Rural Northwest (Terrace)

Site Director Message

So you want to be a Rural Family doc…Where do you want to end up practicing? What kind of working environment do you want to be immersed in? What do you want to do beyond work and how far do you want your working dollar to stretch? The Rural Program, through the North West/Terrace UBC residency site is a community-based, longitudinal, integrated program which prepares residents interested in Rural Family Practice to be confident and competent. Most of our graduates are working in rural locations.

Program Structure

We have built a program that emphasizes continuity, learning in the context of the rural environment, and stability. Most of your time is spent in the NW region of BC with elective opportunities (8 weeks) for international and small rural learning opportunities. Our residency site offers a four week block of time in the Emergency Department at BC Children’s Hospital for our second year residents, which is always well received. An enhanced curriculum will include ACLS, ATLS (or equivalent), ALARM, NRP, and Enhanced Surgical Skills Course which will help you build your foundational skills in rural medicine.  Opportunity for participation in the Society of Rural Physicians of Canada conference will help you consolidate your network of like-minded professional contacts in an educational setting.

We pride ourselves on the community responsive component of our program. Work takes place in many different settings both in the office/hospital and in the community, giving fuel to the adage that Medicine is more than an office job. In a small community you can make a big difference.

Call schedules are flexible and resident-driven. Residents work with a dedicated group of Family Physicians as well as competent specialists, which allows for adequate back up and a degree of unparalleled exposure to many facets of medicine. For example, our hospital functions as a regional ICU as well as a regional acute Psychiatry unit.

Lifestyle

You will work hard, but we also want you to play hard! Terrace and the surrounding area are known for a variety of recreational opportunities and boast some of the cleanest air in the province. Snow tires are a must in the winter, but how else would you get to the most powder in the province? Access to hiking is just outside your back door, and the fishing is world class. Terrace is also culturally rich with local theatre and community music programs.

Our site has a high degree of exposure to First Nations patients as we are located in a diverse population of First Nations in the region. We are also a site for the Northern Medical Program responsible for training third year medical students, so teaching is a major component of our program too.

Since we are located in a small town, the cost of living is affordable and your working dollar will go further… So breathe the fresh air while you get a little more financial breathing room. If you have a student loan, you’ll want to investigate the government student loan forgiveness programs for health care professionals working in rural areas. BC Provincial and Federal student loans are forgiven at different rates starting in first year of residency. The Rural Northwest Program is one of only a few sites in the province where this Loan Forgiveness Program applies.

The people who do best in this setting are adventurous, flexible, and adaptable. If you are seriously considering us, we want to hear from you. Contact us by email with any questions or come for a visit. If you want a resident’s perspective, make sure you get in touch with them. They are very accessible and willing to chat about the program.

Dr. Greg Linton

glinton@parkavemedical.ca

Chief Resident Message

Welcome to Terrace! We are UBC’s Northwestern Family Practice residency training site. If you are looking for a warm welcoming community in the heart of the Coast Mountains and residency training in a rural community hospital, with busy specialists and full-service family physicians, then Terrace is the place to be. We are a close knit group of collegial and active residents and medical students and would love to welcome you to Terrace.

In Terrace, we are leading the change that will soon be seen across UBC’s entire family medicine program, with a switch to the Triple C Curriculum. We are “centered in family medicine,” with family medicine preceptors overseeing inpatient care, clinic visits, emergency room care and academic half days. “Continuity of care” is a main focus of our longitudinal program, with opportunities to follow patients over the full two years in the program, both in family practice and in speciality areas. We have a “comprehensive” program in that we complete all mandatory requirements in Terrace, but there are opportunities to do electives outside of Terrace in areas you feel you want more intensive training.

A typical week here consists of 3 half days in Family Practice with the rest of the time filled with specialists and interdisciplinary care. Each morning we see inpatients either attached to our preceptors or whom we have admitted from the ER.  Call requirements are currently one weekend per month and one day per week. A call shift is a combination of obstetrics, inpatient care and emergency room care. We are involved in obstetrical care and do ER shifts continuously throughout the program.

We are a small site with 2 residents per year and are joined by 3 third-year medical students. This allows all learners to be front and center when interesting cases come through. You will never have to miss out on hands-on opportunities. Preceptors get to know learners well, allowing us to gain as much independence and responsibilities as we are comfortable with for our level of training.In addition to academic sessions, we have monthly grand rounds, module-based group learning with community preceptors and MOREOB sessions.  The program also provides financial support for ACLS, ATLS (or equivalent), NRP, ALARM and ESSC courses.  We have a diverse patient population, with no lack of interesting pathologies. There are frequent opportunities to visit and practice in some of the smaller surrounding communities, including Stewart, Kitimat, Prince Rupert, Smithers, Hazelton and the Nass Valley.

With all that talk about work, it’s time for a break! Terrace and its surrounding area are an outdoor enthusiast’s dream. Skiing, fishing, hiking, biking and just about any outdoor activity or organized sport you can think is at your doorstep when you live in Terrace. There is also an active arts and theatre community in town.  The people of Terrace are generous and happy not only to welcome resident to work, but also play in their area of the Northwest.  If you’re worried you might miss out on your favourite hobby or pastime in Terrace, just ask us and we’ll see what we can find out about it for you.

As residents, we believe that the program in Terrace provides us with the training and confidence necessary to succeed in a full service family practice in any environment in British Columbia or Canada.  We are very happy living and training in Terrace and it we had to do it again, we’d pick Terrace every time!  If you have any questions or require more information please contact us via our provided e-mail. If you want to be here, then we want you.

Regards,

Drs. Amy Passmore & Jasmine Osiowy

millsmemorial@gmail.com

Number of Residents: 2
Location: Terrace, BC
Community: 15,500
Hospital: Mills Memorial

Curriculum Type: Integrated
R2 Elective Time: 16 Weeks
Phone: 250-638-4023
Contact: Site Director – Greg Linton – glinton@parkavemedical.ca / Site Coordinator – Suzan Moldenhauer – suzan.moldenhauer@unbc.ca
Chief Resident: Amy Passmore/Jasmine Osiowy – millsmemorial@gmail.com

Overview

This program is centrally located in Terrace on the Skeena River. Terrace is known for its great recreational opportunities in areas such as sport fishing, hiking, mountain and road biking, skiing, kayaking, and boating. It is also artistically diverse supporting an art gallery, community concert series as well as the Pacific NW music festival. The region supports a diversified economy, with tourism being a major contributor. It is also culturally diverse with many First Nations bands throughout the area.

Program Highlights

  • About 30 resident physicians and 16 specialists providing services in General Surgery, Pediatrics, Ob/Gyn, ENT, Ophthalmology, Psychiatry, Urology, Radiology, Internal Medicine and Anesthesiology, with Orthopedics provided in Kitimat and Prince Rupert
  • Visiting specialists services are provided in the areas of Psychiatry, Internal Medicine, Neurology, Rheumatology, Endocrinology and Pediatrics
  • Mills Memorial Hospital, in Terrace, has 30 acute care beds, 5 ICU beds and 10 regional Psych beds and provides, per annum, 24,000 ER visits, 400 deliveries, 17,000 inpatient days (including Psychiatry) and about 3200 surgeries
  • In Terrace there are about 500 GP visits per day with opportunities to practice in other centers
  • Instead of participating in the Rural Match, residents will be placed in Prince Rupert for one month in their first year and Haida Gwaii for one month in their second year.

While family practice residents will be based in one community for the majority of their time they will need to travel to the other communities for some rotations so a vehicle is required.

Sample Rotation

This program is longitudinally integrated beginning with one month in family practice followed by incorporation of wide range specialty services.

Interview with Ashley Nicholson (previous R2)

The Northwest site is based in the city of Terrace, BC which is fairly remote. What made you choose this site for your postgraduate training?
I wanted a training program that would allow me to practice family medicine in a rural or semi-rural setting. Terrace seemed to fit the bill as it is not very large (18,000 people) but when you factor in the population of the surrounding region, that number increases to 80,000 people, so there is a lot of rural and semi-rural medicine being practiced at this site.

The Northwest program allows me to work in the family medicine clinic and train with specialists at the hospital in Terrace, but I also get to travel monthly to more remote areas for a true rural experience. I feel that I’ve gotten a balanced view of family practice at this site.

What do you enjoy most about the Northwest program?
The community up here is small, so you really get to know your patients and the other physicians on a personal level. Knowing the lifestyles and occupations of my patients helps me provide better care, which benefits them in the long term.

I really appreciate that the physicians and staff at the site are very collegial and treat the residents as peers. They’re very supportive about lending us a hand when we need one, answering questions and teaching. I feel comfortable and confident in this environment because I know that if I need help, it’s readily available.

What kind of learning opportunities are available at the Northwest site?
There are amazing learning opportunities here – with only two residents per year and three medical students from UNBC, there is no competition for procedures so you get a wide range of hands-on experiences. For example, it’s very easy to be included in the surgeries and more often then not, you’ll be the First Assist. In this program, you quickly become used to doing procedures which in turn helps you feel more confident and capable, especially in rural settings.

The specialties here are well represented. There are general surgeons, OB/GYNs, anaesthesiologists, ENTs, a urologist and even an opthamologist. There are internal medicine specialists who make regular trips to Terrace so we have access to that skill set as well. The only specialty that’s not immediately available is orthopaedics – this specialty is however available in Kitimat and Prince Rupert and is included in our residency training.

Is there a large service component to your residency?
Terrace Hospital is not service driven and thus doesn’t rely on residents to function routinely. If our preceptor is on call in the ER, we’ll take the call with them. Generally though, we’re on-call about 1 in 3 to 1 in 4. On the weekends, residents are on-call about 1 in 5 or 1 in 6. The only exception to that schedule is the inclusion of obstetrics call which is in addition to regular call.

Is the community very welcoming of residents?
The community of health professionals is very supportive of residents. There aren’t a lot of other residents so you get to know your colleagues very well – not just as preceptors but as people. Several of the physicians provide mentoring that goes beyond medicine – they provide a lot of advice and coaching about life and career, which I really appreciate.

What kind of facilities are available in Terrace?
Terrace Hospital is an older facility but it has a newly renovated ER/Trauma and the Radiology department has been upgraded with new equipment including a CT machine and fluoroscopy.

All of the clinicians and specialists have their offices in one building with the exception of the urologist. This is really convenient, especially if you have a patient who needs a specialist emergency consult – you can just send him/her down the hall for an appointment and reduce the wait time for a specialist consult.

Are there any recreational and/or cultural opportunities in Terrace?
There are many opportunities for sports and outdoor activities in Terrace. You can go hiking, wildlife viewing, backcountry skiing, cross-country skiing, mountain biking and road riding. The local ski hill is within a 30 minute drive of Terrace and it boasts an average of 40 feet of snow each year. There are several indoor sports facilities for adult recreational hockey, soccer, tennis and badminton.

Culturally, you can tour the ancient lava beds in the Nass Valley, visit the local historical sites and tour native villages in the region. There are also some small galleries featuring local artists.

What are the living conditions like in Terrace?
Housing and accommodation are actually quite reasonably priced, although the availability of rentals varies depending on the time of year. You don’t need to have a car for daily activities/errands in Terrace – I found accommodations within walking distance of the hospital – but it is convenient, especially on the days when you travel back and forth a lot between the clinic and the hospital. A car is definitely a necessity when it comes to traveling to near by communities for clinical consults. Because there is often snow and black ice on the roads in the area during the winters, it’s best to have a vehicle with four wheel drive and winter tires.