Submersion Injuries Richard Dionne MD CCFP-EM Avik Nath MD CCFP EM March 21, 2013.
UBC Family Practice Residency...
Transcript of UBC Family Practice Residency...
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UBC Family Practice Residency Program
Kamloops, BC
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Welcome to Kamloops!
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Goals of our presentation
To provide information about Kamloops and our program.
To have you understand our curriculum.
To outline challenges and opportunities.
Time for discussion, questions and answers.
Excitement!
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Our Vision
To provide a comprehensive Residency Program that inspires
Residents, Medical Staff and Health Care System Innovation
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Kamloops
Friendly, welcoming community of 90,000 people
Referral center for the 125,000 citizens of the Thompson region
Tertiary care hospital with 244 beds, 2nd busiest ER and trauma center in BC
Approximately 1200 deliveries per year, excellent OB and NICU experience
Committed, diverse group of family doctors and specialists
Lots to do! From outdoor recreation and sports to cultural activities
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Skiing at Sun Peaks
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Wakeboard Nationals 2011 (downtown!)
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Awesome mountain biking (we have a world champion living here!)
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Spectacular hiking and camping
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Farmer’s Market Downtown Kamloops
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Kamloops Art Gallery and Public Library
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It speaks for itself
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Royal Inland Hospital (we like it!)
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TCC on TRU Campus (we are the tournament capital!)
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Excellent golfing – just miss the wild sheep!
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Don’t miss the wild lights at Christmas
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Who are we?
Dr. Selena Lawrie – Site Director
Dr. Kraig Montalbetti – Curriculum
Dr. Shirley Sze – Faculty Development
Dr. Tracey Smillie – Behavioural Medicine
Dr. Peter Gorman – Assessment & Evaluation
Dr. Ian Mitchell – Scholar
Laurel Thompson – Site Coordinator
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This is us (Dr. Mitchell was working )
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Our Curriculum Academic and Clinical Curriculum Outline
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Academic Curriculum “Academic Half-Day”: Every Wednesday morning throughout the 2-year
curriculum
Lectures/Case Presentations/Seminars etc. to prepare both for MCCQE-2/CCFP Exams and for practicing as an FP
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Academic Curriculum (Cont.) “Keynote” Topic:
1-2 hour presentation, based on CFPC’s 100 “Priority Topics and Key Features”
1/week over the 2-year curriculum
Delivered by Specialists (“Stroke”) or FP’s (“Travel Medicine”)
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Academic Curriculum (Cont.) Other Presentations:
“Open Invite” for other 0.5-2 hour lectures/workshops/seminars
Examples: WCB, Disaster Medicine, Cultural Education, Medical Leadership, Billing
Delivered by Specialists, FP’s, Other Healthcare Staff, as well as others from the community
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Academic Curriculum (Cont.) Behavioural Medicine:
Sessions focussed on counselling, psychotherapy, family therapy, lifestyle counselling, ethics, medical errors, etc. organized by the Site Faculty for Behavioural Medicine
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Academic Curriculum (Cont.) Evidence-Based Medicine/Research:
Sessions focussed on Critical Appraisals (2/R1), Evidence-Based Reviews (1/R2), etc.
Instruction/review/presentations of FP Audit Projects (R1) and Resident Research Projects (R2)
Organized by the Site Faculty for Scholar/ERI
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Academic Curriculum (Cont.) Other:
Case Presentations (2/Resident/year)
Debates
Etc.
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Curriculum Extras R1 Orientation (Program-wide and Site-specific components): Late June
Resident Research Day (UBC-Wide)
ACLS, ALSO, NRP covered by UBC
ALARM, PALS, ATLS also available
OSCE/General Exam Prep: MCCQE-2/CCFP
Exams: MCCQE-2/CCFP (May of R2 Year)
Procedure Seminars?
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Curriculum Extras (Cont.) Resident Retreats (Each October and April)
?Canoe Day
?Ski Trips
?Hiking Trips
Christmas Party
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Clinical Curriculum
Scheduled into 26 4-week “blocks” ~52% delivered by FP’s ~30% delivered by Specialists ~8% Electives (2 blocks) ~10% Academic Half-Days
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Clinical Curriculum “Exclusive Blocks” (6/26): Family Practice Introductory Month (July of R1 Year- with Primary FP
Preceptor) Rural Practice (2 months in R2 Year) Electives (2 months in R2 Year) Family Practice Graduation Month (June of R2 Year- with Primary FP
Preceptor)
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Clinical Curriculum (Cont.) Academic Half-Day: Each Wednesday morning
“Half-Day Back”: Resident in office with their Primary FP Preceptor each Wednesday afternoon, throughout the 2-year curriculum, to establish continuity of care with a group of patients
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Clinical Curriculum (Cont.) 2 days/week (Monday-Tuesday or Thursday-Friday): Family Practice time,
with: Primary FP Preceptor (20 weeks) Secondary FP Preceptors (16 weeks x2) FP Hospitalist (8 weeks) FP Geriatrics/Long-Term Care (8 weeks) FP Obstetrics (8 weeks) FP Palliative Care (Hospice) (4 weeks)
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Clinical Curriculum (Cont.) 2 days/week (Monday-Tuesday or Thursday-Friday): Specialty time, with: Internal Medicine (20 weeks) Surgery (12 weeks) Pediatrics (12 weeks) Emergency Medicine (12 weeks) Obstetrics & Gynecology (8 weeks) Orthopedics & Anesthesia (8 weeks) Psychiatry (8 weeks)
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Monday Tuesday Wednesday Thursday Friday
AM
FP Primary Preceptor (20) FP Secondary Preceptors (32)
FP Hospitalist (8) FP Geriatrics/LTC (8)
FP Obstetrics (8) FP Palliative Care (Hospice) (4)
Academic Half-Day
Internal Medicine (20) Surgery (12)
Pediatrics (12) Emergency Medicine (12)
Obstetrics & Gynecology (8) Orthopedics & Anesthesia (8)
Psychiatry (8)
PM
Half-Day Back with Primary
Preceptor
Weekly Schedule for 20/26 Blocks (80 Weeks)
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Clinical Curriculum (Cont.) Call: Mostly with relevant specialty rotation, max 1:5, should include some
weekends
“Post-Call”: If resident on call overnight, off at 12:00 the next day
Vacation: 4 weeks/year, taken out of rotation time, though only 25% of any given rotation may be missed
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Clinical Curriculum (Cont.) Electives
Usually Preceptor-Based
Any of above rotations, plus Dermatology, Radiology, Pathology, Ophthalmology, Addictions/Pain Management
Organized by the resident
May take place in Kamloops or elsewhere
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Clinical Curriculum (Cont.) Particular Strengths
Several specialty residents to learn from and medical students to teach but not so many as to take away learning opportunities
Specialists in almost every field yielding high breadth of exposure and elective options
Our ER serves as a regional trauma center
Great city with many recreational opportunities
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Clinical Curriculum (Cont.) Rotation objectives as per the CFPC’s 100 “Priority Topics and Key Features”
and 65 Core Procedures
However, the main idea is to provide residents with an exposure to the specialty as well as the knowledge they need to know in that area to practice Family Medicine (quality work-ups, when to refer…)
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Clinical Curriculum (Cont.) Family Medicine Curriculum
Office with Primary Preceptor (116 days over the 2-year program):
Family Practice Introductory Month (July of R1 Year)
Family Practice Graduation Month (June of R2 Year)
Half-Day Back (each Wednesday afternoon)
2 days/week (Monday-Tuesday or Thursday-Friday): 20 weeks
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Clinical Curriculum (Cont.) Family Medicine Curriculum (Cont.)
Office with Secondary Preceptors (32 days over the 2-year program with each secondary preceptor):
2 days/week (Monday-Tuesday or Thursday-Friday): 32 weeks
Delivered as 8 weeks with each of 2 different preceptors in each year of the program
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Clinical Curriculum (Cont.) Family Medicine Curriculum (Cont.)
Promotes continuity of care/exposure for a select group of patients in one’s “Primary Practice” as well as exposure to different practice styles and patient populations
Allows for a gradual increase in independence/patient volumes throughout the 2-year program
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Clinical Curriculum (Cont.) Family Medicine Curriculum (Cont.)
Follow along several pregnancies (pre-natal appointments + deliveries) throughout the R1 year (TRFO clinic)
Follow along Long Term Care and Hospice patients from Primary Preceptor’s practice throughout the R1 and R2 years
Exposure to PT, OT, SLP, Chiro, Massage, Pharmacy, Pedorthist, Travel Medicine, WCB
Call: with current preceptor, or with concurrent specialty rotation
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Clinical Curriculum (Cont.) Rural Family Medicine Rotation
8 Weeks (2 Blocks) in R2 year
Mostly preceptor-based
Call: with MD’s in community (1st call)
Possible Locations: All throughout BC (“draft” procedure where residents “match”)
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Clinical Curriculum (Cont.) FP Hospitalist Rotation
2 days/week (Monday-Tuesday or Thursday-Friday): 8 weeks
On “off-days”, could round on patients seen the other days to increase continuity of exposure
Mostly preceptor-based
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Clinical Curriculum (Cont.) FP Geriatrics/Long-Term Care Rotation
2 days/week (Monday-Tuesday or Thursday-Friday): 8 weeks
Rounds with LTC Family Physicians
Attend Care Conferences
Geriatric Psychiatry Elderly Services Program
Ponderosa Respite/CCU/Pathways to Home
Home Care and LTC Assessments
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Clinical Curriculum (Cont.) FP Obstetrics Rotation
2 days/week (Monday-Tuesday or Thursday-Friday): 8 weeks
With TRFO and Family Physician, time spent in clinic for pre-natal appointments, on 3W for ward rounds, and in LDR for deliveries
Follow along several pregnancies (pre-natal appointments + deliveries) throughout the R1 year with TRFO clinic
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Clinical Curriculum (Cont.) FP Palliative Care Rotation
2 days/week (Monday-Tuesday or Thursday-Friday): 4 weeks
Round on Patients/Assist with Admissions (Hospice and Hospital patients)
Home Visits
Discuss cases with Palliative On-Call MD or relevant FP MRP
Attend Care Rounds
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Clinical Curriculum (Cont.) Internal Medicine Rotation
2 days/week (Monday-Tuesday or Thursday-Friday): 20 weeks
6 Weeks with consulting internist, ward rounds and care
2 Weeks ICU
4 Weeks in clinics (Outpatient offices, EST’s, MIBI Scans, VIP- RIH and TCC, PFT Lab, Lung Health Clinic, DMEC, EMG lab, TIA Clinic, Sleep Lab, Renal Clinic, Liver Clinic, ID Clinic)
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Clinical Curriculum (Cont.) Internal Medicine Rotation (Cont.)
2x 4-Week Selective Preceptorships in Cardiology, Respirology, Gastroenterology, Nephrology, Neurology, Rheumatology, Oncology, Physiatry, Infectious Diseases/Microbiology
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Clinical Curriculum (Cont.) Surgery Rotation
2 days/week (Monday-Tuesday or Thursday-Friday): 12 weeks
Mixture of office, hospital on-call, outpatient clinics, and OR time
8 Weeks General Surgery (2 Preceptors x 4 weeks each)
4-Week Selective Preceptorship in Neurosurgery, Otolaryngology, Plastic Surgery, Urology, Vascular Surgery
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Clinical Curriculum (Cont.) Pediatrics Rotation
2 days/week (Monday-Tuesday or Thursday-Friday): 12 weeks
4 Weeks Inpatient: Hospital Consults (calls to ER, C-Sections, etc.)/ 5S Ward rounds/ Nursery Rounds
8 Weeks Outpatient: Offices, Homecare Nursing Visits (Pre and Post-Partum), Breastfeeding Clinic, Public Health Clinic (Immunizations, SLP, Hearing), Child/Infant Development Center, SCAN Clinic, IHCAN Clinic, Diabetes Clinic, + Child Psychiatry
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Clinical Curriculum (Cont.) ER Rotation
2 days/week (Monday-Tuesday or Thursday-Friday): 12 weeks
Various preceptors, Various shifts (including weekends)
Trauma Team Leader: ?1-2
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Clinical Curriculum (Cont.) OBGYN Rotation
2 days/week (Monday-Tuesday or Thursday-Friday): 8 weeks
3W Ward Rounds
Hospital Consults (On-Call) (calls to ER, labour complications, vacuum/forecep deliveries, etc.)
Colposcopy clinic, ACU, Gynecology OR
Office gynecology and obstetrics
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Clinical Curriculum (Cont.) Orthopedics & Anesthesia Rotation
2 days/week (Monday-Tuesday or Thursday-Friday): 8 weeks
2 Weeks Anesthesia (Pre-op clinic, OR)
6 Weeks Orthopedics: (Mixture of Hospital/ ER Consults, office orthopedics, Cast Clinic, Acute Knee Clinic, and OR)
Organized as 2x 3-week Preceptorships
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Clinical Curriculum (Cont.) Psychiatry Rotation
2 days/week (Monday-Tuesday or Thursday-Friday): 8 weeks
Mixture of: Office Psychiatry Hospital Consults/1S Rounding Mental Health, Inpatient and Outpatient Groups, Forensics, Hillside,
Southills, King Street, AA, etc.
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R1 July 1-July 30
July 31-Aug 27
Aug 28-Sept 24
Sept 25-Oct 22
Oct 23-Nov 19
Nov 20-Dec 17
Dec 18-Jan 14
Jan 15-Feb 11
Feb 12–Mar 11
Mar 12-Apr 8
Apr 9-May 6
May 7-June 3
June 4-June 30
A FP Intro ER IM IM IM IM IM Surgery Surgery Surgery Peds Peds Peds
FP 1° FP 1° FP 1° FP 2° (B) FP 2° (B) FP 2° (A) FP 2° (A) FP Pal FP LTC FP LTC FP Hosp FP Hosp
B FP Intro OBGYN OBGYN Ortho Ortho Psych Psych ER IM IM IM IM IM
FP Obs FP Obs FP 2° (A) FP 2° (A) FP 1° FP 1° FP 1° FP Pal FP LTC FP LTC FP 2° (B) FP 2° (B)
R2 July 1-July 29
July 30-Aug 26
Aug 27-Sept 23
Sept 24-Oct 21
Oct 22-Nov 18
Nov 19-Dec 16
Dec 17-Jan 13
Jan 14-Feb 10
Feb 11–Mar 9
Mar 10-Apr 6
Apr 7-May 4
May 5-June 1
June 2-June 30
A OBGYN OBGYN
FP Rural FP Rural Ortho Ortho ER ER
Elective Elective Psych Psych
FP Grad FP 2° (B) FP 2° (B) FP Obs FP Obs FP 2° (A) FP 2° (A) FP 1° FP 1°
B ER Peds Peds Peds
FP Rural FP Rural ER Surgery Surgery Surgery
Elective Elective FP Grad FP 2° (A) FP 2° (A) FP Hosp FP Hosp FP 2° (B) FP 2° (B) FP 1° FP 1°
Sample Timetable
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Challenges and Opportunities (and of course some fun)
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Challenges and Opportunities
New site – you will be the first
New faculty and preceptors
New curriculum
You will have an opportunity to influence and shape our site program
Don’t forget the skiing!
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Our commitment: Excellent clinical experience and academic teaching
A solid foundation in evidence based medicine and research
To help you become a professional, competent family physician able to balance a demanding career with personal interests and responsibilities
Excitement! We are a committed, diverse group of enthusiastic doctors ranging from young to experienced. We want to help you succeed.
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THANK YOU