s Jeiwsh Post pre-Yom Tov story, “We are looking forward to 10 days of introspection focused on teshuva and we invite our congregation to experience the message, the spirituality, the music, and the poetry of the High Holidays”.
Temple Shalom High Holiday services will, once again, be led by Rabbi Saitman, along with Cantorial Soloist David Vamos – accompanied by the Temple choir led by Janet Pelletier Goetze.
For further information about Temple Shalom’s Yom Tov services, phone 204-453-1625 or email tshalom1@gmail.com.
South end Winnipeg further offers a fourth liberal Jewish option in the form of Rabbi Matthew Leibl’s “Services on the River: A Modern High Holy Days”. This is the fourth year that Rabbi Leibl will be leading his own services at The Gates on Roblin.
Services will be on the second day of Rosh Hashanah, September 13, starting at 10:00 A.M., while the Kol Nidre service will be on September 20 at 6:00 P.M., with the Yom Kippur service the following morning at 10:00 A.M. Rabbi Leibl will again be joined by the husband-and-wife cantorial team of Justin Odwak and Sarah Sommer, leaders of the SOTR Quartet. New this year will be The Shofar Club Kids Program, led by Halley Ritter for children ages 4-12.
For tickets, email support@tobatickets.ca, or call (during office hours) 204-934-7564.
South Winnipeg’s orthodox options are the Adas Yeshurun Herzlia and the Lubavitch Centre. High Holy Day services at Adas Yeshurun will be led by Rabbi Yossi Benarroch – with Aden Benarroch serving as Chazzan Sheini. Adas Yeshurun has approximately 100 membership units and can comfortably accommodate 250 worshippers. Please call the synagogue office – at 204 489-6262. to confirm attendance before September 9.
The Lubavitch Centre has a capacity of between 200 and 300. There is no charge for davening at Chabad, nor do you have to register in advance.
Still with south Winnipeg – The Simkin Centre offers one more High Holy Day option. Services are all held in their multi-purpose room. Family members can join but priority seating is reserved for residents. Steven Hyman will lead the services along with the Simkin Centre Choir, directed by Bonnie Antel.
If you have any questions, contact Rabbi Matthew Leibl or Heather Blackman, Manager of Resident Experience, either by phone 204 589-9008 or email heather.blackman@simkincentre.ca, so that she knows how many to plan for.
In the North End, High Holiday service options are more limited. The Chevra Mishnayes in Garden City offers an egalitarian service. Synagogue president Rob Waldman reports that about 100 attended services last year and that he is expecting about the same this year. Services will be led by Al Benarroch. For further information phone the office at 204-338-8503.
Both the venerable House of Ashkenazi, the last of our community’s older-style Orthodox congregations, and the Chavurat Tefila Talmud Torah offer Orthodox services- with each attracting about 30 to 40 daveners for the High Holy Days. The latter will have Avi Posen back again to lead services while long time Cantor Adi Stoller will be back for another Yom Tov at the Ashkenazi.
While Camp Massad has also long offered a modified Yom Tov service, the camp at Sandy Hook will bel closed for Yom Tov this year while renovations are underway.
Yom Tov this year begins on Friday, September 11, in the evening.
Wishing all readers a sweet new year.
