Kelowna Site Program Overview

 

Dr. Kevin Clark
Interior Assistant Program Director
Dr. Kevin Clark
keviclark@hotmail.com

 

With the standard for Canadian Emergency Medicine training programs being extremely strong, we are proud of the program we are developing at the UBC FRCP EM Interior Site in Kelowna and hope that our unique strengths will continue to attract elite applicants from across the country.

Over the course of your residency, you will shape the direction of the program. As a program that takes on only two residents per year, administration and staff have the flexibility to respond to resident feedback. Having fewer learners than other programs, you will do more procedures and will assume responsibility earlier compared to your peers elsewhere. The ratio of learners to emergency department volume is among the best in the country.

In a single hospital environment, you will quickly get to know the staff physicians both in the emergency department and in the rest of the hospital. Our interactions with staff are remarkably collegial and residents are treated attentively both on and off the emergency service. Our cohesive group of Royal College and CCFP-EM emergency physicians takes pride in being both strong clinicians and enthusiastic teachers.

Recent influxes of private and public contributions have allowed Kelowna General Hospital to undergo extensive renovations. In 2012, a modern, 30 000 square-foot Emergency Department opened, which features trauma bays that rival the best in the country. Across the street, there is a new Simulation Lab equipped with high-fidelity mannequins. The Clinical Education Centre offers top-drawer videoconferencing and 24/7 library services. Next year will be the unveiling of the Interior Heart and Surgical Centre. This new state of the art facility will include a cardiac critical care unit and will host many of your off-service rotations.

KGH is a tertiary care teaching hospital but its specialty services do not rely on residents for smooth operation. Therefore, much of your time off service will be spent one on one with staff physicians. This creates a unique opportunity for the self starting resident to have a great deal of responsibility on the ward and with ER consults while receiving direct teaching and feedback from staff physicians. There are often clinical clerks from the UBC Southern Medical Program on service as well providing you with ample teaching opportunities.

As with the other UBC sites, our program offers flexibility to suit residents’ specific interests. Residents are actively engaged in choosing when and where they complete their rotations. Quarterly meetings with the program director allow for regular feedback to assess and optimize the perceived value of rotations. We have approximately 10 months of elective time to accommodate research or fellowship interests.

The first year of residency functions to bridge the gap between medical school and residency. The year begins with 8 weeks of Emergency Medicine in the summer, when Kelowna is at its busiest and the population roughly doubles due to tourism. This is also the busiest time for trauma, and residents participate in trauma call shifts during these blocks. In Kelowna, emergency physicians almost exclusively run the trauma team.

 Emergency Medicine/Trauma  16 Weeks  KGH
 Internal Medicine  8 Weeks  KGH
 General Surgery  4 Weeks  KGH
 ICU  4 Weeks  KGH
 Obstetrics/Gynecology  4 Weeks  KGH
 Orthopedic Surgery  4 Weeks  KGH
 Plastic Surgery  4 Weeks  KGH
 Psychiatry (ER Consultant)  4 Weeks  KGH
 Elective  4 Weeks  TBA

In PGY-2 and PGY-3, there are approximately 6 blocks of Emergency Medicine (Adult and Pediatric), and 6 - 7 blocks of off service rotations/electives each year. There are two structured rotations (Education and Research) based out of Vancouver which are videoconference to Kelowna. Trauma Surgery can be completed at Vancouver General Hospital, Royal Columbian Hospital or at other North American trauma centers. In addition, the Emergency Medical Services (EMS) system in British Columbia is known as one of the best in the continent; residents have a well-organized EMS rotation with a list of objectives, and "ride-alongs" with land and air ambulances paramedics.

PGY-2

Emergency Medicine/Trauma 20 Weeks KGH
Pediatric Emergency 4 Weeks BCCH
Ultrasound 4 Weeks KGH
Neurology and Neurosurgery 8 Weeks KGH
Pediatrics 4 Weeks KGH
Anesthesia 4 Weeks KGH
Research 4 Weeks KGH (Videoconferenced)
Trauma Surgery 4 Weeks TBA

 

PGY-3

Emergency Medicine/Trauma 20 Weeks KGH
Cardiology/CCU 8 Weeks KGH
ICU 8 Weeks TBA
Pediatric Emergency 4 Weeks BCCH
Medical Education 4 Weeks KGH (Videoconferenced)
EMS 4 Weeks TBA
Elective 4 Weeks TBA

The senior years are a mix of a few mandatory rotations and emergency medicine and elective time. The Royal College mandates the completion of 6 blocks to pursue an area of subspecialty study. The exact timing of this period is flexible. In the past, UBC residents have pursued many areas of interest, including: Sports Medicine, Disaster Medicine, Wilderness Medicine, Clinical Epidemiology, Public Health, Medical Education, Prehospital Care, Hyperbaric Medicine, ICU and Anesthesia. There is a great deal of flexibility in these final two years to tailor the program to the needs and expectations of the senior resident with an emphasis on subspecialty interest and future career goals.

Emergency Medicine/Trauma 48 Weeks KGH
Pediatric Emergency 8 Weeks BCCH
Pediatric ICU 4 Weeks BCCH
Pediatric Anesthesia 4 Weeks BCCH
Toxicology 4 Weeks TBA
Area of Interest 24 Weeks TBA
Elective 12 Weeks TBA

Residents get full, protected academic days on Wednesdays. Lectures are video-conferenced with Vancouver and other UBC training sites. Residents are funded to travel to Vancouver once per month for academic reasons if they choose. Academic Sessions include: Tintinalli based core curriculum seminars, Rosen’s based senior resident seminars, Radiology Rounds, Pharmacology Rounds, Trauma Rounds, Simulation Sessions and Research Rounds. Emergency department Grand Rounds are given monthly in Kelowna. Vancouver, Fraser and Victoria and province-wide Grand Rounds are all available by video-conferencing.

Residents can choose from a wide selection of electives. Electives in the past have included research, education, sports medicine, ophthalmology, radiology, hyperbaric medicine and trauma in major urban centers in the United States and South Africa. Toxicology is a core rotation offered in Vancouver; however, some residents elect to complete this rotation at the New York City Poison Centre.

Residents have the opportunity to complete rotations at other UBC EM training sites:

  • Vancouver General Hospital
  • St. Paul’s Hospital
  • BC Children’s Hospital
  • Royal Columbian Hospital

Journal Club will be held on a bimonthly basis. Recent relevant emergency medicine articles and topics are review, critiqued and discussed.

  • $1750 from UBC for conferences and courses
  • $500 from the Kelowna Emergency Physicians for textbooks and courses

Residents write a nationally standardized practice exam in a short answer format similar to the Royal College exam once per year. Marks are collated across the country. Residents are then able to benchmark their progress. In addition, the residents have the opportunity to write the American Board In-Training Evaluation Examination every year. Practice oral exams are given once or twice per year. Senior residents receive more practice oral exams as they approach the end of their training and prepare for the Royal College exams.

All residents are required to complete two scholarly projects during the course of their residency. There is considerable flexibility in the types of projects undertaken. In general, residents are expected to complete one case report with a review of the literature, and one piece of original clinical research. These projects are undertaken with a faculty adviser in an area of mutual interest.

Excellent research support is available through the department's Emergency Medicine Research Division. The newly developed Research design block, specifically targeted for our junior residents, allows them to start on the research/scholarly activity that is now mandated by the Royal College. Senior residents are encouraged to present their research projects at the annual CAEP meeting in their final year.

First year residents go to Vancouver in July to complete the introductory ultrasound course. Ultrasound exams can be subsequently logged after that and a one month dedicated ultrasound rotation is offered to focus on skills and knowledge.

A four-week elective in medical education was introduced in 2010/11. It introduces the resident to some of the topics relevant to bedside teaching (e.g. one minute preceptor, how to provide effective feedback, how to teach procedures), and also incorporates teaching shifts allowing the residents an opportunity to put the techniques into practice. There are small group sessions for discussion and debriefing.