St. Paul’s

Site Director Message

Welcome to the St. Paul’s Site of the UBC Family Practice Residency Program! Our Site offers opportunities to gain experiences in Inner City Medicine, Addiction Medicine, LGBTQ2S Health, HIV/AIDS, Palliative Care, Primary Care Maternity, Refugee Health and Indigenous Health, along with highly acclaimed rotations in Emergency Medicine and our own Family Practice Teaching Service. We focus on the development of strong clinical skills and independent judgment through experiential learning with excellent Family Medicine and specialty support in both community-based and hospital settings.

Our first year consists of block rotations as well as longitudinal academic and Family Medicine time to allow you to build comprehensive clinical skills and to start to experience continuity of care with your preceptor’s patients. Our unique “longitudinal” second year allows you to select and tailor your electives and selectives to meet your particular clinical, academic, and career needs and interests. In second year, you will be able to divide your time much like a full-service family physician might: covering your own practice 2-3 days a week and balancing that with electives, shifts in the ER, hospital or nursing home visits, attending births, and taking call with your community preceptor. This provides you with a self-directed, flexible and unique opportunity to focus your training to build the skills you need.

The faculty and community-based preceptors at our site are known for their collegiality, diversity and excellence in teaching and research. We meet regularly as a group with resident representatives to ensure that the concerns of residents are addressed promptly and openly. Collectively, we have a diverse range of interests and academic achievements that are woven into the academic program at our site. These include Addiction Medicine, Behavioural Medicine, Indigenous Health, End-of-Life Care, Maternity Care, LGBTQ2S Health, Inner City Medicine, Health Advocacy, Medical Education and Primary Care Research. We value respectful relationships and resident wellness. We work hard to establish and nurture effective team work and self-awareness.

Our residents have performed well on the certification exams in Family Medicine, and are now practicing effectively across the country from the inner city of Vancouver, to rural locations such as Haida Gwaii. A number of our graduates have also gone on to develop successful research, academic and medical education careers, and many have returned to St. Paul’s as preceptors and leaders.

Our Site Coordinator Dawna Brown and Program Assistant Maria Totsikas are key administrative members of the welcoming community of individuals that make up our training site. We welcome your interest in our training site and hope to see you at the Open House!

Betty Calam, MD, CCFP, MClSc, FCFP

bcalam@providencehealth.bc.ca

Chief Resident Message

Thanks for your interest, and welcome to the St. Paul’s CMG Program!  Located in the heart of downtown Vancouver, our site has enjoyed a proud history of training excellent family physicians that enter practice both in full-service primary care as well as specific areas of interest for family medicine.

With its mission to serve a highly marginalized patient population, St. Paul’s has bolstered its staff with those who truly believe in this mission, and our preceptors are strong advocates for social justice.  As such, residents from our site leave with the full breadth and depth of family medicine but also enhanced competencies in areas including, but not limited to, inner city care, addictions medicine, HIV primary care, LGBT+ medicine, and Indigenous health.  We benefit from the academic success of St. Paul’s Hospital as well as world-leading affiliated groups such as the BC Centre for Substance Use and BC Centre for Excellence in HIV/AIDS.

Unlike Royal College specialty residents, only the St. Paul’s family medicine residents spend the majority of training at our hospital, so you will develop close relationships with other specialties and allied health at St. Paul’s.  It is not uncommon for attendings in the emergency department or consulting services to know you on a first-name basis and pull you into some quick teaching of what they were thinking about a patient.  With this connection, there is a strong emphasis in all rotations to provide the learning opportunities that are relevant to and grounded in family medicine; you are not just an “off-service” resident here.  For being a tertiary care facility, St. Paul’s has a surprisingly community-hospital feel.

Our program is a tight-knit community, and we take resident wellness very seriously.  Our Program Director is a strong believer that how we are treated as residents directly translates into how we will treat out patients as independent physicians as well as how we will treat our future learners.  We are also lucky to be backed by an experienced team of administrative staff who go above and beyond their roles to support us throughout our years of training.  The Site Faculty are always eager to engage us in shaping our curriculum, and our feedback is highly valued; we are not just residents but junior colleagues.

Our program is intentionally designed to emphasize learning and also foster resiliency.  R1 begins with a Foundations of Family Medicine month with no on-call responsibilities so you can get to know your colleagues, settle into Vancouver, and take advantage of the gorgeous patio and beach weather.  Mandatory rotations address the core areas of family practice, and we draw on the strengths of other sites such as the BC Women’s and Children’s Hospital to ensure your rotations are as high-yield as possible.  R2 is extremely flexible where the majority of the year is scheduled longitudinally, giving you the opportunity to align clinical experiences that best support your interests and strengthen areas to be a well-rounded family physician, as well as prepare you for the CCFP exam.  Our residents have completed out-of-province and international rotations and there is ample elective time to explore other areas relevant to family medicine such as research, medical education, and leadership, if you forsee that in your future career.

You are paired with a community preceptor for your two years, spending half a day per week together in R1 and 3-4 half days in R2, ensuring you have a constant patient panel.  Chosen from clinicians who are excited to teach, these preceptors will be some of your best coaches and mentors as you transition from being a newly minted resident to an independent practitioner and lifelong learner.

Needless to say, Vancouver itself is beautiful and offers a fantastic balance of city adventures and outdoor activities.  In addition to academic half day and program retreats, together the residents take advantage of what living here has to offer and we are always keen to celebrate birthdays, holidays, or sometimes just Wednesdays.  Whether you will have family here or are moving here as a new beginning, Vancouver does not disappoint.

Along with the current residents in the program, we are incredibly excited to meet you!  Residency is challenging no matter where you are, but we are all incredibly happy with our experience and we don’t think we can imagine ourselves training anywhere else.  CaRMS applicants are always welcome to get in contact with us through our e-mails below.  We look forward to seeing you during the CaRMS Open House; please stop by and say hello!

Drs. Danielle Chard & Conrad Tsang

Number of Residents: 12
Location: Vancouver, BC
Community: 600,000 – 2 million
Hospitals: St. Paul’s, BC Women’s and Children, Surrey Memorial, etc.

Curriculum Type: Block / Partial Horizontal
R2 Elective Time: 12 Weeks
Phone: 604-806-8569
Contacts: Director – Betty Calam – bcalam@providencehealth.bc.ca / Coordinator – Dawna Brown – dbrown10@providencehealth.bc.ca
Chief Resident: Danielle Chard – danielle.chard@alumni.ubc.ca / Conrad Tsang – conrad.tsang@alumni.ubc.ca

Overview

The St. Paul’s Site is connected to a dedicated group of Family Practice preceptors who serve the urban core and inner city. St. Paul’s Hospital is a tertiary referral hospital located in downtown Vancouver that maintains strong ties with the community. The site trains primary care physicians with a broad range of interests including full-service Family Practice, Palliative Care, HIV/AIDS, Addictions, Lesbian, Gay, Bisexual, and Transgender (LGBT), Aboriginal, and Global Health. It is affiliated with Vancouver Coastal Health Authority and all residents spend at least one month at Three Bridges Community Health Centre, an inner city primary care clinic. St. Paul’s is also home to the BC Centre for Excellence in HIV/AIDS and is a provincial quaternary referral center for Cardiology and Cardiothoracic Surgery related illness. There is a leading edge Palliative Care Service through which all of our resident s rotate, as well as highly regarded departments of Family and Community Medicine, Internal Medicine, and Emergency Medicine.

Program Highlights

  • Home of one of only two active Family Practice teaching wards in Canada, modeling comprehensive and continuous care in a metropolitan setting
  • Family Practice training is carried out in community practices and residents are matched for two years with a community Family Practice preceptor and will spend at least eight months with them
  • Majority of primary care inpatient and specialist training takes place at St. Paul’s Hospital, a tertiary referral hospital of 480 beds including Family Practice Ward, Obstetrics, and a very busy Emergency department
  • Paul’s has been a teaching hospital for residents and interns for over 70 years and has a proud reputation for the quality of its teaching programs
  • Opportunity to spend time in inner-city community clinics orientated to serving marginalized populations in the inner city core, including HIV, Addiction Medicine, and Indigenous Health

Sample Rotation

Block 1

Block 2

Block 3

Block 4

Block 5

Block 6

Block 7

Block 8

Block 9

Block 10

Block 11

Block 12

Block 13

PGY1

Intro

Ward

3 Bridges

FM

Elec/ Vac

Peds

Peds

EM

Elec/ Vac

OB

Mat

Surg/ Pall

IM

PGY2

Psyc

Horiz*

Horiz*

Horiz*

Horiz*

Horiz*

Horiz*

Rural

Rural

Elec

Horiz*

Horiz*

CofE/ Prac

*horizontal curriculum comprises of 16 weeks of Family Med, 8 weeks of elective and 4 weeks of surgery done longitudinally (usually in half days)

Interview with Craig Goldie (previous R2)

What do you enjoy most about the St. Paul’s Hospital (SPH) program?
St. Paul’s feels like a small community hospital even though it’s located in an urban centre. There’s a strong sense of collegiality and you get to know the doctors and nurses.

St. Paul’s unique program provides opportunities to practice inner city, aboriginal and GLBT medicine alongside traditional family medicine. Our program integrates determinants of health and social justice issues.

Is there a strong focus on doing procedures?
If you’re interested in procedures, St. Paul’s is well set up resident teaching – staff are eager to give you hands-on practice, even for ‘off-service’ family residents. I prefer focusing on the doctor-patient relationship, giving patients attention that goes beyond treatment. St. Paul’s views advocacy as a pillar of family medicine and believes that being aware of a patient’s barriers to health care – such as housing, addiction, mental illness, finances – helps you be a better physician.

How is the program organized?
R1 is fairly structured and block-based. In R2, you control your own schedule and can tailor it to include anything that interests you. The schedule is mostly longitudinal with a few blocks. You do approximately 2-3 days/week at your family practice office and then intersperse your electives/surgery clinics. You can do short block electives as well; the scheduling is extremely flexible.

The caveat to having this flexibility is that you need to be a self-directed learner – it helps to have strong administration and organization skills. The program is ideal for forward-thinkers who have a strong sense of their strengths and weaknesses and the ability to direct their longitudinal second year to improve their skills.

Is there a large service component to your residency?
We do work harder than most BC family practice residents but there’s a good balance between service and learning in most rotations. Preceptors try to ensure that we see interesting cases so that we’re not always treating the same thing. SPH depends on residents to a certain extent but the staff doesn’t treat us like scut-monkeys. Our role is clearly defined and well-respected by docs and staff. Post-call rules and days off in lieu are honoured, and we have an amazing program director who backs us up.

Is there competition with the other residents?
There aren’t an excess of residents at SPH, even though Royal College residents also work here. There are good opportunities to be exposed to procedures, deliveries, the OR and clinics without being crowded out by other learners. The SPH family practice residents are fun, vivacious and passionate. It’s common to see your friends frequently in the hallways, the ER, or while you’re up at 3 a.m. Almost nobody is difficult to work with here – we actually rely heavily on each other. If I need help with something, I know who to call because we’re aware of each other’s schedules.

How is the St. Paul’s program different from that of Greater Vancouver? 
Unlike the Greater Vancouver residents, you do most of your training in one hospital. Most of us live within 10 minutes of St. Paul’s so we don’t have a big commute. SPH’s catchment area includes the Downtown East Side so we have more exposure to addictions, infectious diseases, mental illness, and marginalized populations. St. Paul’s is the site for the +1 EM year, so we have a strong emergency medicine program.

Do residents only practice at the hospital?
We work mostly at SPH during R1 and for the R2 palliative care and psychiatry blocks. We all work at Three Bridges, an inner city clinic located near the hospital, for one month during R1. We do pediatrics at BC Children’s hospital and a community pediatric office. Our family practice offices are community-based; mine is in Kitsilano for instance. We also do a two-month rural rotation in BC. Our longitudinal R2 allows us to practice anywhere – electives are available at every hospital in the Lower Mainland and at a number of community clinics.

St. Paul’s is an older facility. What kind of services are available there? 
It’s older but it has character! The Emergency is new and the beds and equipment are modern. Obstetrics is a single-room delivery facility now which is great. It has everything you’d expect in a tertiary-care hospital with the exception of pediatrics and a step-down unit. It is the Centre of Excellence in BC for HIV/AIDS and the Heart Centre for BC.

How easy is it to settle into Vancouver?
There’s plenty of accommodation in downtown or in Kitsilano, but these areas can be expensive. However, the hospital is easily accessible by bike or transit so you don’t need a car. Almost all of the current residents live within 15 minutes and walk/use transit as parking is difficult to find. Since SPH is right on Davie St, it’s close to a lot of good restaurants. In terms of quality of life, it’s very hard to beat Vancouver.

What do you think is the biggest strength of the SPH program?
St. Paul’s is the only hospital in B.C. with a family medicine ward. It’s a great experience because you have interesting patients; you’re mostly on your own and you get to do a lot of decision-making. There’s a lot of responsibility but you have time to read around the cases and decide on treatment, and the admitting GP/Doc of the week is always available to discuss questions and concerns.

Because the R2s are covering the ward during July, incoming R1s can spend their first month of the program completely call-free. It’s a great opportunity for them to settle in and to get to know each other and the hospital. It’s one of SPH’s biggest perks.