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There’s no comfort quite like a quilt. Beyond warmth, quilts have long played a unique role in uniting people, from community knitting-groups to story quilts. Now, a group of students from UBC’s Northern Medical Program have joined together in their down time to knit blankets for cancer patients. Many members of the community have donated squares (and supplies) which the students incorporate in the quilts. Completed quilts are given to patients, accompanied by a note of encouragement to help them on their difficult journey through treatment and recovery. It’s a story sure to “warm” your heart.

In the 140-bed Chilliwack General Hospital, located about 100 kilometres east of downtown Vancouver, virtually everyone – health care professionals, staff and patients – comes into contact with UBC medical students on a daily basis.

Chilliwack has been a pioneering centre for medical education in British Columbia, hosting UBC’s first Family Practice Residency program in an urban setting outside of Vancouver (1990), and the first Integrated Community Clerkship program for third-year medical students (2004).

As of mid-December, 2011, 16 medical residents were at work in the two-year Residency program in Chilliwack, and four others were completing shorter rotations.  Six undergraduates were enrolled in the Integrated Clerkship.

Alumni of the Residency program now play a prominent part in health care in the Fraser Valley.  They include Chilliwack General Hospital’s medical director, Dr. John Hamilton, and the current director of the Chilliwack Family Practice Residency program, Dr. Ken Harder.  “I’m like the guy in the old shaving commercial,” says Dr. Harder.  “I liked the program so much that I decided to run it.”

Dr. Lori Laughland, another alumnus of the Chilliwack Residency program, has a private practice in south Chilliwack and is also a clinical instructor with the Faculty of Medicine.  “Family Practice in our hospital offers a wide scope of responsibilities and opportunities for learning,” she says.  “When I go in, I may find myself doing obstetrics or minor surgery.  Family docs don’t get that kind of range in many of the bigger hospitals.”

“Chilliwack was a logical place for UBC to set up its first Community Clerkship,” she says.  ”We had a pre-existing Residency program, and it’s helpful for the undergrads to be mentored by a resident.  And the staff physicians were on side because of the success of the Residency program.”

Chilliwack-based Dr. Mark Mackenzie now directs the UBC Faculty of Medicine’s Integrated Community Clerkship programs province-wide.  (His wife, Dr. Megan Mackenzie, is an alumnus of the Chilliwack Family Practice Residency.)  He points out that
undergraduate students in the Clerkship program also get the opportunity to train at the community level, in mental health clinics, public health clinics and private family practices, as well as with a variety of specialists in the hospital.

“People in Chilliwack have always been receptive to having students in our midst.  This is the reason that Chilliwack is so popular as a place to train – students feel it’s a community they can come to and be supported and appreciated.”

“And through the community’s willingness to support students, Chilliwack has contributed to the sustainability of B.C.’s health
care system.  Between the Family Practice Residency and the Integrated Clerkship, this one community hospital has helped to create over 150 practicing physicians.”

The first cohort of Southern Medical Program (SMP) students will begin the Year 3 Traditional Clerkships at either Royal Inland Hospital in Kamloops or Kelowna General Hospital (KGH) in the fall of 2013. In preparation for their arrival, UBC medical students continue to pilot and complete Year 3 clerkship rotations at both sites. Four Year 3 UBC students are currently in Kelowna completing a Prototypical Year, a full Year 3 rotation. Learn more about their experiences…

Royal Inland Hospital (video)

 

 

 

Kelowna General Hospital (video)

 

 

 

 

The SMP also offers Year 3 Integrated Community Clerkships in Vernon and Trail.

For more information, visit www.smp.med.ubc.ca

This is our first in a series of posts, featuring UBC Undergraduate Medical student’s experiences in UBC’s Summer Student Research Program (SSRP).  The SSRP is a competition open to undergraduate and first and second year MD students registered at UBC. It provides funding for a summer research project supervised by a member of the Faculty of Medicine.

Kulveer Parhar is a 2^nd Year VFMP Student.  He visited Victoria last summer to participate in a research project supervised by Dr. Paul Zehr.

Please briefly describe SSR Project you were involved in.

I worked along pHD candidate Taryn Klarner on a pilot project investigating the efficacy of an arm and leg cycling rehabilitation intervention on post-stroke locomotion and clinical outcomes. The study involved three male participants with low to moderate post-stroke function. The six week intervention involved participants cycling on an arm and leg ergometer for thirty minutes, three times a week. At five minute intervals throughout the thirty minutes, heart rate, rating of perceived exertion and cadence were recorded. In addition, pre- and post-intervention measurements of stretch reflexes, spasticity, muscle activity, range of motion, and functional walking outcomes were recorded.

What, specifically, about the research topic interested you?

My interests in neuroscience, musculoskeletal dynamics, and rehabilitation in neurotrauma patients attracted me to the research in Dr. Zehr’s lab. My undergraduate education in kinesiology was also applicable to this project. Dr. Zehr and his lab are working on some fascinating projects that have clinical applications and this was definitely an appealing factor.

What did you learn both (a) academically and (b) clinically?

As this was a pilot project, I learned the steps involved in developing an idea into a research project. I also learned about the pathophysiology of stroke and the associated clinical consequences. Furthermore, I expanded my knowledge on current rehabilitation techniques for stroke patients. Also important, I gained exposure to working with stroke patients and learned some of the challenges involved with working with this population group. The skills I gained with prove useful in my future clinical practice.

What do you feel participating in this project will have contributed to your medical education?

I believe gaining exposure to a variety of areas of medicine is an important aspect of one’s medical education. Rehabilitation methods are not well covered within our curriculum so this SSRP provided me with the opportunity to pursue an area of study that I am interested in. Moreover, working on this project showed me the strong interconnect between research and clinical practice. My future as a physician will be based on evidence based medicine and I have a greater appreciation for what that means after working in Dr. Zehr’s lab.

Dr. Paul Zehr is a professor in the University of Victoria’s Division of Medical Sciences.  He supervised the project Kulveer participated in last summer.

Please briefly describe the SSR Project you led.

The project Kulveer participated in under the umbrella “Improving the strength and functional ability in the more affected limb by training the less affected limb after stroke”  includes two components: a) a strength training piece where targeted resistance training of the less affected limb is used to strengthen the untrained, more affected limb (with my PhD student Trevor Barss); and, b) a locomotor retraining intervention using arm and leg cycling (involving both more affected and less affected arms and legs) exercise to improve walking ability (with my PhD student Taryn Klarner).

 

How were the students involved in the research?

Kulveer assisted with data collection in stroke participants, helped supervise the thrice-weekly training sessions, and conducted initial data analysis.

How do you think participation in projects like this enhance the educational experience of UBC medical students?

I think it is very important for MED students to gain direct experience with research work in clinical populations. It gives them a different viewpoint than they might have seeing the same population in clinic. For example, in this project Kulveer got to see participants with stroke achieving improvements in ability through training—he got to see their potential and they were active agents. In a strictly non-research clinical setting that group might be seen as patients with problems that need solving and perceived as more passive agents.

How do you feel you benefit by working with students on research projects?

I look at this as a bit of pay-it-forward. I think exposing medical trainees to our research environment expands their viewpoints that they can bring to their own clinical practice. This is particularly the case for research in clinical populations. It’s also a benefit for the mixture of trainees in my own laboratory who all come from different backgrounds and have different strengths.

 

The Summer Student Research Program provides undergraduate students with an opportunity to explore their interest in medical research by undertaking a project over the summer under the supervision of a principal investigator with an appointment in the Faculty of Medicine. The program is funded through the generous contributions of our donors and partners. If you are interested in making a gift to support student research, please contact Lisa Slater, Development Officer in the Faculty of Medicine, at 604-822-7087 or by email at lisa.slater@ubc.ca.

We are pleased to welcome Dr. Geoffrey Payne, Regional Associate Dean, Northern BC, as a guest contributor to the blog. Dr. Payne provides insight on how the Northern Medical Program and its partners are working to improve access to care in  rural communities.

Re: Doctor shortage in northern B.C. ongoing concern By Kelly Sinoski, Vancouver Sun March 17, 2012

We share the concerns of the community of Fort St. James over physician shortages, and recognize the challenges faced by Dr. Paul Stent as one of the community’s only care providers. Sadly, many communities in the north, like other underserved areas of the province, are under similar strain.

The UBC Northern Medical Program opened its doors at the University of Northern British Columbia in Prince George in 2004 with the goal of educating physicians in the north, where young doctors-in-training can understand the unique challenges – and rewards – of working in rural medicine and become part of the community they may one day serve. We are proud to say that this May, the NMP will graduate its 5^th class, with more than 130 MD’s having received their training in northern communities, and more than half of our graduates are choosing to pursue careers as family physicians.

These graduates must complete residency training – typically spanning two to seven years – before they are eligible to be licensed to practice (editor’s note: see the Physician Training Timeline graphic) . We have already seen NMP grads from 2008 through 2010 complete Family Practice training and return to northern communities. Currently, thirteen NMP graduates are practicing family medicine in rural and northern areas.

Furthermore, our northern family practice residency programs in Prince George, Terrace and Fort St. John demonstrate high-quality training, and offer MDs the opportunity to complete postgraduate training in these unique communities.

Return of Service contracts have not always produced long-term results for recruiting and retaining doctors in rural communities across Canada and elsewhere in the world. We are convinced that distributed medical training – where physicians live, learn and establish strong roots in these communities – presents one of the most promising prospects of meaningful and long-term engagement and service of medical professionals in underserved areas. This, along with ongoing collaborative efforts with Northern Health, the Northern Medical Program and local physicians on projects to improve recruitment, retention and mentorship for new physicians, will contribute to a sustainable system and high quality care these communities deserve.

Dr. Geoffrey Payne

(For more info, see this  story on NMP grads in the Prince George Citizen, and a UNBC profile of several grads working in rural communities.)

On the evening of March 15, students from the UBC’s undergraduate medical program, faculty and clinicians gathered for the — 8th Annual Undergraduate Medical Research Forum. The atrium in the Life Sciences Institute was abuzz with activity as the student researchers set up their presentations for the poster session.

Everyone was welcomed in the lecture hall by Justin Gill and Pavandeep Gill the senior and junior (respectively) Communications Managers for the UBCMJ as the evening got underway.  Dr. Howard Feldman (Executive Associate Dean, Research) gave a welcoming speech on behalf of the faculty. Next was the unveiling of the most recent issue of the UBC Medical Journal.  The UBCMJ is an entirely student-run academic journal with a goal to engage students in dialogue in medicine.  Some of the topics featured in this edition are low carbohydrate diets, health risks and benefits of bicycling, and an interview with Dr. Hedy Fry about suicide, advocacy and politics.

A writing award was given to the author of the best feature article in the journal. This editions recipients were Cody Pollock, Robin Gray and Alex Medellin, who co-authored the piece, “Isolated Pulmonary Nodular Amyloidosis: A Case Report of a Rare Presentation of Amyloidosis in the Lung Confused with Brochogenic Carcinoma”.

The evening’s keynote speaker was Dr. William T. Gibson.  His presentation, entitled “Dr. Who: The Curse of the Clinician-Scientist,” aimed to demystify clinician scientists, their education and what they (actually!) do.

Next up were the student poster sessions.  There were many interesting topics covered from a study on how agreeable are to having their child seen by student doctors to how/if it is possible to improve the strength and functional ability in the more affected limb by training the less affected limb after stroke.  The judges and students were all very engaged in their conversations about the research projects, as they enjoyed the food and wine being served by student volunteers.

The event concluded with the awards portion of the evening.  Awards were presented by Dr. Sharon Salloum (Associate Dean Student Affairs).  The winners (in no particular order), and their projects are listed below.  Congratulations to the winners, all the students who participated and the UBCMJ for another exciting issue.

8th Annual Undergraduate Medical Research Forum Winners:

1. Molly Lin, VFMP, ABSORPTION AND DISTRIBUTION OF AMPHOTERICIN B FOLLOWING ORAL ADMINISTRATION IN NOVEL LIPID-BASED FORMULATIONS

2. Philip Edgcumbe, MD/PhD, ULTRA-FAST TWO-PHOTON MICROSCOPE BASED ON ACOUSTO-OPTIC DEFLECTOR FOR IMAGING OF SYNAPTIC AND NEURONAL MORPHOLOGY IN BRAIN OF IN VIVO XENOPUS TADPOLES FOR STUDY OF EARLY BRAIN DEVELOPMENT.

3. Christopher Cheung, VFMP, HIGH FLOW LOW MEAN GRADIENT SEVERE AORTIC STENOSIS

4. Lawrence Haiducu, VFMP, APPLICATION OF A REAL-TIME RAMAN SCANNING APPARATUS FOR IN VIVO SKIN LESION DIFFERENTIATION AND SKIN CANCER DIAGNOSIS

5. Namrata Jhamb, VFMP, RARE OBESITY DISORDERS: METABOLIC PHENOTYPING AND EXOME SEQUENCING IN THE SEARCH FOR NOVEL GENES

6. Amandeep Ghuman and Rachel Lim, VFMP, VIRTUAL PROBLEM BASED LEARNING (PBL) – A NEEDS ASSESSMENT EXAMINING TRADITIONAL VERSUS VIRTUAL PROBLEM-BASED LEARNING

7. Gareth Mercer, MD/PhD, BREASTFEEDING IS AN EFFECT MODIFIER OF THE ASSOCIATION BETWEEN CAESARIAN SECTION DELIVERY AND ASTHMA IN CHILDHOOD

Oral Presentation Awardee (1):

8. Tina Zhang, VFMP, CLINICAL CHARACTERISTICS AND TREATMENT OUTCOMES OF WOMEN UNABLE OR UNWILLING TO USE A PESSARY FOR THE TREATMENT OF PELVIC ORGAN PROLAPSE

Surrey, a municipality in the Metro Vancouver region, is one of Canada’s fastest-growing cities.  Health care capacity is growing as well, and the UBC Faculty of Medicine is taking on a role in Surrey as a key partner in health, fulfilling its mandate to serve communities across B.C.

A new critical care tower is under construction at Surrey Memorial Hospital; when it opens in 2014, it will become the hub of the Faculty’s Clinical Academic Campus in Surrey, with space for class work and practice consulting.  Even in today’s interim conditions, there are often 100 or more UBC students receiving training in the health professions in Surrey in any given week.  A highlight of the UBC program is a two-year medical residency in Family Practice, which currently has six seats and is slated to grow.

“Surrey’s population is economically and multiculturally diverse, with lots of affluence, some low-income areas and some people with mental health and addictions issues,” says Dr. John Diggle, UBC’s site leader for medical education.  ”It’s a unique place to train because of that.  We have clinical faculty members who have chosen to practice in this environment for 20 or 30 years – these are experienced, community-based doctors working with our trainees.”

Dr. Diggle is a Surrey resident, a neurologist with a practice based in the new Jim Pattison Outpatient Care and Surgery Centre.    The Centre is also home to a Primary Care clinic where UBC-affiliated medical residents, both the core Family Practice group and other trainees on rotation, act as physicians to Surrey residents who don’t have regular family doctors.   Dr. Diggle says UBC residents and undergraduates are also attracted in increasing numbers by Surrey’s growing opportunities in Pediatric medicine, such as an active Pediatric emergency unit and a program in maternal/fetal medicine.

With the steady growth in the student body, UBC’s clinical faculty team in Surrey offers an increasing diversity of professional specialties and interests, including a growing interest in research projects.

“And with more research opportunities and clinical faculty appointments in Surrey and nearby hospitals, we’re seeing more research-oriented graduates coming out to work here,” says Dr. Diggle.  “They’re doing research that will help us understand the choices people make and plan for better health care – locally, across the province and across the country.   It’s an amazing thing for Surrey to be able to attract these graduates and their academic expertise.  It’s changing the way people think
about Surrey.  This is going to be a great place to practice.”

The first class from the distributed and expanded UBC MD program graduated in 2008. Many people, like the CBC’s Natalie Clancy, have wondered what happened to them.

While obtaining an MD degree is a significant achievement, additional training is required before an MD can go into practice.  MD graduates enter residency training programs which range from two to seven years.

Family Practice residents complete two years of training. Many choose to do an optional third year of enhanced skills training, in areas such as emergency medicine or obstetrics. Some may choose to do locums, filling in temporarily for physicians on leave, to gain additional experience before setting up practice. And some may pursue aid work in Canada, or around the world, before returning to a community to establish practice.

For MDs choosing resident specialties such as orthopedics, pediatrics, surgery, internal medicine, psychiatry, obstetrics and gynecology, training programs can take anywhere from four to seven years. Often, specialists will undertake additional fellowship training upon completion of their resident program to learn advanced skills, or conduct research. Some specialists will extend their training to focus on a sub-specialty, like forensic pathology, sports medicine, palliative medicine, or medical oncology (Here’s a handy list of specialties and sub-specialties).

And it is important to remember that physicians, though special, are humans just like the rest of us. Many take time to get married, have kids, do a little traveling, live a little. After ten to fifteen years of advanced education, wouldn’t you?

Thanks to the UBC Faculty of Medicine Evaluation Studies Unit for the Training Time Line graphic!

The UBC Medical Journal is accepting submissions for the Fall 2011 issue. To learn more, visit www.ubcmj.com.

The UBC Medical Journal (UBCMJ) is an internationally recognized student-run academic journal with the goal of engaging students in a dialogue in medicine. The UBCMJ provides an amazing opportunity to:
• To publish a commentary, review or research in a peer-reviewed journal
• To learn about the submission and review process
• To stimulate dialogue on medical issues that matter to you
• To enhance your resume and applications for graduate studies or professional programs

Submission genres include:
• Academic Research
• Reviews
• Commentaries with a medical focus
• Global Health
• Case Reports

The UBCMJ publishes issues every March and September, submission deadlines for each issue are about six months prior to publication; see www.ubcmj.com for deadlines

The First Nations Health Council’s “One Body, One Mind, One Spirit: Pathways to Wellness” conference in February included a potlach to celebrate the completion of a carving project, which will be installed in the lobby at the University Hospital of Northern BC, in Prince George. Master carver Peter George and apprentice Clayton Gauthier worked with local artisans, children, youth, elders, band members and students from the Northern Medical Program to create the carving, and it is a beautiful work. There are number of UBC Faculty members in the video, including Dr. Gabor Mate, and Regional Associate Dean, Northern, Dr. David Snadden (who also receives a very nice blanket!), as well as Sheldon Kennedy, former NHL player. It’s great to see partnerships, such as those between the Northern Medical Program, Northern Health, and the First Nations Health Council, coming together to explore ways to improve health. Congratulations to everyone!

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