Nanaimo

Site Director Message

The UBC Postgraduate Family Medicine Residency Program’s – Nanaimo Site, started in 2007. Nanaimo Site has 16 positions, 8 in the R1 year and 8 in the R2 year. The R1 and R2 residents who have matched to Nanaimo have had a great learning experience centered at our Nanaimo Regional General Hospital (NRGH) and the surrounding community. NRGH has more than 224 acute care beds and a medical staff of more than 200 physicians. All patients admitted to this hospital are admitted under a primary care physician including those with specialist involvement. There are more than 100 faculty members involved in the academic and experiential teaching at this site.

Nanaimo’s central Vancouver Island location makes it an ideal community for Family Medicine learning. Close proximity to Victoria and Vancouver make connections quick, economical and convenient. Many of the disease  clinics within the Central Vancouver Island Health Region are managed and attended by Family Physicians with special interest and focus. The Nanaimo medical community provide a warm welcome to Family Practice residents.

Each of the family practice residents at the Nanaimo Site are matched to a community family practice clinic. They will follow patients within that family practice clinic during their 2 year Family Practice Residency. In circumstances where the spectrum of care provided by a clinic maybe narrowed by preceptor choice, alternative experiences are provided at other clinic settings within the community.

Nanaimo is an ideal Family Practice Residency Program Site for those not wanting to be in a big city every weekend. The cost of accommodation rental and ownership in Nanaimo compares favorably to other British Columbia locations. Short and easy commutes  to the hospital, clinics and home allows Nanaimo residents to have a healthy lifestyle.  Ample social, recreational and cultural activities are available in all four seasons of the year. Our mild climate and adventure culture provides great opportunity for a balanced lifestyle.

Nanaimo is the site of few, but valued Royal College specialty training residents. The specialty residents do not share or conflict for patient care experiences with the family practice residents. Overlap in rotations is minimal. The rotational curriculum has been set up to give the Family Medicine Resident the advantage of the skills and experience available within the community.

Nanaimo has a strong palliative care program delivered by skilled family physicians. Nanaimo has an ICU that is friendly to family practice learners. Nanaimo has a high volume emergency room that provides excellent teaching and experience for learners. Surgery, Internal Medicine, Low Risk Obstetrics, Child and Youth Health and Mental Health and Addictions are all strong rotations at this site. There is an abundance of role models and mentors to meet residents program support needs. We continue to develop an effective Musculoskeletal educational experience and  improved access to marginalized at-risk populations. Residents at this site have outreach opportunity in this region and in other culturally unique experiences in Canada and in the global health network.

Our academic activities are done in 1-week academic blocks throughout the year to allow a strong focus on the academic curriculum in family medicine. Examination preparation is facilitated effectively the Nanaimo Site has state of the art academic space including high definition video conferencing facilities, resident sleeping rooms, a resident lounge and a human performance laboratory (Simulation Lab).  The impressive academic space in a central and strategic location within NRGH, is a strong statement about the importance of Family Medicine education in Nanaimo,

The Nanaimo Site will ensure that you will become a competent, confident, healthy and resilient family physician ready to practice in any Canadian community.

Dr. Steve Beerman, MD, CCFP

steve.beerman@viha.ca

Chief Resident Message

Welcome to Nanaimo. We are a relatively new site which has quickly become highly desired and competitive. This residency site began in July 2007 and has 16 residency positions, 8 in the R1 year and 8 in the R2 year.Our residents are a close-knit, independent and active group who take full advantage of the flexibility this site provides. We have a close relationship with our site administration; they are receptive to our suggestions, so change comes quickly.

Unique Aspects of the Curriculum

Longitudinal Family Practice Time

There is greater emphasis on longitudinal time in the family practice clinic than in other Canadian family medicine residency programs. Throughout specialty rotations, we spend one day a week back at the family practice clinic in which we have a 2-year placement.

Academic Weeks

Academic time is concentrated in one-week blocks. During this time, we are all excused from our rotations and are never on call during the day. We gather as a group with our education as the sole focus. The R2s are responsible for planning one day a week of academic time for themselves, which allows us to focus on CCFP exam preparation. Academic weeks are a great time to reconnect and recharge with other residents.

Flexibility

As a new training site, our rotations are very flexible. Each resident has both the responsibility and the flexibility to tailor rotations around their specific needs. The R2 year specifically is meant to be shaped to your needs and wants.

Other Site Highlights

  • Specialty residents are rare, so we get to see and do almost everything!
  • Strong emphasis on education over service – you can mostly determine your own call schedule and have a lot of input into educational activities.
  • Hospital size is large enough to have most specialties, but patient care is still largely directed by family doctors and hospitalists, maintaining an educational focus on full-service family medicine.
  • Great ER training! We have a beautiful new emergency department opened in 2012 – the busiest emergency department on Vancouver Island. One month in both first and second year, plus opportunities for other shifts if you wish. The ER physicians are highly motivated and enthusiastic about teaching residents.
  • Simulation lab – we have a state of the art simulation lab where we practice acute care (including running codes) on a nearly weekly basis. There is huge potential for simulating a wide variety of situations in this lab.
  • Community clinics – all have keen, multiple preceptors who pursue a variety of interests within Family Medicine (Obstetrics, Addiction, Geriatrics, Palliative, etc.)
  •  Hospital work – doing inpatient evening and weekend call with GPs and hospitalists throughout the two years means you will feel confident with inpatient medicine.
  • We’re the only program that has a mandatory Palliative rotation in first year. All our residents found that this rotation is immensely beneficial to our future careers regardless of what branch of Family Medicine we may choose to focus on.
  • Though we may not get as much exposure to Addictions Medicine as an inner-city program, we’re one of the few sites with a mandatory 4 day experience in our community methadone clinic. Further local electives in addictions available as well.
  • Our MSK rotation includes working with local physiatrists and rheumatologists.
  • We have a new 2 week Nephrology rotation which is run by incredibly enthusiastic internists who tailor it to what Family Practitioners need to know most.

Life Outside of Work:

The term “well-rounded” takes on a whole new significance in Nanaimo. The physicians who run the program have our well-being at the top of their priority list. We are encouraged to be healthy, involved in the community and to pursue interests outside of medicine. In Nanaimo and the surrounding areas, there is an abundance of outdoor activities: hiking, sailing, windsurfing, kayaking, mountain biking, rock-climbing, and scuba diving are plentiful and practically at our doorsteps. Skiing and surfing are only a short drive away. The downtown/waterfront area has undergone significant improvements over the last 10 years and is now ripe with restaurants, cafes, and independent shops.

Nanaimo is a beautiful and diverse community of 85,000. Contrary to popular belief, Nanaimo’s inhabitants are of a wide variety of ages and come from many different socioeconomic backgrounds. Temperatures are moderate throughout the year. Yes, it rains, but mostly in the winter months! Nanaimo is also a really affordable place to live.

Who Are We Looking For?

We would like to invite those of you who love to learn and love to live. To get the most out of this program, you must be self-motivated and confident in your ability to identify your academic and psychosocial strengths and weaknesses, so that you can shape the program to suit your educational needs.

Academics aside, we are a fun-loving and adventurous group and would love to attract other residents who enjoy the great outdoors, whether you’re a hard-core adventurer or just looking to take in the scenery. We look forward to meeting you and your partners/families next year. Please feel free to contact us with questions at any time.

Drs. Jesse Gordon & Erica Hack

Number of Residents: 8
Location: Nanaimo, BC
Community: 85,000
Hospital: Nanaimo General Hospital

Curriculum Type: Partial Integrated
R2 Elective Time: 6-9 Weeks
Phone: 250-739-5979
Contacts: Director – Steve Beerman – steve.beerman@viha.ca / Coordinator – Lisa Ripka – lisa.ripka@viha.ca
Chief Residents: Jesse Gordon –  jesse.gordon@alumni.ubc.ca & Erica Hack – erica.hack@alumni.ubc.ca

Overview

The Nanaimo Site offers a good balance of responsibility and education. A wide spectrum of family physician and specialist colleagues offer preceptor based experiential learning in an environment of mutual support and respect. Each resident is assigned a family practice clinic with multiple family physician preceptors. Residents achieve their own patient population and follow patients throughout their year program. The academic curriculum is accomplished during full weeks of academic activity throughout the year. Residents are not in rotations and are not on call for another discipline during academic weeks. There is generous elective opportunity in the R2 year and learner centered flexibility to the schedule of rotations.

Program Highlights

  • Residents start with 4 weeks in their community Family Medicine clinic
  • Academic weeks during the year with complete academic content focus (no call, no rotations and no Academic Half Days)
  • Residents focus on education
  • Learner centered flexibility
  • Ensure residents will have the skills, knowledge, aptitude and attitude to practice in an urban, regional, rural or isolated practice
  • Family Medicine taught by family physicians whose philosophy and practice are consistent with the aims and aspirations of family medicine
  • Community network of health care providers and will become skilled at collaborating as team members and team leaders
  • Nanaimo Regional General Hospital provides service at the primary care and secondary referral level. It serves an immediate population of 90,000 and a referral population of 160,000. Current acute care bed allocation is 224 and annually there are 76,487 acute patient days, 12,828 admissions, 11,116 in-and-out patient surgical operations, 48,000 visits to emergency and 1,179 deliveries. There are 208 physicians on active staff.

Sample Rotation

Wk 1 Wk 2-5 Wk 6-8 Wk 9 Wk 10-15 Wk 16-19 Wk 20 Wk 21-24 Wk 25 Wk 26-29 Wk 30 Wk 31-36 Wk 37 Wk 38-41 Wk 42-45 Wk 46 Wk 47-52
PGY1

AW*

FM

MSK

AW*

FM

Pall

AW* MH AW* AAC AW* Surg AW* EM IM AW* OB
PGY2

AW*

MH

R

R

R

Elec

AW* Elec AW* OB/WH AW* C&Y AW* FM FM AW* FM

AW = Academic Week
MH = Mental Health
C&Y = Child and Youth
R = Rural

Resident Feedback

What do you enjoy most about the Nanaimo Site?

The overall well-roundedness. Its medical community is small enough that it doesn’t take long to get integrated into but large enough that we have most specialists so that care is comprehensive. For the hospital, that means family doctors still play a significant role but there is also a large patient-volume with high acuity. It’s not a big city so we have lots of access to nature and the cost of living is reasonable; we still have a beautiful downtown with Victoria and Vancouver just a short commute away. The program itself is new enough that we are able to stay flexible, yet old enough that we have the kinks worked out.

What learning opportunities are available at the Nanaimo Site?

The program here is longitudinal and the emphasis is on exposing residents to many different types of cases. The residents provide input into a call-protected academic week every two months so there is a lot of opportunity for us to shape the curriculum. We decide together what we want to learn about. Nanaimo also offers residents the option to travel to and train in other facilities to broaden their experiences. You can easily travel to Duncan, Courtney/Comox, Port Alberni and Vancouver (or beyond) for your electives.

Is there a large service component to your residency?

Our program was designed to fit into a hospital and a community that was well-functioning before residents. Care is taken to arrange our schedules so that there are times when every service is without a resident so that they do not become dependent on us. As a result, our focus when we are there is on participating in whatever is of highest educational value. This also means we are given significant flexibility in our schedules, which is a huge step toward achieving a good work-life balance.

Does it get fairly competitive with the other residents?

Our group is very supportive of one another and we’re very collegial, both amongst current residents and recent graduates. Support and help is easy to find. Most rotations have only one learner at a time; learning opportunities are abundant, yet the hospital is small enough that you see colleagues almost daily.  Family practice residents make up the majority of learners at NRGH, and occasionally there are some Royal College residents or medical students who are studying sub-specialties at the hospital – and our experiences working with visiting learners has been great.

Is the community very welcoming of residents?

Both the medical and larger communities in Nanaimo are exceptionally welcoming. As hinted at previously, the medical community is not overburdened with residents which means preceptors are keen to teach and allied health are excited to have us here. Specialty residents are not common so when working with specialists we are generally viewed as residents rather than “off-service” residents. The medical community is small enough that you get to know almost all other physicians in town and are frequently invited to social gatherings. As for the community at large, Nanaimo is excited to have residents. There are lots of events, sports and social groups to get involved with.

What are the facilities like at Nanaimo Regional General Hospital?

The hospital is the primary referral centre for the North Island. It covers the same volume as Victoria and has the third busiest ER in BC. NRGH has many new and/or renovated units that are a joy to work in, including ER, renal, palliative and maternity. The residents’ area is really nice, quiet, and easy to access and includes a lounge, private call rooms, showers, lockers, and kitchen.

What traits should incoming residents have to appreciate the Nanaimo program?

Self-directed learners do best given the amount of freedom and flexibility we are given. If you’re interested in full-scope family practice or are interested in several focus areas this will be a good fit for you. Loving the outdoors means you will love Nanaimo.

What kind of lifestyle do you have in Nanaimo?

Even though it’s small, Nanaimo is definitely a city. There’s a thriving arts community and there are some great restaurants. A lot of outdoor activities are easy to get to – hiking, biking, kayaking, and diving. Nanaimo has extensive parks and recreation facilities as well as an interconnected path system within the city. Surfing and skiing are a short drive away. The city is large enough to have all the amenities but still small enough to have a community feel to it. If you want to visit Vancouver, there are two ferries to the Lower Mainland that run regularly, or a quick twenty-minute float plane ride. Victoria is only 100km drive from Nanaimo so everything truly is really close.

What do you think is the biggest strength of the Nanaimo program?

Some of our biggest strengths/unique features are:

  • Choose your own call schedule plus significant flexibility in your schedule otherwise
  • Opportunity to do international elective (such as a palliative care elective in Nepal)
  • Weekly resuscitation rounds in our simulation lab with an intensivist and emergency nurse
  • Lots of work with the hospitalists throughout the 2 years
  • Opportunity to follow your patients from community clinics when they are admitted to hospital