UBC Family Practice Residency Program Kamloops, BC Welcome to - - PowerPoint PPT Presentation

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):

 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

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

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

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

 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

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

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

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

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)

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

 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

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

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

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

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

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.

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