Welcome to Victoria! CaRMS 2015
Victoria BC's capital Population: 420, 000 in region Great weather, less rain than Vancouver (608mm/yr v. 1589mm/yr) Friendly, active Great size, easy to commute around by bike, foot, car, longboard!
Victoria Very bikable Amazing outdoor recreational opportunities Hiking, kayaking, cycling, horseback riding, running... Gulf Islands, Tofino... Many provincial parks Mt. Washington
The Program The largest UBC family practice training site For 2015-2016: 18 CMG and 4 IMG R1 positions available Over 40 FP residents in total ~20 Royal College - R1 only Obs/Gyn, Anaesth, Psych, Pathology, Radiology, etc. Royal College Elective/Senior Residents Internal Medicine, EM, Cardiology, General Surgery, Psychiatry
The Program Family Medicine residents form the core of the medical team on every specialty service and rotation. You are never just a family practice resident
The Program FACULTY/ADMINISTRATION Dr. Lys Fonger, Site Director Josie Terlesky, Program Administrator Stephanie Goult, Academic and Site Faculty Support Coordinator Leanne Ruston, Assessment and Evaluation Coordinator CHIEF RESIDENTS R1 Reps Jerusha Millar Talia Brennan Shereen Nessim Aidan Wharton
The Hospitals ROYAL JUBILEE HOSPITAL Victoria s central hospital CTU, ICU, Medicine, Cardiology, Gen Surg, Plastics, Psychiatry, Hospitalist Hospital library, classrooms, teleconference facilities New on-call facilities Resident lounge UBC IMP
New RJH Patient Care Centre New 500-bed Patient Care Centre at RJH site open since spring 2011 Site of CTU, Specialty wards, single rooms Very nice facility!
The Hospitals VICTORIA GENERAL HOSPITAL Trauma centre for Vancouver Island 350 beds ICU, General Surgery, Gynecology, Obstetrics, Pediatrics, Hospitalist Hospital library, classrooms, teleconference facilities New on-call facilities Combo med student/resident lounge 15min car, 30min bike, a long walk from downtown Galloping Goose Trail
Sample R1 rotation Block 1 Block 2 Block 3 Block 4 Block 5 Block 6 Block 7 Intro to Family Medicine Horizontal Family/OB /Gyne Horizontal Family/OB /Gyne Horizontal Family/OB /Gyne Horizontal Family/OB /Gyne Elective/ Vacation (2+2) ICU or Surg Spec Block 8 Block 9 Block 10 Block 11 Block 12 Block 13 Internal Medicine Pediatric Inpatient Pediatric Ambul Cardio/ CCU Elective/ Vacation (2+2) Emergency Basically a Rotating Internship, with Half-Days back to your main Community Family Medicine Office, plus Academic Half-Day **4 weeks total elective, 2 week vacation blocks
Rotations: R1 INTRO TO 4wk Community preceptor-based 1:1 Light call (4/month) with the RJH House Physician Behavioral medicine (small group sessions) HORIZONTAL FAMILY/ OB / GYNE (women s health) 16 weeks At your base clinics (FP ¾ & Obs ¼ ) as well as clinics with gynecologists Plus Half-day back throughout the year 4-7 call shifts per month of in-hospital house call and OB call House call! 300+ sick patients, you are the physician overnight. Also, great support
Rotations: R1 OBSTETRICS AND GYNAECOLOGY (part of horizontal) 1 week on High-Risk Antepartum Ward 2 weeks-equivalent Gyne Preceptor-based (longitudinal) 80% of deliveries are by FP-OBs: Excellent exposure to fullservice FM ~ 3 000 deliveries/year; 20-30 deliveries/resident/rotation Opportunities to pick up more OB shifts Specialty clinics Staff obstetricians and gynecologists Sexual Health, Genetics, Colposcopy, Fertility Clinic, Maternal Fetal Medicine, etc.
Rotations: R1 MEDICINE (CTU and Cardiology) 8wk CTU ward 4 weeks Cardiology or CCU ward 4 weeks (2 weeks each) Team-based at RJH 1-in-4 call Internal Medicine Senior Residents from Vancouver Lots of teaching Med students
Rotations: R1 PAEDIATRICS 8wk 4wk Inpatient Pediatrics 4wk Outpatient Pediatrics clinics 1-in-5 call Team-based ward at VGH Preceptor-based outpatient community clinics Specialty clinics Child Psychiatry Endocrine Cardiology Developmental Ortho Breastfeeding Allergy
Rotations: R1 EMERGENCY 4wk Cowichan District Hospital in Duncan, or Victoria Hospitals 16-17 eight-hour shifts Work with Royal College, CCFP-EM Great teaching Award winning rotation Tons of procedures (lacs, digital blocks, splint/casts, RSI, occasional polytrauma) Accommodation provided in Duncan (45 min drive from Vic, easily commuted if you want)
Rotations: R1 Selective: ICU 4wk 1-in-4 call 2wk at RJH: CCU/CVU, post-op 2wk VGH: trauma, neurosurg, stroke Excellent teaching, brilliant staff: basic science and physiology will finally make sense, opportunities for procedures (lines, LP, intubation) No elbow-to-elbow like in big centres, 1 on 1 with intensivist Residents from other BC FP programs often come to Victoria for ICU elective
Rotations: R1 Selective: Surg Subspecialty 2 wk/2 wk ENT/Neurosurgery/Vascular Surgery/Rad Onc/Thoracics/Ortho/ Plastics 1-in-4 call on average Clinic/OR/Office *** No surgical specialty residents, great 1-on-1 working with staff
Rotations: R1 ELECTIVE 2wk x 2 Under-serviced populations project Intra/inter provincial/national Great opportunities in Victoria for Inner-City Medicine, Methadone Clinic, HIV/AIDS Youth Clinic Palliative Care Sports Medicine
R2 Rotation Block 1 Block 2 Block 3 Block 4 Block 5 Block 6 Block 7 Family Medicine Longitudinal (16) Ortho/MSK (2+2) Psych (2 or 4) Elective (4) Block 8 Block 9 Block 10 Block 11 Block 12 Block 13 Rural Family Medicine (8) Elective (4) Elective (4) Procedural skills (2) Vacation 4 weeks - flexible Palliative (2 or 4) Family Practice Practicum (4)
Rotations: R2 (Integrated/Horizontal 28wks) With both primary and obs preceptor Integrated with Psychiatry, Ortho/Sports Med, Elective RURAL 8wk Province wide program with a lottery based match You run the show : clinics, ER, surg assist, obs, etc Possible sites include: Inuvik, Haida Gwaii, Northern BC, Interior BC, North Island NEW Enhanced Rural Training allows for total of 16 weeks of rural if desired in R2!!
Rotations: R2 ORTHOPAEDICS 2wk OR, clinic, cast clinic, no Ortho resident Very light call SPORTS MEDICINE 2wk Outpatient clinic with experienced FPs No call!! PSYCHIATRY 2 or 4wk Emergency Psychiatry, Outpatient mental health clinics, Ward, Psychiatry ICU Work with Victoria Psychiatry post-grad program residents 4 on-call shifts over 4wk
Rotations: R2 PROCEDURAL SKILLS 2 wks Replaces old 4 week General Surgery block Mandatory two week block to improve procedural skills May choose from a variety of experiences depending on own interests E.g. anaesthesia, lumps and bumps/plastic surgery, ICU, ER, general surgery, subspec surgery, hospitalist *** Removing mandatory Gen Surg rotation was residentled initiative three years ago, good feedback since. Still ample opportunity to do so if desired
Rotations: R2 ELECTIVE 4 weeks Horizontal, 8 weeks block Can be local or outside of BC/Canada Up to 4 wk international In total only 4 weeks outside BC over 2 years
Academics ACADEMIC HALF-DAYS Every Wednesday afternoon Resident-led Guideline Presentations on CCFP objectives. *Preceptor/Faculty facilitator McMaster Modules GP and specialist presentations Simulation rounds Giant Sim Suite in construction!! Fluid rounds SPECIALTY ROUNDS: - every service has dedicated teaching rounds
Academics COURSES some free, some very nicely subsidized NRP ALARM Soft Tissue Trauma by Plastic surgeons! PALS Palliative Care course ATLS optional in R2 IUD workshop CCFP Exams Exam prep by preceptors and site faculty 5 days off before exam MOCK CODES: Monthly, organized by ER docs and CCU/ICU nurses. Valuable experience with all team members/learners present: RTs, RNs, MDs etc. FP residents run the code!
Medical Student Teaching UBC ISLAND MEDICAL PROGRAM 3rd- and 4th-year clerks on wards and clinics with you, sometimes on call with you! Lots of new infrastructure: new library, call rooms, etc. Opportunity to participate in teaching clinical exam skills to 2 nd and 3 rd year students Not too many learners on any service Teaching is a great way to consolidate your own learning!
Education/Research RESEARCH PROJECTS R1: Practice Improvement Project" Practice Audit warm-up for R2 project R2: Research scholarly project Province wide requirement with research day in June of R2 in Vancouver EDUCATION FUND $700/2yr for books, courses, conferences, etc
Resident life
Resident life PROS Friendly, athletic city, lots to do CONS Housing can be expensive Laid back island atmosphere Close-knit residents, get to know everyone Restaurants, mmmmm Large resident community - always something going on (surf trips, ski trips, board game nights, etc) Less nightlife than Vancouver or Toronto (although more than most other BC sites) Smaller city so less robust public transit Living on an island Tons of great outdoors: hiking, running and cycling (year round!), swimming, skiing, surfing, climbing, etc. Living on the island!
Strengths Pro-Family Medicine culture Family physicians working Emerg, Obstetrics, House Despite being tertiary care centre, GPs are still the backbone of care, and are well-respected. Unique setting Small enough that staff get to know you and trust you Never "just a Family Resident" Friendly, laid-back atmosphere Lots of social activities outside of working hours Your staff may invite you to go for a run/ride after work!
Strengths FM residents are key on every service (well respected) Often you're the only Resident working directly with staff FM residents get to do a lot: Running codes (if you want) Any procedure (no competition) Staff always available you in case you need them Excellent Program Director and Admin Staff (very understanding!) Exposure to Aboriginal Health Great life outside of work, great place to live!
Strengths Can shape the program to YOUR interests more or less OB, acute care, ER, etc. Site graduates ready for and do well in various settings 50% go rural (and feel ready to do so) 50% go urban Strong candidates for R3 programs Successful EM R3 matching every year 100% EM matching this year (2 for 2), and last year (3 for 3) Successful applicants to Public Health, Palliative, etc. The program has a reputation of producing strong residents, likely because of the volume we see and independence we have
Not-so-strengths Less contact with Royal College and senior residents than urban Vancouver sites Little resident-to-resident teaching (IM & cardio) Less frequent organized bedside teaching More on-the-fly style with your preceptor Requires self-motivation and ability to seek out own experiences (only a weakness if you want to be told what to do) the opportunities are there, just ask
Is Victoria the site for you? MAYBE NOT, IF YOU... Want to train at a major academic centre Need a lot of structure Want to do 1 in 7 call with no weekends, and a hot tub in the call room. (*no such program exists. Trust me, I looked)
Is Victoria the site for you? MAYBE, IF YOU... Are self-motivated and can function independently Want to be respected as a Family Practice resident Want to be respected as a Victoria grad Are looking for a fun, comprehensive, "full-service Family Medicine" program Want to live a (mostly) balanced life! Want to finish your Family Medicine training feeling fully prepared to start practicing anywhere
CHIEF RESIDENTS Shereen Nessim shereennessim@gmail.com Jerusha Millar jerushamillar@gmail.com R1 Reps: Aidan Wharton aidanwhartonfp@gmail.com Talia Brennan taliabrennan@gmail.com
This could be you!
Hope to see you this July! Questions?