Abbotsford-Mission

Site Director Message

Dear Future Residents,

Welcome to your CaRMs match year. There are a lot of choices to be made this year and I’m sure some of you will be wondering why you should consider choosing Abbotsford-Mission.

We are in our seventh year as a site. We have 17 wonderful residents and will be looking for 8 more highly motivated and hardworking individuals.

Family Practice remains strong in Abbotsford and Mission. As a group we believe that family doctors should be well trained as generalists and should have the skills to provide ongoing care to the entire population. We believe that family doctors should be able to work in hospital and community settings and that you should be mentored by physicians who currently do this. The only way to get good at this is through seeing patients — lots of patients.

Our site is busy and you will not be competing with other programs for patients. For example, our maternity department delivered over 2000 babies last year. Our ER department receives over 50,000 visits per year. The Abbotsford Regional Hospital and Cancer Center is a 300 bed facility in which family doctors and specialists work closely together. Our proximity to and distance from Vancouver put us in a unique position where we have access to tertiary care but manage our acute patients more so than in larger urban centers. For more specifics about our program, please take a look at the Program Information section of this website.

What will it be like to live here? For those not from the West Coast, be prepared to bring your winter gear… but just so you can go skiing! We have hot summers and moderate (wet) winters. We get snow on average less than 1 week per year. We have access to Vancouver in 1 hour, to Seattle in 2 hours, and to Whistler in 3 hours. Your friends and family can visit by flying directly to Abbotsford and it is a part of the Lower Mainland that is still affordable (and easy to drive around in, with minimal traffic). Of course, there are also all the usual outdoor BC activities, with easy access to hiking, water, golfing, skiing, and whatever sport you want!

Why should you come here? In the end, it’s all about you. Our site is built around our residents. You will become part of our team, and you will help to continually change and improve your learning experience.

Our track record so far tells us that we make happy residents!  Yes, you will work hard, you will be challenged, but you will make enduring friendships, and you’ll have a lot of fun!

Dr. Holden Chow

j.holden.chow@fraserhealth.ca

Chief Resident Message

Welcome to Abbotsford-Mission!

Abbotsford is a suburban regional center with a population of over 100,000.  It is home to the brand new Abbotsford Regional Hospital and Cancer Centre.  Mission is located about 10 minutes away by car (or a beautiful bike ride over the Mission Bridge).  It is home to the smaller Mission Memorial Hospital, and although it is not the site of any core rotations, it does offer optional learning opportunities for those that want additional emergency medicine and hospice experience.

Our program is a close one, just like the group of generalist and specialist physicians practicing in Abbotsford.  Thanks to both the department of family practice and our specialist colleagues we have a learning-focused environment with minimal service requirements.  Family doctors have a strong presence both in the community and in the hospitals here, and our doctors are keen to ensure that our residents graduate as fully capable full-service family physicians – after all, we just may be their close colleagues in two years’ time.

The Abbotsford-Mission family medicine residency program is no longer new – we have graduated 5 cohorts of residents and have a 100% pass rate.  Our graduates have gone on to do full-service family medicine including obstetrics, inpatient medicine, and emergency medicine in a variety of communities, including rural locations. It is our goal to have well-balanced, capable, and happy graduates that are fully able to practice the entire spectrum of family medicine.  To that end, we have maximized flexibility within the program so that you can build up your skills wherever your interest and needs are.  Abbotsford-Mission graduates have also gone on to complete extra training in emergency medicine, palliative care, addictions medicine, and sports medicine. We even have one graduate who has gone on to do prison medicine.

Benefits of the Abbotsford Site:

Excellent Learning Opportunities

  • Totally frankly, the hospital runs fine without you. This translates into minimal “service”/“scut work” and more time spent learning. Your experiences are for your own learning… you get to go see the best cases. Preceptors see your work as an appreciated extra set of hands as opposed to an expectation.
  • As the only residents in the hospital, you will be working directly with staff: first in line for consults, first for procedures in the ER and first to perform deliveries on the maternity ward. When on surgical rotations, you can do your own intubations before scrubbing in and you are strongly encouraged to be a part of the code team in the hospital.
  • Family doctors are at the core of inpatient care in the hospital. They take care of all non-surgical, non-ICU/CCU/paediatric patients. This provides excellent opportunities to manage sick patients. While you’re free to manage these patients on your own/with your preceptor, when things get over your head, you’re still fully supported in a tertiary care hospital with consultants of many specialties. In addition to the units mentioned above, we also have a NICU run by local paediatricians, a psychiatric ward, a tertiary palliative care ward, and an oncology ward that benefits from being adjacent to a regional cancer centre.

Call – Abbotsford Style

  • Call is pretty unique in Abbotsford compared to other family medicine programs in BC.  On all of our core rotations except obstetrics we do call until 11pm, without a post-call day (OB is the standard 24-hour call). The reason behind this is simple, and comes down to two things: learning and wellness. We have high-quality and high-volume days on rotation, and we feel that you learn more during a full day on rotation than you do overnight on the last eight hours of a twenty-four hour shift. We are not getting bumped for interesting cases or procedures during the day by other residents (because there are none!) and so why work overnight? This is also great for keeping our residents rested and happy, which is also best for learning.
  • Be forewarned, however, that we do 1:4 call for all of our core rotations, including family practice. This is a great asset in our R2 year, when we are allowed to do “choose your own adventure” call. This means that instead of doing our standard hospital call (dealing with ward issues and admitting patients from the ER) in R2, you may instead opt to do shifts in the Mission Memorial Hospital ER, obstetrics call in Abbotsford, shifts in the minor treatment section of the Abbotsford ER, or really any other type of call that appeals to you!  If you can set it up, you can do it.

Longitudinal Family Medicine

  • The Abbotsford Site allows you to provide real continuity of care to a very diverse patient population. Throughout your two years here, you have at least one half-day per week with your family practice preceptor. Patients can be scheduled on your half-days so that you can follow them over the course of weeks and months. Furthermore, on the mornings before your afternoon in the clinic you will have half-day with the rest of the residents, and so you have one full day devoted to family practice each week, regardless of the service you are on.

Great Staff and Colleagues

  • The staff here are eager to teach, whether you’re working with them or not! If you pass by and there’s something interesting on the go, they’re happy to have you along. Of equal importance, our program staff are very friendly and receptive to feedback. We all see each other regularly and the program is constantly evolving and everyone in it genuinely wants to make Abbotsford-Mission the best program in Canada.

Beautiful Hospital

  • Built in 2008, ARHCC is a 300+ bed hospital and it is beautiful. It’s also your home for almost two whole years. You’ll be able to greet people by name as you walk in each morning. You’ll only have to learn one EMR, one telephone system, one layout. Best part is, all your rotations are done in one hospital, with the exception of two weeks of intermediate care nursery, which takes place at BC Children’s Hospital in Vancouver.

Leadership Opportunities

  • Since Abbotsford is a constantly evolving site this is an excellent chance to further your medical leadership skills. We are involved in a few community outreach programs (Abbotsford Connect, most notably) and have an incredible youth clinic, which is often staffed by our new graduates and has become a model for other youth clinics throughout the province. Furthermore, we work as a team with the program staff, who strongly value our feedback, and make changes to optimize learning and resident satisfaction.

Work-Life Balance

  • We have spouses, kids, partners, pets, plants… and are learning how best to create a healthy balance between work and the rest of life. The staff encourages us to work hard, but also want us to be healthy and happy in residency. Our resident group supports each other, and we love to have fun! Dinners out, ski trips and retreats to wine country are just a few of our recent adventures. There are even two resident retreats per year and because this is not a service-based hospital no one is forced to be on call and left out.

Great Outdoors

  • The Fraser Valley has wonderful opportunities to spend outdoors. From hiking to skiing, you can be active year-round. Or, you can go to the well-equipped but very (very!) affordable, gym at ARHCC to keep in shape! You can ski Mount Baker, hike Mount Cheam, and then drive down to the US to bike around the San Juan Islands.

Special Rotations

  • The rotations that stand out to us are too many to mention but we thought we would highlight a few here. One is an excellent inpatient palliative care rotation on our own tertiary palliative care unit, which is run by family physicians with extra training in palliative care. This is a core four-week rotation done by all residents. We also do a core two weeks of anaesthesia, which is airway-focused. You are not obligated to stay in one room but instead are free to hop from room-to-room working on your intubation skills and should get around fifty intubations over the course of the two weeks. On our paediatric and psychiatry rotations we spend time at Abbotsford’s Youth Clinic, which caters to vulnerable youth. Our emergency department is entirely staffed by CCFP (EM) and FRCP (EM) graduates and is a core six-week rotation. It is a busy department and ARHCC is a Level 3 trauma centre that gets patients from many neighbouring communities including Mission and Hope. Our obstetrics rotation is six-weeks and is very high volume. You get to be involved with all the family practice and obstetrician deliveries and are responsible for seeing all patients that come through triage. Most residents will deliver around fifty babies over the course of their rotation.

Weaknesses:

The most frustrating part of CaRMS is hearing everyone play-up their strengths and having no clue what the potential downsides of particular program might be. We’re going to save you that wonder. We love our program, the list of weaknesses is short, but we think these things are better to know up-front.

  • Firstly, there are minimal opportunities to teach medical students. We do presentations at half-days, presentations for nurses during rotations and we have a very active journal club. However, we only have medical students coming in for a few rotations where you will have the opportunity to pass along your wisdom (peds, psych, IM).
  • Residents are still somewhat new to the hospital culture in Abbotsford. This means, as mentioned above, the hospital will run fine without you. In order to maximize your experience here, you really do need to take the initiative to get involved.  People love having your around once you declare yourself, but no one will force you to do anything.  If nurses don’t know you’re on call, they will just call the staff. If the staff doesn’t know you’re on call with them, they will do the consult themselves. The ideal residents for Abbotsford are willing to put themselves out there – there’s a treasure trove of learning to be had, but you have to go for it!
  • There is also less academic teaching in Abbotsford.  Internal medicine illustrates this well. There is no CTU here as internists consult in Abbotsford, they do not admit (medical inpatients are admitted under family practice).  Our internal medicine rotation is fantastic, you can pick and choose from a high volume of consults and your staff will teach around your cases, but there are no bedside rounds, no morning report and no CTU team, just you and the staff person.  It is up to you to read around cases and topics, and ask your preceptors your burning questions.

Feel free to send us an email with any questions about the program… we’d love to hear from you. We look forward to meeting you on the CaRMS tour!

Drs. Josh Song and Sanja Vukicevic

joshua.song@alumni.ubc.ca
sanja.vukicevic@alumni.ubc.ca


Number of Residents: 8
Location: Abbotsford, BC
Community: 135,000
Hospital: Abbotsford Regional Hospital and Cancer Centre

Curriculum Type: Partial Integrated
R2 Elective Time: 
12-16 Weeks
Phone: 604-851-4700 x 642326
Contact: Director – Holden Chow – j.holden.chow@fraserhealth.ca / Coordinator – Ann Douglas – ann.douglas@fraserhealth.ca
Chief residents: Josh Song joshua.song@alumni.ubc.ca / Sanja Vukicevic sanja.vukicevic@alumni.ubc.ca

Overview

The people of Abbotsford expect the family physician to be their main caregiver providing full service care. The site will train family doctors who will service smaller urban communities where the care of patients is directed by family doctors. Residents will be mentored by preceptors who practice full service care. Abbotsford is one of the fastest growing communities in Canada and you will be amply exposed to all ages. Particular strengths are obstetrical, pediatric, and palliative care.

A majority of training will occur through the regional referral center, the Abbotsford Regional Hospital and Cancer Center, a 300 bed facility. Some highlights include a 150 bed Medical Unit under family practice, Obstetrical unit with approximately 2,000 births per year mostly delivered by family doctors, a tertiary Palliative Care unit, dedicated Geriatric unit, stand alone Oncology unit, a busy Emergency Department, and a Regional Trauma center run by CCFP-EM Colleagues. Because we have a small number of learners, you will be able to do lots of procedures and see lots of patients. You will also be given responsibility.

Academic Structure

We use a ‘partially integrated’ model which means in the first year, you will rotate through core rotations. However, you will be back in your FP offices one to two half days a week on an ongoing basis. This ensures that you stay well grounded in family practice and develop continuity with your practices. This ability to stay connected with your family practice office is one of the strengths of this training site.

We also pride ourselves in our Academic Half Day program. We take advantage of this time to supplement and emphasize important topics. There is plenty of interaction and we always have a family physician facilitate to maintain relevance to Residents. In our Academic Program, we also focus on reflective practices and medical leadership. In addition to key topic lectures, we have resident lead journal clubs and case presentations. Our past residents wanted more practice in certain skills and as a result, we created a recurring series to strengthen skills in ECG reading, Oncology, Radiology, Clinical Reasoning and Procedure Days. We also focus on reflective practices and medical leadership.

How are we unique?

We are currently the only program with a Program Coach whose main focus is the quality of teaching and evaluations. The Program Coach provides resources and training to the preceptors and residents from an educational perspective.

We have flexible call with overnight call options for some rotations. Most call shifts are evenings and end at 11pm. Call is flexible in the second year.

We also have very strong leadership in our residents and actively collaborate with all 17 residents to improve the program experience. Please contact Josh or Sanja if you have any questions. For more information on what is happening at our site please visit https://abbotsfordfamilymed.wordpress.com/

Abbotsford is known as the “City in the Country”. The city is surrounded by beautiful mountains and farmland but has great amenities in close proximity to the city center. Please check out http://www.abbotsford.ca/ for more on our beautiful community.

Sample Rotation

Block 1 Block 2 Block 3 Block 4 Block 5 Block 6 Block 7 Block 8 Block 9 Block 10 Block 11 Block 12 Block 13
PGY 1

FM

Pall

Ortho/
MSK

Peds

Peds

OB

OB

ER

ER/FM

FM/ANA

Gen Surg

IM

CCU/Neph

PGY 2

Psych

Elec

Rural

Rural

Elec

FM

FM

Geriatrics/
Surg-subs

GYNE

Elect

Elec

FM

FM

Interview with Jesse Janssen (Former Resident)

What made you choose the Abbotsford Site?

Abbotsford is similar to the kind of city that I would like to practice in – it’s small (150,000) and has a strong sense of community. The family doctors here are full-service so there are opportunities for me to learn a broad range of family medicine.  While it’s small enough that there’s minimal competition for learning, t’s large enough that you have access to all specialists (minus cardio-thoracic and neurosurgery).

Describe and average day of family medicine in Abbostford…

Abbotsford is nice because everyone eases into the program with a month of family medicine.

Most docs still have hospital privileges so your day begins rounding on your preceptor’s patients at the hospital.  From here, you’ll go to clinic and as your training goes on you’ll become more and more independent.  As you spend more time in the clinic, you’ll begin to pick up your “own patients.”  These are people that you’ll follow—almost exclusively—and the MOAs will make sure to book them with you.  Most residents’ days end around five.  Prior to starting residency, efforts will be made to pair you up with the preceptors whose practice closely resembles your future goals (ie. Preceptors with special interests in rural, inpatients, ER or maternity etc)

What are some of the unique learning opportunities at this training site?

I think all of our rotations are strong, but our most unique opportunities would be:

  • Month long palliative care rotation on a well-established palliative care ward.  I now feel comfortable using opioids, addressing pain, and feel more prepared for end of life discussions.
  • Youth Clinic runs twice weekly in the evenings. A new initiative by one of our faculty members, it’s only a few years old, is often staffed by new grads from our program, and brings a smile to your face regardless of the kind of day you’ve had.  Probably one of my most meaningful experiences to date: I’m away on elective now and can’t wait to get back and help out.
  • Aboriginal reserve visits.  Weeklong trip up North with Dr. John to visit some of the reserve communities he cares for via telemedicine in Abbotsford.  We’ve only had two residents participate in this program.  The funding is a bit spotty at the moment, but we’re trying to get everyone up North with Dr. John to see the kind of medicine he practices.  It’s an inspirational experience, and while not fully up and running (and may never be), I think it highlights our programs desire to seize new opportunities.

Is there a large service component to your residency?

We are on call roughly 1 in 4 for all rotations. For most rotations we are on call until 11 pm, and then work the following day. This is different from the typical 24 hour call followed by a post call day. There are so many rich learning situations available at Abbotsford Regional Hospital and the staff are eager to teach residents. This makes our call shifts a great learning experience.  There is minimal service expectation at the hospital.  This allows your experiences to be maximized for learning.

Does it get fairly competitive with the other residents?
There’s no competition amongst the residents – in fact, it’s quite the opposite. There aren’t very many learners at our site but there are a lot of staff who are available to teach. They give us first crack at the interesting cases and we’re often first in line to help out with surgeries. We’re encouraged to go to the ER to see what’s happening and to sign up to help out if we have time.

What kind of facilities are available in Abbotsford?
The hospital was built in 2008, so it’s really new. It’s a tertiary care facility – nearly all of the specialties are represented here and we handle most of the cases within the hospital. To my knowledge, the only cases that are transferred out are neurosurgery, cardiac surgery and cardiac catheterization. The hospital handles a high volume of obstetric (~2000 deliveries) and emergency cases so it can be busy even though the community is smaller than an urban centre like Vancouver.  Abbotsford also has a wing for the BC Cancer Agency and has an extensive dialysis program as well.

Are there many recreational and cultural activities available in Abbotsford?

We work hard, and love our time outside the hospital too! Over the last year, we’ve toured BC’s wine country, explored the San Juan Islands, and even been paintballing together (funded by our site director!).  We make a point of spending time together outside the hospital, which is a fun way to bring us some balance.

There are established annual activities in Abbotsford, such as the International Airshow, the Berry festival and Agrifair. Abbotsford has its own symphony and an excellent recreation centre. Vancouver is only a 45-minute drive away, so residents have access to big city events as well.

For outdoor enthusiasts, there are a lot of amazing opportunities. There is excellent mountain biking, hiking, white water rafting and camping in the Chilliwack and Mount Baker areas. During the winter, you can go skiing at Mount Baker as well.

What do you think is the biggest strength of the Abbotsford Site?
The learning opportunities at this site are excellent. The environment is very supportive, there is a lot of one-on-one learning with staff members. I love walking through the hospital and knowing many of the faces. As a resident, you can explore all that medicine has to offer. Personally, I’ve found that this residency has allowed me to really put all the pieces of my training together and apply it to patient care. I love being in a smaller site, getting the chance to know the people around me.