Kootenay Boundary

Site Director Message

The Kootenay Boundary Site is based in our two largest communities – Trail (Kootenay Boundary Regional Hospital)  and Nelson (Kootenay Lake Hospital), but extensively involves the many smaller communities of our region (Castlegar, Rossland, Fruitvale, Salmo, Grand Forks, Christina Lake, Greenwood, Kaslo, Nakusp, Midway, New Denver, and Rock Creek).  The citizens, physicians and allied health staff across the region have enthusiastically embraced the opportunity to train Family Medicine Residents and show them our special corner of BC.

So who should choose Kootenay Boundary Site?

If you are a motivated, independent and adventurous learner looking to acquire rural competencies and practical skills in a well-supported learning environment, we are for you. 

If you value developing a personal relationship with hospital staff, being asked to function at the top of your scope, forming a lasting relationship with your preceptor, and working without competition for cases with other residents, we are for you.

If you can live without a shopping mall (but like eclectic boutique ‘main street’ shopping), we are for you.

If you want to see how rural physicians can enjoy a balanced personal life (skiing, biking, hiking, camping, swimming) with a highly rewarding career in family medicine, we are for you.

If you are willing to stay late to see an interesting case through and put some organizational effort into ensuring your educational needs are met, we are for you.

If you hate driving in the snow, and want a reliable airport in the winter, we are not for you.
REPEAT, If you hate driving in the snow, and want a reliable airport in the winter months, we are not for you.

Still interested?
Let me tell you a little more about the Kootenay Boundary Program.

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. We offer a distributive medical education in which residents can obtain valuable medical experience and introduce themselves to the value and pleasure of rural practice and lifestyle. Undertaking your residency here 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 site is an established medical training site with a robust undergraduate UBC Integrated Clinical Clerkship program that trains four medical students completely in their third 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.  Residents will have the opportunity to teach students. Previous residents and students alike have been enthusiastic about the close relationships and collegial interactions between the residents and medical students. 

UBC administrative and clinical offices are established, and there is 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. We are also happy to offer a brand new call room, which has been fully furnished with (almost) everything you could want.

Medical education here is fully supported by experienced, 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. 

The Kootenay Boundary is a very special medical community. We are surrounded by mountains and snowy highway passes. Our local resources are often all that we can access.  We have learned to depend on each other in a very real and meaningful way and pull together as a team. This happens across a facility but also across the region. Many of our physicians have developed unique competencies to support our population locally. We have a strong sense of social justice and equity. Each small community has a unique history and culture that informs the experience of the patient and physician. This area is an amazing opportunity for the curious learner who wants to become a strong generalist while developing a specialized skill set in an area of interest. 

I urge you to take a closer look at this incredible area and site. There is a reason so many people come here to locum for a ski season and never leave! It is a hidden gem, both recreationally and in terms of the opportunities for learning and the skills and collegiality of the Medical Staff.  

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

Warmly,

Dr. Megan Taylor

megan.taylor@ubc.ca

Lead Resident Message

Welcome to the Kootenay Boundary Program!

We are a small, rural site with four incoming residents each year. The residents here are a supportive, fun-loving group who frequently meet up to ski, hike, or have campfires depending on the season. We have diverse backgrounds coming from different provinces and countries, but share a common passion for rural medicine and independent learning.

Our curriculum is largely block-based, with rotations lasting between two to eight weeks. We have longitudinal components throughout the two years including Family Medicine, Obstetrics, and Long Term Care. The majority of rotations are local, either at one of the two main hospitals (Trail and Nelson).

These rotations include Hospitalist, Emergency Medicine, Internal Medicine, Pediatrics, Obstetrics and Gynecology, General Surgery, Orthopedics, Anaesthesia, and ICU. All residents complete an eight-week block in one of two smaller surrounding communities, either Nakusp or Grand Forks. Residents also head to the Mainland for three rotations (Pediatric Emergency, Intermediate Nursery, and Obstetrics) to ensure skill development in areas where large volumes of patients are not always available locally. There are also approximately 16 weeks of electives in R2 to pursue personal learning goals.

One of the greatest strengths of our program is the quality of learning. Typically we are the only learner on a given service and work one-on-one with staff. Being on a first-name basis with our preceptors is not only a perk when standing behind them in the coffee line, but also when interesting cases and procedural opportunities arise in the hospital. Our formal teaching time comes in the form of Scholarship Days (in R1), one Academic Day per month, and two Academic weeks per year.

Most residents choose to live in Rossland, Castlegar, or Nelson. These towns are full of renowned recreation, including downhill and nordic skiing, mountain biking, kayaking, rock-climbing, hiking, and camping. Additionally, there are numerous beaches in the area such as Syringa, and Christina Lake, where you can lounge, swim, or paddle. Perhaps unlike other rural areas, the Kootenay Boundary has a number of fantastic bakeries, coffee shops, and restaurants. During pandemic-free times, there are also many festivals in the area including Rossland’s Winter Carnival and Kaslo’s Jazz Fest.

Resident wellness is a very real priority at this site. We incorporate yoga into our academic days whenever possible. As well, the physicians we work alongside lead by example in maintaining a healthy and sustainable work-life balance. We are also very lucky to have an incredibly supportive administration that works closely with us to resolve issues.

Perhaps one of the best indications of residents’ satisfaction with the Kootenay Boundary site is that many stay to work in the region after graduating. Past grads are now working in the same clinics in which they trained, on the Hospitalist, Pediatric-extender, and Psychiatry-extender services, delivering babies, and running solo-provider emergency departments.

If you are looking to pursue a rural Family Medicine residency that supports your learning, provides flexibility, is close-knit, and promotes overall wellbeing, Kootenay Boundary is for you! Please join us at the Virtual Open House to learn more.

All the best,

Dr. Svetlana Hadikin

Number of Residents: 4 CMG, 1 IMG
Location:  Trail, BC & Nelson, BC 
Community: 80,000
Hospital: Kootenay Boundary Regional Hospital & Kootenay Lake Hospital
Distance from Vancouver: 630 km

Curriculum Type: Block based with longitudinal elements
R2 Elective Time: 12 Weeks
Phone: 250-364-3442
Contact:  Site Director – Dr. Megan Taylor, Coordinator- Leah McInnes 

Lead residents: Dr. Svetlana Hadikin 

Overview

Program Highlights

  • A genuine rural medical experience, with training in a regional referral hospital, community hospitals, and remote community health centers;
  • 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 two 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 block in family practice obstetrics clinic that allows you to follow antenatal patients;
  • Unique learning opportunities include a KERPA elective (Road side attendance at high acuity EMS calls), working in the Shambhala music festival medical tent, and training in managing a medical practice;
  • The interprofessional 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 the 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 the first two months of your program and subsequently a half-day a week for the remainder of your residency while you are in the region. This will allow you to develop your own ‘mini practice’ and follow your patients in the community and 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 electives in areas including pain, pharmacology, diabetes, palliative care, group visits, HIV, occupational health and interdisciplinary teamwork. The specialty core content is delivered by a supportive contingent of specialists who work directly with family physicians.

Sample Rotation

Block 1 2 3 4 5 6 7 8 9 10 11 12 13
PG1 FP FP IM ER Gen. Surg Ortho/
Anaesthesia
Peds Hospitalist Elect Obs ICU Remote Rural FP Remote Rural FP
PG2 High volume Obs SC nursery/ Peds ER ER IM Chronic pain/FP Oncology MH Elect Elect Elect Exam Prep / Practice Mgmt FP FP FP

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, MH = mental health

Our Training Site 

The Kootenay Boundary region is located in southeastern BC, 650 km east of Vancouver and 650 km 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 three community hospitals in Nelson, Grand Forks, and Nakusp, along with three community health care centers 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 turnaround of the 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 local Divisions of Family Practice is leading the province in many initiatives and 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 third year. We have also hosted Family Medicine Residency Rural rotations site for many years. Our resources include UBC clinical and administrative offices, state of the art video conferencing education rooms, a well-stocked and 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 tourism companies. Many of the communities are located on lake shores or river banks, 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 is 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