University of British Columbia - Family Medicine - Kootenay Boundary
This residency program is for 2 years.
Program length of training does not exceed the Royal College or College of Family Physicians of Canada standard.
The Kootenay Boundary Program is ideal for a highly motivated and independent resident who is comfortable living and working in rural, isolated sites. It is located 630 km from Vancouver. Travel between several of the training locations and communities is required, and so experience in mountain winter driving conditions and having a 4-wheel drive vehicle is essential. The area is remote and often difficult to access by air, especially in the winter, so an understanding of the difficulties in traveling to and from the site must be appreciated. The site attracts residents who are motivated to practice in isolated areas, who enjoy what rural life has to offer, and who seek the challenges of experiential, independent, self-directed learning. Our residents thrive on trying new things and being flexible and willing to adapt. While the area excels in offering premier recreational and outdoor activities, as well as artistic and musical events, it may not suit those who are more comfortable with greater cultural opportunities and more diverse social networks.
The first year of the program delivers the majority of the curriculum in the two communities of Trail and Nelson (70 km distance), and so significant driving is involved. This involves having to stay away from a primary residence to participate in on-call responsibilities. The residents are attached to family practice clinics clustered around Nelson and Trail but must travel between the two sites for structured learning opportunities delivered in both Kootenay Boundary Regional Hospital and Kootenay Lake Hospital. At the end of the first year, a two-month remote rural rotation is undertaken in the communities of Grand Forks and Nakusp, and residents will need to live in these communities during this time. The second year gives residents the opportunity to customize their learning opportunities to each site, but realistically significant travel will still be involved.
Residents who do well in our program enjoy self-directed learning, meaning they are comfortable working in a hospital where they need to take the initiative to get involved with patient care to meet their personal learning needs. In the R1 year, because we are not a full service-based hospital, the level of responsibility may be less on some rotations compared to other programs, but in the R2 year, responsibility is closer to the level of a practicing rural physician, with the support of preceptors. Residents need to be able to motivate themselves in the R1 year so that they are not overwhelmed in the R2 year.
Residents who struggle in our program tend to be those who have difficulty being away from their partner or family. Travel to and from a larger center is often arduous and complicated by weather conditions, and so weekend trips away are difficult to arrange. Due to the remote locations and travel involved, it is preferable that a resident’s partner or family be mobile and able to move with them.
Our program delivers curriculum in a longitudinal and integrated manner over two years with the first year involving more structured learning in acute presentations and management and the second year allowing more flexibility for electives and focuses on individual learning requirements for competency.
Family physicians primarily deliver the program in their private offices, and in several rural, community and regional hospital settings and a variety of other outpatient community healthcare clinics and facilities, e.g., Primary Maternity Care, Mental Health and Chronic Pain Clinics, and Geriatrics in residential care centers. The specialty core content is delivered by a supportive contingent of specialists who work directly with family physicians.
The resident will be based in a family practice clinic with two preceptors for the full two years and will be rotated through more rural family practice clinics during scheduled rural elective blocks to broaden their experience. After an initial two months based in family practice, on a weekly basis, the resident will spend a half day per week in the family practice office and will be encouraged to develop their own “mini-practice.” The remainder of the week is allocated to specialty exposure or tailored learning needs.
Purpose / Objectives
As reflected in the Department's Mission Statement, we welcome applicants who are committed to meeting the rural medical needs of British Columbia and Canada. We train residents to be prepared for full-service family practice including obstetrics and inpatient care. This site specifically trains residents to practice in rural areas, utilizing experienced and community-based faculty as mentors.
- We provide community-based training.
- We encourage experiential learning in an academically monitored environment.
- We foster self-confidence and skills necessary to allow graduates to function effectively in a rural practice setting.
- We encourage residents to learn how to balance their personal needs with the demands of rural practice.
- We are committed to ongoing evaluation of the outcome and effectiveness of a rural training program.
Rural Training Program
A rural training program is ideal for you if you have:
- Motivation to practice in rural, remote locations;
- Commitment to meet the medical needs of these types of communities;
- Understanding of and an interest in family medicine;
- Excellent interpersonal and communication skills, and also the ability to be self-directed;
- Reference letters which attest to your ability and interest in family medicine, as well as your specific interest in rural medicine;
- A willingness to live in a geographically isolated region of the province and to travel to several remote rural sites for training;
- The ability to adapt to learning in a non-traditional non-academic center;
- The ability to function psychologically and socially in remote settings;
- The ability to take rational risks ('Rational Risk Takers'), while maintaining a sense of professionalism; and
- A strong sense of social justice and accountability.
Residents attend mandatory academic activities — usually a half day per week. This includes academic teaching which is a mix of clinical case discussions and core topics. Residents are also expected to do presentations. Throughout the program, we stress "Evidence-Based Medicine" in both academic and clinical areas.
In June of each year, residents will come together for a mandatory Site specific Scholarship Day.
In the first year, residents will be expected to complete a quality improvement project. Throughout the two years, residents must complete a scholar project and present their work at Scholarship Day.
Residents can do one month of interprovincial or international electives during the second year of their training.
Third year training positions are available in the area of Emergency Medicine, Care of The Elderly, Anesthesia, Palliative Medicine, Sports and Exercise Medicine, Clinician Scholars program and a wide range of other category 2 Enhanced Skills programs.