Abbotsford-Mission

Site Director Message

So…  Another CARMS Website… Argh!!

​If you’ve arrived on this page, hopefully you’ve decided that Family Med is what you want to do and you’re now at the step of “Where do I want to go?”

Honestly, what sets us apart?

Like all other training programs you’ll be trained in all aspects, will feel comfortable with full service family practice, will have lots of support and responsibility, and will work in an FP office and in a regional hospital and become part of our communities. So, what makes us different?

Deep down, we really do love our Residents! Residency is a stressful time and we try to make your learning environment as supportive as possible. So, that means, you do call until 11pm for most rotations. We try to be as flexible as possible (while supporting 17 residents) and you get lots of elective time in your second year (4 months).

And so far, it’s working! We’ve graduated 7 classes so far. We have a great, and every grad is doing some sort of full service or enhanced family practice!

There are a few things to expect if you come to Abbotsford-Mission:

  1. It’s best if you move here. It makes your life so much easier and you will get to become part of the community. Traffic is getting worse and worse making for a difficult commute from surrounding communities.
  2. You will need a car. (sorry) You can get away with biking to work for parts of the year but you will still need to be able to drive.
  3. We place 3-4 residents in Mission which is a 15 minute drive across the Fraser River.
  4. Expect to work hard. We have high expectations in terms of training you to be the best physician you can be.

To get a better sense of what we’re about, come look at our Website: https://abbotsfordfamilymed.wordpress.com to see what we’re up to.

And … if you decide on another site but want to come do an elective here, we are always happy to have visitors!

Good luck on your CARMS journey!

Sincerely,

Dr. Holden Chow

j.holden.chow@fraserhealth.ca

Chief Resident Message

Welcome to Abbotsford-Mission!

Abbotsford is a suburban regional centre with a population close to 150,000, whereas Mission is smaller with a population of just under 40,000. Abbotsford is home to the Abbotsford Regional Hospital and Cancer Centre. Mission is located about 15 minutes away by car (or a beautiful bike ride over the Mission Bridge); the smaller Mission Memorial Hospital is located there. Residents will spend most of their time in Abbotsford, with some home Family Practice clinics and optional rotations located in Mission.

Our program is a close-knit one, just like the group of generalist and specialist physicians practicing in Abbotsford-Mission. Thanks to both the Department of Family Practice and our specialist colleagues, we have a professional environment that emphasizes learning over service. Family doctors have a strong presence both in the community and in the hospitals, and our doctors are keen to ensure that our residents graduate as fully capable full-service family physicians – after all, we just may be their close colleagues in two years’ time.

The Abbotsford-Mission Family Medicine residency program is no longer new – we have graduated 7 cohorts of residents. Our graduates have gone on to practice full-service Family Medicine including Obstetrics, Inpatient Medicine, and Emergency Medicine in a variety of communities, including rural locations. It is our goal to have well-balanced, capable, and happy graduates that are fully able to practice the entire spectrum of Family Medicine. To that end, we have maximized flexibility within the program so that you can build your skills wherever your interests and needs lie. Abbotsford-Mission graduates have also gone on to complete extra training in Emergency Medicine, Maternity Care, Palliative Care, Addictions Medicine, Sports Medicine, Prison Medicine, and even Psychiatry!

Benefits of the Abbotsford Site

Excellent Learning Opportunities

  • As the only residents in the hospital, you will be working directly with staff – first in line for consults, first for procedures in the ER, and first to perform deliveries and assist on c-sections on the maternity ward. When on surgical rotations, you can do your own intubations before scrubbing in and you are strongly encouraged to be a part of the code team in the hospital.
  • Family doctors are at the core of inpatient care in the hospital. They take care of all non-surgical and non-ICU/CCU/Pediatric patients. This provides excellent opportunities to manage sick patients. While you’re free to manage these patients on your own and with your preceptor, when things get over your head, you’re still fully supported in a tertiary care hospital with consultants in most specialties. In addition to the units mentioned above, we also have a NICU run by local Pediatricians, a Psychiatric ward, a tertiary Palliative Care ward, and an Oncology ward that benefits from being adjacent to a regional cancer centre.
  • The hospital runs efficiently without residents. This translates to less service requirements and more time spent learning. Your experiences are for your own learning, which means you get to go see the best cases. Preceptors see your work as an appreciated extra set of hands as opposed to an expectation.

Call…Abbotsford Style

  • Call is unique in Abbotsford compared to other Family Medicine programs in BC. On all our core rotations (except Obstetrics) we do call until 11pm without a post-call day. Obstetrics is the standard 24-hour call. The reason behind this is simple: learning and wellness. We have high-quality and high-volume days on rotation, and we feel that you learn more during a full day on rotation than you do overnight on the last eight hours of a twenty-four hour shift. This call structure is also great for keeping our residents rested and happy, which we feel maximizes learning.
  • We do 1-in-4 call for all of our core rotations, including Family Practice. This is a great asset in our R2 year, when we are allowed to do “choose your own adventure” call. This means that instead of doing our standard Hospitalist call (dealing with ward issues and admitting patients from the ER), you can opt to do shifts in the Abbotsford or Mission ERs, Obstetrics on the maternity ward, or really any other type of call that appeals to you. If you can set it up, you can do it!

Great Staff and Colleagues

  • There are only 8 residents in Abbotsford-Mission per year, so the staff are not burnt out from teaching. Having a learner along is the exception, not the rule, so they are eager to teach…whether you’re working with them or not! If you pass by and there’s something interesting on the go, they’re excited to share the learning opportunity with you.
  • Of equal importance, our program staff are very friendly and receptive to feedback. The program is constantly evolving and everyone genuinely wants to make Abbotsford-Mission the best program in Canada.

Special Rotations

  • The rotations that stand out to us are too many to mention, but we thought we would highlight a few here…
  • Our Emergency Department is entirely staffed by CCFP (EM) and FRCP (EM) graduates, and residents complete a core six-week rotation. It is a busy department and ARHCC is a Level 3 trauma centre, treating patients from many neighbouring communities including Mission and Hope.
  • Our Obstetrics rotation is six-weeks in length and is very high in volume. Residents are involved with all the Family Practice and Obstetrician deliveries and are responsible for assessing all patients that come through triage. The Abbotsford Maternity Group is staffed by Family Physicians who do exclusively Obstetrics and as a result, are among the most competent mentors to learn from. Most residents will deliver around fifty babies over the course of their rotation.
  • Another is an excellent four-week inpatient Palliative Care rotation on our own tertiary care unit. This unit is run by Family Physicians with extra training in Palliative Care.
  • We also do a core two weeks of Anaesthesia, which is airway-focused. You are not obligated to stay in one room, but instead are free to hop between rooms, maximizing time spent working on your intubation skills. Residents typically get around thirty intubations over the course of the two weeks.
  • On our Pediatric and Psychiatry rotations, we spend time at Abbotsford’s Youth Clinic, a truly unique place which caters to vulnerable youth.

Longitudinal Family Medicine

  • Abbotsford-Mission allows you to provide real continuity of care to a very diverse patient population. Throughout your two years here, you have at least one half-day per week with your Family Practice preceptor. Patients are scheduled on your half-days so you can follow them over the course of weeks and months. For the other half of the day, either before or after clinic, you will have an academic half-day with the rest of the residents. This means one full day devoted to Family Practice weekly, regardless of the service you are on.

Beautiful Hospital

  • Built in 2008, ARHCC is a 300+ bed hospital…and it is beautiful. It’s also your home for almost two whole years. You’ll be able to greet people by name as you walk in each morning. Conveniently, all of your rotations are done in one hospital, so you’ll only have to learn one EMR, one telephone system, one layout.

Leadership Opportunities

  • Abbotsford and Mission are constantly evolving communities, making them excellent places to further your medical leadership skills. We are involved in a few community outreach programs and have an incredible youth clinic, which is often staffed by our new graduates. This clinic has become a model for other youth clinics throughout the province.
  • Furthermore, we all hold a leadership role throughout residency and work as a team with the program staff, who strongly value our feedback, to make changes to optimize learning and resident satisfaction.

Work-Life Balance

  • We have partners, kids, families, friends, pets, and plants… and are committed to create a healthy balance between work and the rest of life. Staff encourage us to work hard, but also want us to be healthy and happy in residency. Our resident group supports each other and we love to have fun! Dinners out, ski trips, and retreats to wine country are just a few of our recent adventures. There are even two resident retreats per year that are call protected so everyone can attend.

Great Outdoors

  • The Fraser Valley has wonderful outdoors opportunities. From hiking to skiing, you can be active year-round. Or you can go to the well-equipped, but very affordable, gym at ARHCC to keep in shape! You can ski Mount Baker, hike Mount Cheam, and then drive down to the US to bike around the San Juan Islands.

Weaknesses

A frustrating part of CaRMS is hearing everyone play-up their program’s strengths while minimizing the downsides of the program. We love our program and feel that the list of weaknesses is short, but we think these things are better to know up-front.

  • Residents are still somewhat new to the hospital culture in Abbotsford. This means, as mentioned above, the hospital will run fine without you. In order to maximize your experience here, you really do need to take the initiative to get involved. People love having your around once you declare yourself, but no one will force you to do anything. If nurses don’t know you’re on call, they will just call the staff. If the staff doesn’t know you’re on call with them, they will do the consult themselves. The ideal residents for Abbotsford are willing to put themselves out there – there’s a treasure trove of learning to be had, but you have to go for it!
  • There is also less formal academic teaching in Abbotsford. Internal Medicine illustrates this well. There is no CTU here as Internists do not have admitting privileges; they function as a consulting service. Our Internal Medicine rotation is fantastic – you can pick and choose from a high volume of consults and your staff will teach around your cases, but there are no bedside rounds, no morning report, and no CTU team. It is up to you to read around cases and topics, and ask your preceptors your burning questions.
  • There are limited opportunities to teach medical students. We do case presentations at half-days to teach each other, presentations for nurses during certain rotations, and we have an active journal club. However, we only have medical students coming in for a few rotations where you will have the opportunity to pass along your wisdom (Pediatrics, Psychiatry, and Internal Medicine).

Feel free to send us an email with any questions about the program – we’d love to hear from you! We look forward to meeting you on the CaRMS tour!

Drs. Michelle Hanbidge & John Stimson

michelle.hanbidge@alumni.ubc.ca

john.stimson@alumni.ubc.ca


Number of Residents: 7 CMG, 1 IMG
Location: Abbotsford, BC
Community: 150,000
Hospital: Abbotsford Regional Hospital and Cancer Centre

Curriculum Type: Partial Integrated
R2 Elective Time: 
12-16 Weeks
Phone: 604-851-4700 x 642326
Contact: Director – Holden Chow j.holden.chow@fraserhealth.ca / Coordinator – Ann Douglas ann.douglas@fraserhealth.ca
Chief residents: John Stimson – john.stimson@alumni.ubc.ca / Michelle Hanbidge – michelle.hanbidge@alumni.ubc.ca

Overview

The people of Abbotsford expect the family physician to be their main caregiver providing full service care. The site will train family doctors who will service smaller urban communities where the care of patients is directed by family doctors. Residents will be mentored by preceptors who practice full service care. Abbotsford is one of the fastest growing communities in Canada and you will be amply exposed to all ages. Particular strengths are obstetrical, pediatric, and palliative care.

A majority of training will occur through the regional referral center, the Abbotsford Regional Hospital and Cancer Center, a 300 bed facility. Some highlights include a 150 bed Medical Unit under family practice, Obstetrical unit with approximately 2,500 births per year mostly delivered by family doctors, a tertiary Palliative Care unit, dedicated Geriatric unit, stand-alone Oncology unit, a busy Emergency Department, and a Regional Trauma center run by CCFP-EM Colleagues. Because we have a small number of learners, you will be able to do lots of procedures and see lots of patients. You will also be given responsibility.

Academic Structure

We use a ‘partially integrated’ model which means in the first year, you will rotate through core rotations. However, you will be back in your FP offices one to two half days a week on an ongoing basis. This ensures that you stay well-grounded in family practice and develop continuity with your practices. This ability to stay connected with your family practice office is one of the strengths of this training site.

We also pride ourselves in our Academic Half Day program. We take advantage of this time to supplement and emphasize important topics. There is plenty of interaction and we always have a family physician facilitate to maintain relevance to Residents. In our Academic Program, we also focus on reflective practices and medical leadership. In addition to key topic lectures, we have resident lead journal clubs and case presentations. Our past residents wanted more practice in certain skills and as a result, we created a recurring series to strengthen skills in ECG reading, Oncology, Radiology, Clinical Reasoning and Procedure Days. We also focus on reflective practices and medical leadership.

How are we unique?

We are currently the only program with a Program Coach whose main focus is the quality of teaching and evaluations. The Program Coach provides resources and training to the preceptors and residents from an educational perspective.

We have a flexible call with overnight call options for some rotations. Most call shifts are evenings and end at 11pm. Call is flexible in the second year.

We also have very strong leadership in our residents and actively collaborate with all 17 residents to improve the program experience. Please contact Michelle or John if you have any questions. For more information on what is happening at our site please visit https://abbotsfordfamilymed.wordpress.com/

Abbotsford is known as the “City in the Country”. The city is surrounded by beautiful mountains and farmland but has great amenities in close proximity to the city center. Please check out http://www.abbotsford.ca/ for more on our beautiful community.

Sample Rotation

BLOCK 1 2 3 4 5 6 7 8 9 10 11 12 13
R1 FAMILY PRACTICE PSYCH IMCS SURGERY PALLIATIVE FAMILY PRACTICE EMERGENCY ANA/NEPH CCU FAMILY PRACTICE PEDS OBSTETRICS

 

BLOCK 1 2 3 4 5 6 7 8 9 10 11
12 13
R2 ELECTIVE – ADDICTION MED ST. PAUL’S ELECTIVE – EMERG ELECTIVE-ANA, Calgary ELECTIVE-DERM Vancouver ELECTIVE-ENDO FAMILY PRACTICE RURAL-Williams Lake ELECTIVE-OBS Surrey Memorial/ELECTIVE-TRAVEL MED FAMILY PRACTICE

Interview with Jesse Janssen (Former Resident)

What made you choose the Abbotsford Site?

Abbotsford is similar to the kind of city that I would like to practice in – it’s small (150,000) and has a strong sense of community. The family doctors here are full-service so there are opportunities for me to learn a broad range of family medicine.  While it’s small enough that there’s minimal competition for learning, t’s large enough that you have access to all specialists (minus cardio-thoracic and neurosurgery).

Describe and average day of family medicine in Abbostford…

Abbotsford is nice because everyone eases into the program with a month of family medicine.

Most docs still have hospital privileges so your day begins rounding on your preceptor’s patients at the hospital.  From here, you’ll go to clinic and as your training goes on you’ll become more and more independent.  As you spend more time in the clinic, you’ll begin to pick up your “own patients.”  These are people that you’ll follow—almost exclusively—and the MOAs will make sure to book them with you.  Most residents’ days end around five.  Prior to starting residency, efforts will be made to pair you up with the preceptors whose practice closely resembles your future goals (ie. Preceptors with special interests in rural, inpatients, ER or maternity etc)

What are some of the unique learning opportunities at this training site?

I think all of our rotations are strong, but our most unique opportunities would be:

  • Month long palliative care rotation on a well-established palliative care ward.  I now feel comfortable using opioids, addressing pain, and feel more prepared for end of life discussions.
  • Youth Clinic runs twice weekly in the evenings. A new initiative by one of our faculty members, it’s only a few years old, is often staffed by new grads from our program, and brings a smile to your face regardless of the kind of day you’ve had.  Probably one of my most meaningful experiences to date: I’m away on elective now and can’t wait to get back and help out.
  • Aboriginal reserve visits.  Weeklong trip up North with Dr. John to visit some of the reserve communities he cares for via telemedicine in Abbotsford.  We’ve only had two residents participate in this program.  The funding is a bit spotty at the moment, but we’re trying to get everyone up North with Dr. John to see the kind of medicine he practices.  It’s an inspirational experience, and while not fully up and running (and may never be), I think it highlights our programs desire to seize new opportunities.

Is there a large service component to your residency?

We are on call roughly 1 in 4 for all rotations. For most rotations we are on call until 11 pm, and then work the following day. This is different from the typical 24 hour call followed by a post call day. There are so many rich learning situations available at Abbotsford Regional Hospital and the staff are eager to teach residents. This makes our call shifts a great learning experience.  There is minimal service expectation at the hospital.  This allows your experiences to be maximized for learning.

Does it get fairly competitive with the other residents?
There’s no competition amongst the residents – in fact, it’s quite the opposite. There aren’t very many learners at our site but there are a lot of staff who are available to teach. They give us first crack at the interesting cases and we’re often first in line to help out with surgeries. We’re encouraged to go to the ER to see what’s happening and to sign up to help out if we have time.

What kind of facilities are available in Abbotsford?
The hospital was built in 2008, so it’s really new. It’s a tertiary care facility – nearly all of the specialties are represented here and we handle most of the cases within the hospital. To my knowledge, the only cases that are transferred out are neurosurgery, cardiac surgery and cardiac catheterization. The hospital handles a high volume of obstetric (~2000 deliveries) and emergency cases so it can be busy even though the community is smaller than an urban centre like Vancouver.  Abbotsford also has a wing for the BC Cancer Agency and has an extensive dialysis program as well.

Are there many recreational and cultural activities available in Abbotsford?

We work hard, and love our time outside the hospital too! Over the last year, we’ve toured BC’s wine country, explored the San Juan Islands, and even been paintballing together (funded by our site director!).  We make a point of spending time together outside the hospital, which is a fun way to bring us some balance.

There are established annual activities in Abbotsford, such as the International Airshow, the Berry festival and Agrifair. Abbotsford has its own symphony and an excellent recreation centre. Vancouver is only a 45-minute drive away, so residents have access to big city events as well.

For outdoor enthusiasts, there are a lot of amazing opportunities. There is excellent mountain biking, hiking, white water rafting and camping in the Chilliwack and Mount Baker areas. During the winter, you can go skiing at Mount Baker as well.

What do you think is the biggest strength of the Abbotsford Site?
The learning opportunities at this site are excellent. The environment is very supportive, there is a lot of one-on-one learning with staff members. I love walking through the hospital and knowing many of the faces. As a resident, you can explore all that medicine has to offer. Personally, I’ve found that this residency has allowed me to really put all the pieces of my training together and apply it to patient care. I love being in a smaller site, getting the chance to know the people around me.