Pediatric Rheumatologist Honoured with Council Award

Council Award recipient, Dr. Rayfel Schneider
Council Award recipient, Dr. Rayfel Schneider

Dr. Rayfel Schneider

At its March 2019 meeting, the College presented its Council Award to Dr. Rayfel Schneider, an international leader in pediatric rheumatology.

He has been at the forefront in the development of new treatments and standards of care in juvenile arthritis and associated inflammatory diseases.

Dr. Schneider is a staff physician at The Hospital for Sick Children (SickKids) and is currently a Professor of Pediatrics and the Associate Chair in the Department of Pediatrics at the University of Toronto. He previously served as the Chief of the Division of Pediatric Rheumatology at SickKids and as the university’s Pediatric Rheumatology Program Director.

Over the course of his 30-year career, Dr. Schneider has built a solid reputation as a devoted and talented physician and is, viewed by peers, co-workers patients and families as being extremely knowledgeable and caring. He is a key contributor to ground-breaking pediatric rheumatology research and his scientific contributions have led to new biologic therapies to manage juvenile arthritis – changing the trajectory and prognosis for young patients through more effective, less toxic treatments.

In his roles as academic and a clinician, Dr. Schneider has trained and mentored hundreds of medical students, residents and interns. Former trainees, many of whom are now also respected leaders in pediatric rheumatology, acknowledge him as a major influence on their careers.

We recently spoke to Dr. Schneider about his life and career:

What made you choose to leave South Africa for Canada?
After my internship, I started training in general pediatrics in South Africa, which was excellent. However, sub-specialty training to care for children with less common or chronic conditions was not as well developed. When the opportunity arose to join one of the best training programs in the world at SickKids, where I knew I would be able to get this specialized training, I jumped at this chance of a lifetime. And SickKids was a wonderful place to train. Throughout my fellowship, training, and faculty appointments, I have been the beneficiary of outstanding role models who were wise, generous and shared their expertise beyond my expectations.

How did you develop your interest in pediatric rheumatology?
In my early years in pediatric training at the hospital, I was impressed by a small group of dynamic young faculty who had recently started a division of rheumatology. At the time, pediatric rheumatology was a nascent subspecialty in Canada, with only a few physicians with experience and formal training. I hadn’t seen a lot of patients with these rare inflammatory diseases, but enough to see the devastating effects on children and the awful side effects of the few available treatments. I was excited by the opportunity to train with this group and the potential for transformative care in the subspecialty.

You work in a relatively small subspecialty, do you find that challenging?
Not at all. While we are indeed a small group of specialists who deal with challenging conditions, we are also a collegial and collaborative group – certainly, in Canada, we all know each other. And the collaborative nature of the specialty has allowed for national and international research efforts that would not have been possible in a single centre or country. And the rewards are incredible. We encounter children diagnosed with chronic diseases at a very young age, so as a physician, you get to share a journey with patients and families. You can never be quite sure where the journey will take you, but it can be inspirational, filled with courage, resilience and positivity.

What makes you most proud in your academic work?
I’m most gratified by the relationships that have developed with the trainees I’ve known over the years; to see them transition from trainees to colleagues, friends and collaborators, and successful leaders in their own centres. SickKids trains physicians from all over Canada and around the world, so there is now an international network of alumni I can call to consult on difficult cases. Just recently, when I hit a crossroad in treating a patient, I found myself contacting a former trainee who has experience with a treatment approach I was considering. To be able to say to him “I need your help’ was quite a lovely moment.

How did you come to focus so much of your scholarly work on systemic juvenile idiopathic arthritis?
Juvenile arthritis has many subtypes, but SJIA is particularly severe because the inflammation affects not just the joints with aggressive arthritis, but potentially multiple organs. I did a study on predictors of outcome in SJIA during my fellowship and it launched my interest. When I joined the rheumatology faculty, my mentors encouraged me to start an SJIA clinic. There were really no effective treatments back then, except for steroids which had terrible side effects. We are fortunate that research has led to better understanding of the pathogenesis of the disease and new treatments. Treatment has more or less moved from steroids to new biologic agents which are very effective. There are still frontiers to cross for those children who don’t respond well, but for the majority of patients, outcomes have improved dramatically.

Tell us about your family.
My wife, Rochelle, and I have been married for 36 years – in fact we got married just four months before we left South Africa for Canada. I was doing my internship then and we could only take two days off for the wedding because my vacation time was reserved for our move to Canada. We raised two kids in Toronto, a great city for us, and we now have five grandchildren. Unfortunately, they don’t live close by, but frequent visits and almost daily FaceTime go a long way to keeping us closely connected.