UBC Family Practice Residency Program · Pediatrics Rotation 2 days/week (Monday-Tuesday or...

UBC Family Practice Residency Program

Kamloops, BC

Welcome to Kamloops!

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!

Our Vision

To provide a comprehensive Residency Program that inspires

Residents, Medical Staff and Health Care System Innovation

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

Skiing at Sun Peaks

Wakeboard Nationals 2011 (downtown!)

Awesome mountain biking (we have a world champion living here!)

Spectacular hiking and camping

Farmer’s Market Downtown Kamloops

Kamloops Art Gallery and Public Library

It speaks for itself

Royal Inland Hospital (we like it!)

TCC on TRU Campus (we are the tournament capital!)

Excellent golfing – just miss the wild sheep!

Don’t miss the wild lights at Christmas

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

This is us (Dr. Mitchell was working )

Our Curriculum Academic and Clinical Curriculum Outline

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

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”)

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

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

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

Academic Curriculum (Cont.) Other:

Case Presentations (2/Resident/year)

Debates

Etc.

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?

Curriculum Extras (Cont.) Resident Retreats (Each October and April)

?Canoe Day

?Ski Trips

?Hiking Trips

Christmas Party

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

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)

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

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)

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)

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)

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

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

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

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…)

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

Clinical Curriculum (Cont.) Family Medicine Curriculum (Cont.)

Office with Secondary Preceptors (32 days over the 2-year program with each secondary preceptor):


Delivered as 8 weeks with each of 2 different preceptors in each year of the program


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


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

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”)

Clinical Curriculum (Cont.) FP Hospitalist Rotation


On “off-days”, could round on patients seen the other days to increase continuity of exposure

Mostly preceptor-based

Clinical Curriculum (Cont.) FP Geriatrics/Long-Term Care Rotation


Rounds with LTC Family Physicians

Attend Care Conferences

Geriatric Psychiatry Elderly Services Program

Ponderosa Respite/CCU/Pathways to Home

Home Care and LTC Assessments

Clinical Curriculum (Cont.) FP Obstetrics Rotation


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

Clinical Curriculum (Cont.) FP Palliative Care Rotation


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

Clinical Curriculum (Cont.) Internal Medicine Rotation


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)

Clinical Curriculum (Cont.) Internal Medicine Rotation (Cont.)

2x 4-Week Selective Preceptorships in Cardiology, Respirology, Gastroenterology, Nephrology, Neurology, Rheumatology, Oncology, Physiatry, Infectious Diseases/Microbiology

Clinical Curriculum (Cont.) Surgery Rotation


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

Clinical Curriculum (Cont.) Pediatrics Rotation


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

Clinical Curriculum (Cont.) ER Rotation


Various preceptors, Various shifts (including weekends)

Trauma Team Leader: ?1-2

Clinical Curriculum (Cont.) OBGYN Rotation


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

Clinical Curriculum (Cont.) Orthopedics & Anesthesia Rotation


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

Clinical Curriculum (Cont.) Psychiatry Rotation


Mixture of: Office Psychiatry Hospital Consults/1S Rounding Mental Health, Inpatient and Outpatient Groups, Forensics, Hillside,

Southills, King Street, AA, etc.

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

Challenges and Opportunities (and of course some fun)

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!

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.

THANK YOU

UBC Family Practice Residency Program · Pediatrics Rotation 2 days/week (Monday-Tuesday or...

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