UBC Family Practice Residency Program. Kamloops, BC

Transcription

1 UBC Family Practice Residency Program Kamloops, BC

2 Welcome to Kamloops!

3 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!

4 Our Vision To provide a comprehensive Residency Program that inspires Residents, Medical Staff and Health Care System Innovation

5 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, 2 nd 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

6 Skiing at Sun Peaks

7 Wakeboard Nationals 2011 (downtown!)

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

9 Spectacular hiking and camping

10 Farmer s Market Downtown Kamloops

11 Kamloops Art Gallery and Public Library

12 It speaks for itself

13 Royal Inland Hospital (we like it!)

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

15 Excellent golfing just miss the wild sheep!

16 Don t miss the wild lights at Christmas

17 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

18 This is us (Dr. Mitchell was working )

19 Our Curriculum Academic and Clinical Curriculum Outline

20 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

21 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 )

22 Academic Curriculum (Cont.) Other Presentations: Open Invite for other 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

23 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

24 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

25 Academic Curriculum (Cont.) Other: Case Presentations (2/Resident/year) Debates Etc.

26 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?

27 Curriculum Extras (Cont.) Resident Retreats (Each October and April)?Canoe Day?Ski Trips?Hiking Trips Christmas Party

28 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

29 Exclusive Blocks (6/26): Clinical Curriculum 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)

30 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

31 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)

32 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)

33 Weekly Schedule for 20/26 Blocks (80 Weeks) AM PM Monday Tuesday Wednesday Thursday Friday Internal Medicine (20) FP Primary Preceptor (20) Academic Surgery (12) FP Secondary Preceptors (32) Half-Day Pediatrics (12) FP Hospitalist (8) Emergency Medicine (12) FP Geriatrics/LTC (8) Half-Day Back Obstetrics & Gynecology (8) FP Obstetrics (8) with Primary Orthopedics & Anesthesia (8) FP Palliative Care (Hospice) (4) Preceptor Psychiatry (8)

34 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

35 Clinical Curriculum (Cont.) Usually Preceptor-Based Electives Any of above rotations, plus Dermatology, Radiology, Pathology, Ophthalmology, Addictions/Pain Management Organized by the resident May take place in Kamloops or elsewhere

36 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

37 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 )

38 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

39 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

40 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

41 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

42 Clinical Curriculum (Cont.) 8 Weeks (2 Blocks) in R2 year Mostly preceptor-based Rural Family Medicine Rotation Call: with MD s in community (1 st call) Possible Locations: All throughout BC ( draft procedure where residents match )

43 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

44 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

45 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

46 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

47 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)

48 Clinical Curriculum (Cont.) Internal Medicine Rotation (Cont.) 2x 4-Week Selective Preceptorships in Cardiology, Respirology, Gastroenterology, Nephrology, Neurology, Rheumatology, Oncology, Physiatry, Infectious Diseases/Microbiology

49 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

50 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

51 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

52 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

53 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

54 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.

55 Sample Timetable 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 B FP Intro 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 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 B OBGYN OBGYN Ortho Ortho ER ER Psych Psych FP 2 (B) FP 2 (B) FP Rural FP Rural FP Obs FP Obs FP 2 (A) FP 2 (A) Elective Elective FP 1 FP 1 FP Grad ER Peds Peds Peds ER Surgery Surgery Surgery FP 2 (A) FP 2 (A) FP Hosp FP Hosp FP Rural FP Rural FP 2 (B) FP 2 (B) FP 1 FP 1 Elective Elective FP Grad

56 Challenges and Opportunities (and of course some fun)

57 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!

58 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.

59 THANK YOU