Chilliwack

Site Director Message

Thank you for your interest in the Chilliwack Site of the UBC Family Practice Residency Program. I trust the information provided here will help you to consider Chilliwack as an option for your family practice residency. Chilliwack is a vibrant city of approximately 75,000 people, 100 km east of Vancouver, BC. The hospital services an area of about 85,000 people. Family physicians form the backbone of the care model at our hospital. All family practice preceptors have hospital privileges and provide the majority of care for their inpatients. If required, there are specialty supports available in the areas of internal medicine, general surgery, orthopaedic surgery, urology, paediatrics, rheumatology, obstetrics, gynaecology, ophthalmology, and ENT. There are no hospitalists (or other residents) at Chilliwack General Hospital. We are constantly working to improve our program. We feel we had made huge strides forward as of July 1, 2014 as residents will no longer need to travel to Abbotsford for part of their paediatrics and internal medicine experiences. Expanding programs and increased number of specialitsts in both of these disciplines allows us to offer quality clinical experiences in Chilliwack.

Triple C has provided a framework to assess the educational experience we provide. Residents will receive more teaching from their family practice preceptors and have better opportunity to care for their own group of patients as two half days back per month are now mandatory. There are six third year UBC medical students participating in an integrated clinical clerkship at CGH. Their presence has proven to enhance the resident experience. Our family practice preceptors are leaders and pioneers in implementing EMR, advanced access strategies, and improved outpatient care of chronic-disease patients. All of this creates an outstanding environment for family medicine residency training. If you are a self starter and self-motivated, this community will provide you with an amazing residency experience.

Hospital call over the two years provides residents with the opportunity to assess and manage patients who develop new medical problems during their hospital stay. We consider this as a longitudinal experience in the care of hospitalized patients. Residents are provided emergency medicine experience throughout their two years of training as part of their evening call schedule. Our graduating residents consistently inform us that these experiences are key pieces in acquiring the skills to be able to practice wherever and whichever style of family medicine they choose.

Chilliwack is a welcoming medical community. The resident role in the community and hospital is well defined. Residents are well received by patients and the community in general. Residents come to Chilliwack from all parts of Canada. Consequently the resident group tends to form a close-knit group providing social and professional support for each other.

The community of Chilliwack and surrounding area offers a large selection of recreational pursuits including hiking, mountain biking, fishing, skiing, rock climbing, a new cultural center, YMCA and two city-operated recreational complexes. Residents are encouraged to enhance their experience by engaging in the many opportunities Chilliwack has to offer. I trust this information is helpful to make you consider Chilliwack as an option when choosing your family practice residency site.

Dr. Ken Harder, MD, CCFP, FCFP

ken.harder@fraserhealth.ca

Chief Resident Message

In our opinion, Chilliwack is hands down the best program in the country to prepare a graduating medical student for full service family practice!  Our residents come from across the country, attracted by the reputation of our graduates; they are highly competent and confident in their abilities to practice in rural and remote communities across the country, and have great success in pursuing additional training if this is of interest to them.  If you want to be confident in the family practice office, emergency room, inpatient care setting and the labour and delivery suite, you should seriously consider training in Chilliwack. Here are a few of the highlights of our program:

1. Excellent learning environment

Chilliwack General Hospital is a friendly smaller community hospital. It is largely run by family doctors who have an extremely collegial relationship both with each other and with local specialists. All of our non-elective rotations are at CGH, and we quickly operate on a first-name basis with the nurses, preceptors and specialists. The size of the catchment area (approximately 90,000) affords ideal volume and significant pathology while maintaining its rural/community hospital feel, without the dilution of educational experiences that academic teaching centres can develop.

2. Continuous emergency department exposure

This has always been a strong component of the program and currently includes regular evening emergency shifts throughout the two years, a month-long core emergency medicine rotation, as well as elective opportunities (locally, at larger teaching centres, or internationally).

3. Responsibility

Our program allows us to assume as much responsibility as we are willing and able to handle while providing reliable and quick backup for situations beyond our abilities. These are the principles behind our hospital call, when we are the one MD in-house responsible for the 250 admitted patients. This is a huge benefit in preparing us for in-patient and emergency care in our future practice, offering gradual development of independent management skills with back-up only a phone call or short drive away. We furthermore have the opportunity to become competent in numerous procedures, including central lines, arterial lines, intubations, chest tubes and many more.

4. Fewer learners

Except for the odd elective student and occasional surgical resident, the only medical learners at CGH are 16 FP residents and six medical students. That means we are frequently first assist, regularly 1:1 with our preceptors, and always have first access to available procedures.

5. Dedicated preceptors

A large number of preceptors and family physicians in the community are graduates of the program. This is a testament to the collegial nature or our medical community, and to their dedication to seeing the residency program continue to be a highly respected and valuable training opportunity.

6. Spectacular recreational opportunities

The Fraser Valley offers incredible hiking, mountain biking, paddling, fishing, camping and back-country skiing, with easy access to world-class ski resorts. If your taste runs more towards top-end shopping malls, theatre, and classy martinis, then Vancouver is merely an hour away by car.

7. Friendly, close-knit group of resident colleagues

Being a relatively small site, the group of residents in Chilliwack is very supportive. Residents moving from across Canada proudly claim to have “instant friends” within the first week of their residency, and become our chosen family in our new home. We regularly organize social nights, outdoor activities, weekend trips, resident retreats (call protected) to name a few, and have a great time together.

If you hate big-city traffic and crowds, you appreciate knowing and liking the people you work with, and you would like to be a confident full-service family physician, then Chilliwack is the place for you!

Please feel free to contact us or the program should you have any other questions about our amazing program!

Drs. Martin Lipinski & Lara Traczyk

chilliwack.residents@gmail.com

 

Number of Residents: 8
Location: Chilliwack, BC
Community: 92,000
Hospital: Chilliwack General Hospital

Curriculum Type: Partial Integrated
R2 Elective Time: 
12 Weeks
Phone: 604-702-4757
Contacts: Director – Ken Harder – ken.harder@fraserhealth.ca / Coordinator – Amber Taylor – amber.taylor@fraserhealth.ca
Chief Residents: Martin Lipinski & Lara Taczyk – chilliwack.residents@gmail.com

Overview

  • Chilliwack is 100 km from Vancouver with the majority of rotations in Chilliwack and other regional settings in the Fraser Valley
  • Nature of the clinical experience is to be close at hand in order to be able to participate in the opportunities when they arise
  • Residents live and become involved in the community because the region does not have the volume for a strict call system
  • All residents share hospital-based call, which gives maximum exposure to the hospital-based clinical work done by the general practitioner in the emergency room and after-hours urgent in-hospital care; strong focus on Emergency Room Medicine
  • Resident/teaching focus as opposed to service-focus, many family physicians committed to teaching and involved in the program
  • Family practice oriented rotations (e.g. Paeds is mostly office-based, like our future practices will be)
  • Bed occupancy is 336 (140 acute care) and annually there are 39,322 (excluding ECU) patient days, 7,773 admissions, 6,366 in-and-out patient surgical operations, 52,000 visits to emergency and ambulatory care and 816 deliveries
  • Lots of hands on experiences, responsibility and collegiality
  • Academic half-days, while offering a core academic program, are resident-based and resident-driven
  • Ensure residents will have the skills, knowledge, aptitude and attitude to practice in an urban, regional, rural or isolated practice.

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 ER FM FM IM OB Peds Surg FM FM Peds OB Surg IM
PGY 2

Psyc

Elec

Rural

Rural

Elec

FM

FM

Med Sel

MSK Sel

Elec

FM

FM

ANA Surg Sub

Interview with a resident:

What do you enjoy most about the Chilliwack Site? 
Having searched the country for a residency program that would best prepare me for full spectrum rural practice, I have no doubt in my mind that Chilliwack was the ideal choice.  The location and size of the catchment area (approximately 90,000) provides the ideal balance of experience (with sufficient volume and pathology) with a more rural, family-medicine-oriented community hospital environment (without competition for learning opportunities or ready-access to specialists).  I feel confident that my experiences in my two years of training will prepare me for full-service family medicine including clinic work, caring for inpatients, ER and obstetrics.  It is a real bonus that it attracts a great group of co-residents and is located in the stunningly beautiful Fraser Valley, where you can get your fill of hiking, biking, summer afternoons at the lake, and ready access to fantastic skiing!

What kind of learning opportunities are available at the Chilliwack Site? 
Some of our best learning occurs on overnight hospital call – other than the emergency doctor, the family practice resident is the only physician in the hospital at night and on weekends (with supervising physicians on call available by phone), so you really develop your diagnostic and resource management skills (for instance, does this patient need a CT scan tonight or can it wait until tomorrow?). It helps push up your confidence.

The longitudinal ER is also a real strength of the program, as it contributes to the development of skills and confidence with acute care.  Because there is ongoing exposure and practice of these skills, residents graduate confident to practice emergency medicine.  We are also very fortunate to have a department that supports recent grads transition to independent practice.

Most of the curriculum is arranged into blocks and everything is scheduled for you. There are 12 weeks of elective time in second year, which allows for tailoring of training to future practice goals.  You can access resources in Vancouver and the lower mainland, with accommodation available in Vancouver, so you are able to get a varied training experience that meets your needs and interests.

We also have weekly Academic Half Days, where we have presentations from local specialists, family physicians, and from our colleagues.  The focus is always on application for family medicine, and content ranges from behavioral medicine to evidence-based medicine to case presentations and much more!

We are very lucky to have such engaged specialists who are highly involved in our teaching (orthopedics, general surgery, OB GYN, pediatrics and psychiatry).  Not only are they invaluable on our core rotations, but make for friendly and educational telephone consults throughout our experience and are always available for a hallway or doctors lounge consult or conversation.

Is there a large service component to your residency?
The service at Chilliwack (primarily with hospital call) can be heavy at times, but we never feel used. Our preceptors talk about this with us beforehand. They are supportive and try to emphasize learning over service. We are proud of the service we provide and are really valued by the community. It is this independence and “service” that really allows us to optimize our learning.

Does it get fairly competitive with the other residents?
It’s actually the opposite situation – all of the residents help each other learn whenever we can. If we’re on call or in the emergency, we’ll contact the other residents when there’s an interesting case, and we regularly teach each other with presentations at Academic Half Days.  With only 8 residents each year, there are more than enough learning opportunities to go around!  We are also involved with the third year medical students doing their integrated clerkship in Chilliwack, however this is in a teaching role on overnight call and competition for procedures or experience is rarely an issue on rotations.

Our group is close and we socialize a lot together. There’s quite a lot to do in Chilliwack: there are movie theatres, restaurants, lots of outdoors activities and a strong arts community. We hike up Mt. Cheam together every year, we have regular social gatherings and weekend ski trips, a book club, and we have two call-protected retreats during the year, so we do much more than just work together!

Is the community very welcoming of residents?
People here are very welcoming. This residency has been a part of the community for 20 years, patients and office workers are very happy to have a teaching hospital in their town, and being “just a resident” is rarely, if ever, an issue.

Professionally, we have very strong teams. We get a lot of interprofessional support and there is a strong sense of collegiality with nursing staff, students, and other allied health professionals.

What kind of facilities are available in Chilliwack?
Chilliwack General Hospital had a large renovation in 2010. We have a gorgeous, brand new Emergency Department, a new Ambulatory Care Department, Pediatric Clinic and Short-stay beds, Orthopedic Clinic, and an in-hospital Primary Care Clinic with a Seniors Clinic, a Nurse Practitioner, and potential for other interesting teaching clinics.

Two weeks of pediatrics are also available to be done at the BC Children’s Hospital in Vancouver for NICU (Intermediate Nursery) experience, with accommodation in a (gorgeous!) basement apartment provided.

The apartment in Vancouver is typically also available for electives and MSK selectives, making these learning opportunities much more accessible.

What traits do you need as a resident to really appreciate the Chilliwack Site?
You definitely need to be a self-directed learner who is responsible and accountable for yourself. Independent learners thrive in this site – if you’re not excited to learn, you really won’t get the most out of the experience.

You also need to really enjoy living in a non-urban environment. Chilliwack has a lot of amenities, and is close to the city, but it’s not the city.  The community has the overall feel of being smaller than its population size by virtue of the people who live there – they truly are a community.

What do you think is the biggest strength of the Chilliwack Site?
We have the greatest proportion of residents who ultimately practice rurally of the BC family medicine programs (according to our Site Director!), and the reputation of Chilliwack residents resonates across the country.  I believe this is attributable to the many ways in which our program affords graded development of skills in independently assessing and managing acute care patients in addition to comprehensive community care.  The ongoing ER and hospital call are integral to this.

We also have the highest short-term retention of residents. Many of our graduates stay in Chilliwack for about six months to a year after they finish the program, or settle here for long-term practice. They do locums and Emergency shifts to help transition into practice, and the community is exceptionally supportive of this.

One of the community programs being offered by residents is the “mini-medical school.” We offer free information sessions on pertinent health-related topics to the community.  This was a resident-initiated program that has continued for years now.  We also have community engagement efforts newly initiated in Agassiz (a rural community 25 minutes away) regarding youth suicide prevention.