Prince George

Number of Residents: 6 CMG, 4 IMG, and 5 Northern Rural
Location: Prince George, BC
Community: 72,000
Hospital: The University Hospital of Northern British Columbia
Distance from Vancouver: 752 km

Curriculum Type: Block
R2 Elective Time: 12 Weeks
Phone: 250-565-2549
Contact: Director – Dr. James Card / Coordinator – Roghieh Soufinia
Lead Residents: Dr. Graham Shaw & Dr. Jerome Williams 

Overview

Prince George is the largest Northern center for healthcare, inclusive of surrounding regions, servicing approximately 320,000 people. The University Hospital of Northern BC (UHNBC) is Northern BC’s largest state-of-the-art healthcare facility. This program incorporates the best practices of rural and remote medical education from around the world, providing outstanding exposure to direct care to patients. Through its collaboration with northern communities and Northern Health, the program utilizes various acute care facilities, long-term care facilities, community health centers and public health unit to ensure residents in Prince George are ready to take on any challenge their future in family practice hands them!

The PGY-1 year is structured in block rotations that includes a two-month rotation in the resident’s home family practice office.  This is complemented by weekly office half days that allow for the development of a “resident practice” and a reminder of how each rotation is relevant to our future as family physicians. In the PGY-2 year, residents have 12 weeks of elective time to accommodate their own learning objectives. There is a 5-month family medicine block with integrated longitudinal exposure to palliative care and geriatrics. At the end of this rotation, there is the opportunity to do a “trial locum” under the supervision of attending family medicine staff. There is an 8-week emergency rotation with excellent teaching and the opportunity for the resident to “run the department” within their abilities and challenges residents that are up for it. Further critical care training is provided in a closed ICU where the PGY-2 works with the intensivist as the sole learner; there is ample opportunity bedside teaching to help prepare the family medicine resident and ample opportunity for procedures.

The distribution of the first and second year residents throughout the hospital makes virtually no learner conflict for clinical opportunities and procedures. The presence of clinical clerks both in their third-year rotations and visiting fourth-year electives also provides ample opportunity to act as a resident teacher and supervise clinical opportunities and procedures. There are senior residents visiting from Vancouver in internal medicine with CTU, and often in general surgery, peds or OB/GYN, whose presence typically benefits our learning as they act as mentors and offer valuable bedside clinical teaching. Our resident group is very close-knit and often can be found spending our leisure time together.

Within Northern health, there are over two dozen acute-care facilities, 14 long-term care facilities, public health units, and offices providing specialist services. In Prince George, there is a 219-bed tertiary care hospital, with an ICU and a level 2 NICU. We don’t have a hospitalist model and most of the family physicians within the community take an active role in caring for their patients admitted to hospital.  There is a brand new BC Cancer Agency center which opened in January 2013. The Central Interior Native Health Center provides primary care to First Nations peoples, outreach services to patients with complex problems and those who live close to or on the street. Other agencies include the Child Development Center, the Suspected Child Abuse and Neglect Clinic and innumerable traveling specialty clinics. As residents, we have access to this wide range of facilities that provide abundant learning opportunities where the resident finds him or herself to be the sole learner. Northern Health is known for strong primary health care system. People experience seamless and coordinated service. The ‘Primary Care Home’ is the foundation for multidisciplinary health care and helps people navigate across services.

Since there are fewer learners, people who choose the Prince George Site should be relatively independent and motivated to seek out the many learning opportunities available. As the family physicians in the North have a broader scope of practice, the residents have greater opportunity to gain clinical experience, procedural skills, teaching, leadership, community involvement and patient advocacy. If you are willing to commit, engage in the program and take charge of your own residency training, you will complete the two years with a solid foundation and readiness for independent practice.

Program Highlights

The University Hospital of Northern British Columbia provides referral services to much of Northern BC and includes an emergency department, ICU, ambulatory care facilities and in-patient tower with all major specialties, except cardiothoracic surgery, neurosurgery and dermatology.

• Our Purpose is to foster diversity and clinical excellence to produce competent, professional, full service family physicians.  Our Aspiration is to be a connected, vibrant community of adaptable family physicians and trainees, committed to an excellent learning environment, high quality primary care and community health and well-being.
• Family physicians are involved in the care of most hospitalized patients, do all the primary care obstetrics, and staff the emergency department.
• Teaching practices located either in a clinic on the grounds of the regional hospital with 17 Family Physicians, or 5 community practices with 9 Family Physicians, providing full service.
• Primary focus is training for work in communities outside major metropolitan areas with emphasis on procedural skills, primary care and management of acutely ill or injured patients, especially when access to a specialist’s care may be limited.
• Optional enhanced rural exposure in R2
• Call is busy, occurs approximately 1:4, with Call free Fridays – a common night off, creating the opportunity for all residents to get together socially.
• Emphasis on a balanced life with a goal being to afford residents the opportunity to hone personal qualities and skills in a work environment that is challenging but also collegial, supportive and fun

Sample Rotation

Current PGY1 Rural options:

Quesnel – General Surgery, ER

Williams Lake – General Surgery, ER, Ob/Gyn, Peds

…and we are working on more!

To get an understanding of what life could be like outside the learning hours, please refer to the Chiefs message above and please don’t hesitate to contact us with any further questions.

Here is a highlight of R1 rotations in Prince George (modified if you are choosing rural options) to get an idea of what your first year would look like:

General Surgery: a 4-week rotation. Potential of being the senior for 1-3 medical students, organizing rounds, organizing medical students, OR assisting or care of ward patients. Opportunity to attend scope clinics, lumps and bumps clinics and wound care clinics etc. Call 1 in 4 in hospital overnight.

ER: a 4-week rotation, paired with an ER physician for your shift. 4 hours in acute care, 4 hours in minor, or 8-hour shifts in acute care. Tons of hands-on experience including suturing, intubations, etc. and lots of independence.

Pediatrics: 3 weeks on CTU and 3 weeks on ambulatory. Call is 1:4, with only 1:7 during ambulatory. Potential of being senior for medical students, and lots of 1:1 time with staff. Opportunity to participate in the care of infants in a level III NICU.

Orthopedics: 4 weeks working 1:1 with orthopedic surgeons doing consults in the CAST clinic, assisting in trauma OR and routine replacements, as well as X-ray rounds. 1:4 call.

Obstetrics/Gynecology: 6 weeks of 1:2 call for obstetrics gaining hands-on experience doing deliveries and assessments with family physicians and in complicated cases, assisting in the C-sections with obstetricians. Many residents have 10 or more supervised solo deliveries. 2 weeks of Gynecology gaining skills in office 1:1 with the Gynecologists.

Psychiatry: 4 weeks of a combination of outpatient and inpatient medicine.

Internal Medicine: 7 weeks on CTU and 1 week of ambulatory with no call for ambulatory. 1:4 call for CTU. The most learning is done by residents on this rotation as you work closely in a large team led by an attending physician, clinical teaching associates, pharmacy, and senior internal medicine resident during the day. Opportunities to do skills like ultrasound and weekly ultrasound teaching, as well as thoracentesis/paracentesis. During the night, you gain independence in seeing consults, with backup from your staff.

Family Medicine: two 4-week blocks where you get to spend time in your family practice office.

Addictions: a unique two-week rotation working in adult and youth Detox, opioid agonist therapy clinics, as well as obtaining your prescription privileges for suboxone and methadone.

Central Interior Native Health: This unique rotation focuses on Indigenous health and is a mixture of inpatient and outpatient care. One weekend of call. Loved by all residents; it involves getting to know how to work in an interdisciplinary team and utilize community resources.