Northern Rural- Prince George

Site Director Message

Hi, welcome to the Northern Rural site. We are passionate about rural medicine with a northern context. If you are interested in the north, and in full service rural practice, please read on…

Our site is for you if:

  • You are interested in full-service (urban or rural) Family Practice which includes office, hospital care, ER, and/or obstetrics.
  • You are interested in rural medicine
  • You are interested in rural locums
  • You want to develop a solid foundation of acute care and ER Family Practice skills to apply for an R3 ER or GPA program (we have 4 weeks of ER and 4 weeks of ICU during R1)
  • You want a rigorous, diverse, and relevant clinical experience with lots of rural influence.

This site is probably not for you if:

  • You want to work in an urban-based Family Practice office only setting
  • You want to sub-specialize into a narrow scope of urban Family Practice [we do have numerous specialty clinic experiences available but our overall focus is on fullscope family practice]
  • You enjoy traffic and unaffordable housing

So what makes us unique?

Lots!

  • We have a strong focus on northern and rural medicine. This involves heavy on call responsibility and lots of training in emergency and acute care medicine to have you ready to run that rural ER and hospital once you are done.
  • We believe in resident autonomy. Whenever possible, we try and tailor the rotations and experiences to meet the needs of our residents. Autonomy = wellness!
  • We offer optional rural experiences during some of our core R1 rotations. This will take advantage of smaller communities with more one-on-one time with specialists and Family Physicians in an enthusiastic atmosphere. This will be balanced with the volume and experience of the preceptors in Prince George, one of UBC’s most established residency sites.
  • We are currently offering mentorship in rural committee work and policy development for those interested in involvement with provincial rural networks.
  • We are incorporating frequent SIM lab sessions and ultrasound teaching (COVID restrictions depending) throughout the residency.
  • We are also piloting the use of SIM sessions in our local site orientation. This is being driven by our current residents.

Who am I?

I am James Card, the site director for the Prince George and the Northern Rural Family Practice Programs. I am a UBC Northern Medical Program graduate and a graduate of the Prince George Family Practice Residency Program. I am currently a rural physician with my clinical practice in Valemount. I am passionate about full-service family practice and Rural medicine. It is my goal to create a program that excels in transitioning residents into competent and confident physicians for Northern and Rural British Columbia and Canada.

Who are we?

The Prince George and Northern Rural site is one of the largest and most established of the UBC Family Practice residency sites. We have been training residents in Prince George since 1995.

Our hospital is unique for a community this size as most inpatients are still managed by their family physician. We do not have a hospitalist model here. The focus is on full-service Family Practice. Numerous community-based Family Physicians also work in emergency, including many of our graduates.

Historically we are known for extensive hands-on training from enthusiastic preceptors. There is also ample opportunity for teaching as Prince George is home to the Northern Medical Program.

I’ll be honest, our site has also been known for hard work. The call here is heavy, with diverse experiences. We are paying close attention to the volume and diversity of clinical experiences to ensure that our residents are appropriately prepared for independent practice. We produce strong residents (…and strong physicians)! I have heard this from numerous other rural Physicians and I have seen this personally as a rural preceptor, working with residents from all over the province.

The community:

There’s a frequent saying in Prince George, “I came here on a 2-year plan”. As a transplant from the Vancouver area myself, my 2-year plan is now going on 20. There are many reasons for this. This is truly a multicultural and diverse community of friendly people and ample opportunities.

  • Medical community – most of the family physicians here are graduates of our program, there is a reason they stick around!
  • Housing – affordable. Many residents buy. Enough said.
  • Amenities – the community is just big enough for a Costco, two indoor swimming pools and multiple other recreational facilities
  • Opportunity – many opportunities for spouses, children and family including a community college and a university.
  • The outdoors – truly amazing. I could go on for hours, please ask. If you are into it, chances are you can do it here. This includes things you would not expect. Sailing? I had a boat here for six years. Diving? Yes, that too. Really, anything!
  • Student loan forgiveness! – yes, you get that too as a resident here.

As is probably obvious by now, I believe Prince George and our program has much to offer the Resident who is interested in hands on hard work with the goal of becoming an excellent, independent, full service, fulfilled Family Physician who can practice competently anywhere.

If you are interested, please reach out to either myself or our residents.

Lead Residents – pg.fm.chiefs@gmail.com

R1 Reps – pg.fm.reps@gmail.com

I hope to chat with you soon!

Dr. James Card MD, CCFP

James.Card@unbc.ca

Lead Resident Message

Welcome to the Northern Rural program!

We are a small—although recently expanded program—who are adventurous, don’t mind a little bit of winter, and are passionate about rural medicine. Our program, now offering five residency positions, strives to train residents to be fully prepared to practice full scope rural medicine, in addition to whatever future setting you might imagine yourself in. Many of our grads are locuming across rural BC, pursuing FM-EM or GPA training, are working in rural and semi-urban emergency departments, or are focusing in Addictions medicine or Women’s Health. The Northern Rural program is overall a strong program, offering opportunity for lots of adventure, a fun year amongst your Prince George co-residents in R1, and the opportunity to maintain ties to some fairly amazing rural communities across BC.

The Northern Rural program is comprised of two distinct years, with block based learning in R1, and largely rural and elective time in R2. The R1 year is spent in Prince George, the major hub and referral centre in northern BC. PG has a population of approximately 75,000, with a large catchment area of approximately 320,000. The medical community in PG is warm and inviting, composed of many grads from the PG and Northern Rural family medicine programs. R1 is comprised of a total of two blocks of family medicine (combined time in your primary clinic and the Native Health Centre), with the remainder of the blocks “off-service”. Other rotations in R1 include Psychiatry, Obstetrics and Gynecology, Orthopedic Surgery, Pediatrics, General Surgery, Internal Medicine, Emergency Medicine, and the newly added one month of ICU. The call schedule can at times be heavy, with one-in-four call on most rotations. There are few specialty residents that rotate through Prince George, which provides the family practice residents with more hands-on learning and experience. If you wish for more rural exposure, there is also the option of completing some of these off-service rotations in Quesnel or William’s Lake. The R1 year is at times intensive but mostly enjoyable, the latter largely as a result of the really cohesive group of residents who help make the experience lots of fun.

The R1 year also features call-free Fridays, which offer a great chance to get to know your fellow PG family practice residents, to spend some extra time with your family, or to get a head start on your weekend camping or ski trip. There are ample outdoor activities to keep you busy, with innumerable hikes that you can enjoy all to yourself within an hour’s drive. There is  “resort” and backcountry skiing nearby, a number of rivers and lakes to paddle and enjoy, and rocks to climb just outside of PG. The city itself offers nice walking paths, and some fun mountain biking and cross-country ski trails.  There is also an abundance of great restaurants, two breweries, a winery, and a number of nice cafes to frequent during your year here. The best thing is there is often zero traffic, and so it’s not challenging to incorporate many of the listed activities in a single day, after leaving your family clinic at 4:30pm.

The R2 year is comprised of two 4-block rural rotations, 4 blocks of electives, and 1 block back in your family clinic during block 13. For the rural rotations, you get first choice out of a select number of great rural communities across BC and NWT. Your weeks during these rural blocks vary, but often involve family clinic, ED, anesthesia, GP assist, GP obstetrics, Addictions Medicine, Sports Medicine, and whatever else might be offered by the GPs in your community. The preceptors during these rotations are often very flexible, and help tailor the rotations to your need. The rural rotations offer a lot of hands on learning, and help consolidate everything that you have learned during your specialty rotations in R1. The elective blocks include one block of either ED or Trauma, and there are a great number of electives offered both in and out of Province that our residents pursue. Finally, you return back to Prince George for the 13th block of R2 to spend time in your family clinic from your R1 year.

If you’re adventurous, passionate about rural medicine, and enjoy the outdoors, the Northern Rural program just might be for you! We look forward to meeting you at the virtual open house.

Kathleen Lloyd Wismer, Lead Resident

klloydwismer@nosm.ca

Number of Residents: 5 CMG Northern Rural  (plus 6 CMG and 4 IMG at the Prince George site)
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: 16 Weeks
Phone: 250-565-5749
Contacts: Director – Dr. James Card / Coordinator– Roghieh Soufinia
Lead Resident: pg.fm.chiefs@gmail.com
R1 Reps – pg.fm.reps@gmail.com

Overview

First year residents do the Prince George-based curriculum, along with their Prince George colleagues. The University Hospital of Northern British Columbia provides referral services to the people of Northern and Central BC. The medical staff of 145 includes all major specialties except cardiac and neurosurgery. There are 1100 obstetrical deliveries, 45,000 emergency visits, and 8600 surgical procedures annually.

Family Practice teaching is centered in 5 community practices or in a free standing clinic, accommodating six practices. All practices use electronic medical records and are connected to the hospital systems allowing for access to all laboratory and radiology results. All preceptors embrace leading edge practice solutions such as group visits and integrated health strategies.

In the second year, joining the schedule of the Kelowna-based Rural Site, residents locate in two rural communities where they experience extended block time in accredited, high quality rural training sites. The setting affords the resident the opportunity to learn procedural skills and assume responsibility for a variety of clinical problems. The combination of hospital-based training in a regional referral center (Prince George) in the first year, followed by the challenge of a more independent style of practice during second year, arguably combines the best of both worlds as an ideal training for rural family practice.

Participating rural communities include (these may change from year to year): Inuvik, Bella Coola, Revelstoke, Cranbrook, Port McNeill, Vanderhoof, Creston, Queen Charlotte City, 100 Mile House, Grand Forks, Lillooet, Powell River, Gibsons, Golden, Masset, Sechelt, and Smithers.

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.
  • The final block of R2 year is back in your Family Practice office in Prince George.
  • 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

Current PGY1 Rural options:

Quesnel – General Surgery, ER

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

…and we are working on more!

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

ER

Peds

Peds/

elec

FM

FM

IM

IM

Gen

Surg

Native

Health

Ortho

OB

OB / Gyn

Psyc

PGY2

Rural1
FM

Rural1
FM

Rural1
FM

Rural1
FM

Surgical skills week

Elec

Elec

Trauma Emerg

Elec

elec

academic

week

Rural2
FM

Rural2
FM

Rural2
FM

Elec

 

What kinds of learning opportunities are available in the Northern Rural Site?

The learning at this site is very hands-on and you will have plenty of opportunity for procedural skills, direct patient management, etc. Self-directed learners will thrive in Prince George – unlimited opportunities are there for you to create if you take initiative. This is particularly good practice for your following R2 year when you are even more independent.

The R1 year is identical to the Prince George program. Block rotations in specialties, including a 2-month block in your family practice office is offered.

The R2 year consists of two 4-month blocks in rural communities. During this time, the learning is generally longitudinal. In most communities, you will function as a full member of the family practice team and be responsible for the same services that the local practicing physicians offer. A typical day may have you rounding on your inpatients, running a clinic or the ER, delivering your obstetrical patients, or doing surgical assists!

The remainder of the R2 year dedicates 4 weeks to Trauma/ER and the rest to electives of your choice.

Does it get fairly competitive with the other residents?

Absolutely not. Prince George residents are truly supportive of each other, and because there is a relatively low volume of learners, there is no need to fight over who gets to do the central line! In your R2 year, you will often be the only resident on site, so competition is not an issue.

Is the community very welcoming of residents?

Yes! The medical community in Prince George is extremely welcoming and happy to have residents. The community of Prince George itself is also quite invested in its medical learners and was, in fact, instrumental in the creation of a Northern Medical Program. The rural communities you will visit in R2 are specifically selected because they are learner-centered and eager to engage in resident education.

What kinds of facilities are available in Prince George?

The hospital in Prince George has been recently renovated with a new addition. The resident lounge and call rooms are spacious with brand new beds and there are currently many resident lead directives to continue to improve the space and make it a warm and welcoming place to relax. Currently, RDBC and PGME have new initiatives to fund snacks for on-call residents. There is also a BC Cancer Agency center connected to the hospital that has been operational since 2012.

The family practice building houses 6 family practice offices and is directly across from the hospital, making commutes from clinic to hospital very convenient. Other community preceptors are within 5-10 minutes to the hospital.

Prince George itself has all the amenities of a mid-size city. There are plenty of good restaurants, including two breweries and a local winery, gyms, and an aquatic center. The city is full of parks and walking/biking trails with easy access.

Facilities available in the R2 year are variable and depend on what rural communities you choose. All communities will have a clinic and hospital – the smaller ones may be combined within the same building. Check out individual communities for more information.

What traits do you need as a Resident to really appreciate the Northern Rural Site?

Self-directed learners and self-starters are best suited to this program. If you have a sense of adventure, love to travel, and can pack light, this program is for you! There is a lot of moving around in your R2 year, but the payoff is well worth it. And yes – it is doable with a family. Many past residents have moved around BC with spouses, children, dogs, and cats!

What do you think is the biggest strength of the Northern Rural Site?

In my opinion, the independence and full-service emphasis in Prince George in the first year will prepare you for rural practice in a way other programs may not. As far as R2 goes, the adventure is endless! Not only do you develop a broad scope of practice and confidence, but you get to live in some of the most beautiful places on earth!

Key Point: You will be comfortable and competent to practice medicine anywhere when you finish this program. For example, GPs are working in ER, Sports Medicine, Clinical Associate for Internal Medicine, teaching, rural locums, inpatients, assisting in OR, GP anesthesia, addictions, Indigenous Helth, Women’s Health, Prison Health, LGBTQ+ Health, Travel Medicine, Palliative Care, and the list goes on!