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 Kitty Dich 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 in the St Paul’s Hospital (SPH) CMG Program!  Located in central Vancouver, our site enjoys a proud history of training excellent Family Physicians who provide full-service primary care and/or practice within more focused areas of interest in Family Medicine.

Serving marginalized patient populations in Vancouver’s downtown core, SPH attracts members of the healthcare community who believe advocacy is fundamental to the practice of medicine. As such, our preceptors tend to be strong advocates for social justice.  Residents from our site experience the full breadth and depth of Family Medicine, but also have unique opportunities to develop enhanced competencies in areas including, but not limited to, inner city care, addictions medicine, HIV primary care, LGBTQ+ medicine, and Indigenous health.  We benefit from the academic success of SPH as well as world-leading affiliated groups such as the BC Centre for Substance Use and BC Centre for Excellence in HIV/AIDS.

Unlike our fellow Royal College residents, only the SPH Family Medicine residents spend the majority of training at this hospital and consequently develop close relationships with various specialists and other multidisciplinary health care providers at this institution. It is not uncommon for attending physicians in the Emergency Department or consulting physicians to know you on a first-name basis and pull you into opportunistic bedside teaching. With this connection, there is a strong emphasis in all rotations to provide learning opportunities that are relevant to and grounded in Family Medicine; you are not just an “off-service” resident here.  Although it is a tertiary care facility, SPH feels remarkably community-based.

Our program is a tight-knit community, and we take resident wellness seriously.  Our Program Director strongly believes that how we are treated as residents directly translates into how we will treat our patients and future learners.  We are also privileged to be backed by a wonderful team of administrative staff who go above and beyond their roles to support us throughout our years of training. Site Faculty are eager to engage us in shaping our curriculum and feedback from us is highly valued; we are treated as junior colleagues with agency to effect authentic change.

Our program is intentionally designed to promote learning while fostering 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 core areas of Family Practice, and SPH Family Medicine residents benefit from training at high-yield sites such as the BC Women’s and Children’s Hospital. After a year of core exposures, R2 provides the flexibility – by way of its mostly longitudinal format – for residents to align clinical experiences to support personal vocational interests and to strengthen areas of personal weakness to become a well-rounded family physician and in preparation for the CCFP examination.  Our residents have completed out-of-province and international rotations, and there is ample elective time to explore areas relevant to Family Medicine including research, medical education, and leadership.

At the start of the R1 year residents are paired with a community preceptor who provides mentorship throughout the duration of the residency program, spending half a day per week together in R1 and 3-5 half days per week in R2.  Chosen from clinicians who are excited to teach, these preceptors are skilled coaches who ease the transition from being a newly minted resident to an independent practitioner and lifelong learner.

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

Current residents in the program 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 via email, as listed below. We look forward to seeing you during the CaRMS Open House; please stop by and say hello!

Drs. Madalena Dearden and Vera Khramova
maddea@alumni.ubc.ca
vera.khramova@alumni.ubc.ca

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: R1 Block / R2 Horizontal
R2 Elective Time: 12 Weeks
Phone: 604-806-8569
Contacts: Director – Betty Calam – bcalam@providencehealth.bc.ca / Coordinator – Kitty Dich – kdich@providencehealth.bc.ca
Chief Resident: Madalena Dearden – maddea@alumni.ubc.ca / Vera Khramova – vera.khramova@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)

Current and Past Resident Perspectives

What do you enjoy most about the St. Paul’s Hospital (SPH) program?

St. Paul’s feels like a community hospital despite its location in a large urban centre. There’s a strong sense of collegiality and you get to know the other doctors and nurses.

St. Paul’s is a unique program that provides enhanced opportunities to develop skills in providing care to marginalized populations, including from the inner city and those who identify as Indigenous  or as part of the LGBTQ spectrum, 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 for resident teaching – staff are eager to give you hands-on practice, even as “off-service” Family Medicine residents. That said, you do have to seek it out a bit if you’re looking to do a lot of drains, intubations or LPs. For many of us, the focus is more on the doctor-patient relationship, providing patient-centered care grounded in awareness of the power of the social determinants of health. The St. Paul’s Hospital Family Medicine Program views advocacy as a central pillar of Family Medicine and believes that being aware of patients’ barriers to health – such as housing, addictions, mental illness, and financial insecurity – promotes effective medical care.

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 what 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 longitudinal experiences. 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 hard 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 do not treat us like scut-monkeys. Our role is clearly defined and well-respected by doctors 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 other residents?

There isn’t an excess number 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 frequently see your friends in the hallways, the ER, or while you’re up at 3 AM. Most people are enjoyable 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. Many 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 Eastside so we have more exposure to addictions, infectious diseases, mental illness, and other marginalized populations.

Do residents only practice at the hospital?

We work mostly at SPH during R1 and for the R2 Psychiatry block. We all work at Three Bridges, an inner city clinic located near SPH, for one month during R1. We do Pediatric Emergency Medicine at BC Children’s Hospital, which complements a rotation in outpatient community Pediatrics. Our Family Practice offices are community-based around the city, ranging from maternity heavy, to Downtown Eastside addictions heavy. 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 large 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 Department 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?

Vancouver is a gorgeous spot and there’s housing in a lot of central places including Downtown, Kitsilano, or Mount Pleasant 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?

At St Paul’s we have amazing flexibility to tailor our program to our own interests and gain skills and confidence in areas that will be relevant to our own future practice. We get to do this with amazing back up from our staff and Program Director, and encouragement from preceptors from other services in the hospital who we get to know through our time at SPH. A lot of residents have felt they had time to pick up strong skills in areas of interest such as HIV care, Maternity, Addictions, Transcare, and others.

The other big thing that can’t go without mention is the people. R1s have an intro block for July, with no call so you get to know each other as a cohort and have some time to settle into the city and explore before you truly launch in.