Kootenay Boundary

Site Director Message

The communities and medical professionals of the Kootenay Boundary Site (Trail, Nelson, Castlegar, Rossland, Fruitvale, Salmo, Grand Forks, Christina Lake, Greenwood, Kaslo, Nakusp Midway, New Denver, and Rock Creek) have enthusiastically embraced the development of a new teaching site in our geographical area.

We have developed an exceptional educational experience that will meet all your clinical and academic residency requirements within the context of a rural recreational paradise. Our communities wholeheartedly support the concept of distributive medical education as a means by which residents can obtain valuable medical experience and as a way of introducing future family physicians to the value and pleasure of rural practice and lifestyle. Undertaking your residency here with us will be a unique and rewarding training opportunity that will equip you with the confidence and skills necessary for success in your future careers as family physicians anywhere you choose to practice.

This is an established medical training site with a robust undergraduate UBC Integrated Clinical Clerkship program that trains 4 medical students completely for their 3rd year. The Family Medicine Residency Rural rotations have been hosted at this site for many years, so we have very experienced preceptors for postgraduate training.

UBC administrative and clinical offices are established and there are state of the art Video-conferencing education rooms, a well-stocked, up to date medical library as well as access to all online UBC and Health Authority Library resources. Medical education here is fully supported by well- seasoned, dedicated and skilled clinicians who are passionate and enthusiastic about teaching. They will welcome you wholeheartedly.

This is a site where a resident will be exposed to family physicians and specialists, across several communities through varying degrees of “rural-reality”, who have advanced clinical skills and who provide essential care for a relatively isolated geographic area. Our facilities there are well equipped to support rural practice.

Choosing the Kooteney Bounday Site will be an opportunity for motivated, independent and adventurous learners to acquire rural competencies and practical skills in a well supported learning environment. We are committed to offering you opportunities to develop all the core competencies required for successful completion of the CCFP/MCCQE-2 exams. Most importantly, residents will enjoy their learning experience, become part of the community, and form significant relationships with their preceptors. Residents will be exposed to how rural physicians can enjoy a balanced personal life with a highly rewarding career in family medicine.

Together with my colleagues at the Kootenay Boundary Site, I would like to welcome and encourage you to undertake a transformative postgraduate medical education here with us.

Dr. Nattana Dixon-Warren
nattana@telus.net

Chief Resident Message

Welcome to the Kootenay Boundary Family Medicine Program! We are a distributed program looking for four residents who are interested in rural family medicine and learning medicine in the Kootenays. Our program is based out of the beautiful Trail and Nelson and 2017 will be the program’s third year in existence. Have a look at our brochure and feel free to email me with any questions.

Hope to hear from you!

Dr. Gretchen Snyman
gretchen.snyman@alumni.ubc.ca

 

Number of Residents: 2 CMG, 2 IMG
Location:  Trail, BC & Nelson, BC 
Community: 80,000
Hospital: Kootenay Boundary Regional Hospital & Kootenay Lake Hospital

Curriculum Type: Longitudinal and Integrated
R2 Elective Time: 12 Weeks
Phone: 250-364-3442
Contact:  Site Director – Dr. Nattana Dixon-Warren – nattana@telus.net / Site Coordinator – Michelle Sylvest – michelle.sylvest@familymed.ubc.ca
Chief residents: Gretchen Snyman – gretchen.snyman@alumni.ubc.ca

Overview

Program Highlights

  • A genuine rural medical experience, with training in a regional referral hospital, community hospitals and remote community health centres;
  • An innovative flexible curriculum that meets the CCFP’s requirements and will give you the skills and confidence to practice family medicine in any setting;
  • A home family practice clinic in a community where you will be based with 2 preceptors throughout the program, develop a mini practice and follow patients in the community;
  • Specialist rotations specifically designed to meet the needs of family physicians;
  • A longitudinal primary obstetrics program that allows you to follow antenatal patients throughout pregnancy and delivery;
  • Unique learning opportunities include a mountain medicine elective, working in the Shambhala music festival medical tent, and training in managing a medical practice;
  • Inter-professional learning environment, with the opportunity to teach medical and pre-med students and to undertake research;
  • Quarterly meetings with an academic advisor to ensure learning objectives are being met while still allowing for an individualized and flexible curriculum;
  • An innovative mindfulness practice integrated throughout the program;
  • A rural recreational paradise of pristine wilderness and creative communities, where you can achieve a healthy balance of professional and personal life, with an attachment to community;
  • Eligibility for student loan forgiveness of up to $8,000 per year.

Program overview

The core foundation of your family practice training will be your home clinic. You will be based here for four half-day sessions a week for 79 of your 104 weeks. This will allow you to develop your own ‘mini practice’ and follow your own patients in the community and in hospital. You will also be exposed to different scopes and styles of practice through spending one month in another family practice clinic and two months in a remote rural setting (Grand Forks or Nakusp).

The curriculum’s emphasis is on integrating learning back to your family practice experience.  You will have rotations in all the core specialty areas – surgery and procedural skills, ER, internal medicine, women’s health, obstetrics and pediatrics, mental health. We also offer ‘special interest’ rotations in areas including pain, pharmacology, diabetes, palliative care, group visits, HIV, occupational health and inter-disciplinary team work. The specialty core content is delivered by a supportive contingent of specialists who work directly with family physicians.

Our local electives include 2 weeks mountain and wilderness medicine and 2 weeks practice management. In addition you will have 16 weeks (in 4 x 4 week blocks) for elective experience, one of which will be specifically for pediatrics.

Sample Rotation

Block 1 2 3 4 5 6 7 8 9 10 11 12 13
PG1 HP Orient-ation SI IM ER MH Surg & PS SI Surg & PS Elec-tive WH/ OB/ Peds SI SI Remote Rural FP Remote Rural FP
PG2 IM 2nd FP clinic ER MH Elec-tive IM Elec-tive Surg & PS Mtn. med. Mgt. Skills Elec-tive ER WH/ OB/ Peds SI SI Exam Prep Pract-icum

 

All blocks involve 4 half-day sessions per week in your home clinic, except for electives and Remote Rural FP, which are full time rotations.

HC = Home Clinic, FP = family practice, IM = internal medicine, includes ICU, hospitalist, MH = mental health, SI = special interest, PS = procedural skills, WH = women’s health

 

Our training site 

The Kootenay Boundary region and is located in south eastern BC, 650 km east of Vancouver and 650km south west of Calgary. The population of about 80,000 has an unusual rural demographic, with many engineers, scientists, doctors and dot-com specialists.

The region’s health facilities consist of the regional hospital in Trail and 3 community hospitals in Nelson, Grand Forks and Nakusp, along with 3 community health care centres with ER in Castlegar, New Denver and Kaslo. Primary care is provided in GP offices, primary OB clinics, mental health and addictions clinics, chronic pain clinics and chronic disease management clinics. We have a very efficient turn-around of lab and diagnostic services and access to specialist referrals.

The medical community is made up of 105 family physicians and 47 specialists. With a low number of learners, the environment is non-competitive. The KB Division of Family Practice is leading the province in a number of initiativesand is the only one with nurse practitioner members.

Our education resources. We are an established medical training site with a robust undergraduate UBC Integrated Clinical Clerkship program that trains four medical students throughout their 3rd year. We have also hosted Family Medicine Residency Rural rotations site for many years. Our resourcesinclude UBC clinical and administrative offices, state of the art video-conferencing education rooms, a well-stocked, up to date medical library as well as access to all online UBC and Health Authority Library resources.

Our playground – Kootenay Boundary is an outstanding outdoor recreational paradise with world class skiing (Rossland and Nelson were voted best ski towns in North America), mountain biking and hiking. The region supports a thriving cultural and artistic community featuring many music venues, theatre performances, craft shows and galleries, as well as a surprising array of interesting restaurants, bookshops, coffee shops, boutique stores and adventure tour and sporting/adventure back country tourism companies. Many of the communities are located on lakeshores or riverbanks and all have an impressive array of parks, aquatic centers, golf courses, baseball stadiums, ice arenas, indoor field houses, curling rinks, tennis and squash courts and several soccer pitches. There are a wide range of schools, including French and Russian Immersion and the Waldorf School in Nelson.

Interview with a resident

Interview with Nick Leinweber, who is one of UBC’s rural family medicine residents doing a 4 month rotation here.

What in particular drew you to Kootenay Boundary?

Of all of the rotations and hospitals I have experienced throughout my medical training, the KB region has one of the most collegial healthcare teams I have worked with.  As a medical student and now resident I have felt embraced by the healthcare community, I am included in hospital and non-hospital community activities and feel I have become a part of something, and not merely a learner in the academic machine.

Furthermore, if you enjoy the many outdoor opportunities and laid back lifestyle that British Columbia has to offer, the Kootenay region is pretty much the holy grail of mountain culture.  After all, Rossland (just outside Trail) and Nelson were voted North America’s Best Ski Towns in 2012!

What learning opportunities are there that make KB unique?

The Kootenay Boundary is a regional centre that essentially offers all major medical and surgical services and has very few learners. As a result it is very flexible and easy to maximize and customize your schedule and learning experience.  If you want more time with airway skills, go spend time with the anesthetists, if you think your suturing needs some work, talk with the plastic surgeon. The staff is approachable and happy to teach if you want to learn.

What do you enjoy most about your residency?

Without a doubt it is how easy it is to achieve work-life balance.  I live in Rossland, (10km from the Trail Hospital). After – or sometimes before – work I can get in a lap ski touring in the local Rossland mountain range or catch last chair for a lap on Red Mountain; go for a bike or pick huckleberries in the summer; and pick up a growler of fresh beer from our local brewery before dinner.  As a result I enjoy life, avoid being burnt out, and continue to enjoy the marathon of medical training.

Is there a large service component?

No, not at all. It is focused on the resident’s learning and development into a competent rural family practitioner. This is a medical community that has had tremendous success with an integrated community clerkship with UBC medical students and has now created a residency program with a similar ideology. The focus is around the learners’ experience and not the workload of the hospital. Scut work is essentially non-existent.

How would you describe your relationship with your preceptor and the wider KB medical community?

I feel I have become a member of the KB medical community. Some preceptors are friends I ski and bike with while others are like parental figures who offer guidance with regards to all sorts of life aspects. My wife takes her kindergarten class on field trips through one of the clinics; the whole hospital puts on an annual talent/skit show for the entire community that is hilarious and regularly sold out; the ER/ICU Christmas party is outrageous. This is an amazing community to be a part of and I am very grateful to be a member.

Any drawbacks to being a resident in KB?

The volume of high acuity patients is less than tertiary centres. It can be very beneficial to experience the volume of larger centres and receive the teaching from subspecialty services. I think this is something that can be accomplished with the large amount of elective time in the residency program.

What sort of residents do you think would do well in KB?

Individuals who are comfortable with uncertainty, are motivated to get what they want out of their training and are willing to speak up if they think something needs to change. This is a new program and everyone wants it to succeed, they take learner input seriously and as a student or resident in KB you become a part of shaping the experience for future learners.

What’s life like in KB outside work?

The Kootenay region is filled with Canadians and expats who have sought a life of adventure, and alternative living. The communities are vibrant with a unique mountain culture that offers much more than world class skiing and mountain activities. There are funky music venues, arts and film festivals, yoga studios, micro-breweries and pretty much the best neighbors you could ask for.  Life here is terrific.

Trail       Rossland       Recreation-2

Recreation-1       New Denver     Nelson-2

 

Nelson-1      Nakusp       Medical facilities-3

Medical facilities-2       Medical facilities-1       Kaslo

 

Jazz Fest & Shambhala-2       Jazz Fest & Shambhala-1      For the kids

 

Farmer's markets       Christina Lake & Grand Forks      Castlegar

 

Whitewater & Red Mountain