Five thousand family doctors is a pretty amazing number. This is a real tribute to the CEO of the college Cal Gutkin who will be stepping down this year. He has been acknowledged in many events but it is worth repeating how important he has been to the practice of academic family medicine. He has been tireless in his enthusiasm for family medicine as a cornerstone of health care in Canada and has been one of the key factors in the success family medicine has today in the expanded education in postgrad and undergrad as well as the total number of Canadians who now have access to a family physician.

Last week marked the celebration of the tenth anniversary of the midwifery program. Two events were held in Victoria and Vancouver recognizing the contributions of the leaders, faculty and all the preceptors and alumni in both establishing and securing the midwifery program at UBC. The program has expanded and has secure core funding making its future very bright. The events celebrated all the individuals and groups who helped establish midwifery in BC. In Vancouver we were honored to be joined by the Minister for Health Margaret MacDiarmid, herself a family physician, who has recently spoken out supporting the right of women to be able to chose home birth.

Last week also saw the first Family Medicine Peter Wall Institute International Visiting Research Scholar Presentation. Dr Raina Elley gave a very comprehensive talk on the Pandemic of Physical Inactivity One Patient at a Time. Raina has been in the department for three months and will be returning to New Zealand at the end of November. During her stay in BC she has held seminars, and set up and run a study:  “Screening for Lifestyle Risk Factors and Mental Health Conditions in Family Practice” in two practices in BC. She will be running a workshop next Saturday 24^th November on How to Design a Randomized Controlled Trial for Family Practice or the Community.

Martin

It is with great sadness that we mark the passing of a friend and colleague, Peter Granger. Many tributes have been coming to me from all parts of the province and from further afield, about his mentorship, and about how he set a wonderful example. Many will miss him and we extend our sincere condolences to his family.

Peter, who practiced in both Ontario and British Columbia, died on the evening of November 12.  In addition to being a wonderful person and clinician, he also exemplified the CanMEDS-FM health advocate role for many of Canada’s under-served and under-recognized. Peter had an exemplary career.  He was the past president of the College of Physicians and Surgeons of Ontario and past Vice-President of Medical Affairs for North York General Hospital.  In Vancouver, he was a physician at Three Bridges Community Health Centre, the director of the Division of Inner City Medicine at UBC and he played a critical role in supporting the establishment of the Community Health Initiative by University Students (also known as CHIUS).   Many of you will know of his work as an advocate for inner city health populations, aboriginal youth and the LGTB communities. In 2010 he was the deserved recipient of the Geeta Gupta Equity and Diversity Award. Peter was an advocate for many, a friend to all.  He touched the lives of many of our colleagues as a loved mentor.  We will remember him for his gracious, giving nature, his ability to lead from behind and his undying modesty.  Please join us in recognizing the passing of this wonderful person.

I am occasionally asked why we promote clinical research so much within  the discipline of family practice. My answer is that without clinical research we have no evidence of whether we are doing harm or good. A classic example of the need for clinical research is the relationship between smoking and cancer. Until Richard Doll undertook this research we had no idea of the risk of smoking. Richard Doll is one of the major role models for clinical epidemiology and clinical research. His multiple studies, and the presentation of his findings over a period of four years eventually led to the UK government to accept the link between smoking and lung cancer. Tomorrow would have been his 100th birthday and this is his BMJ obituary  & classic paper on smoking & lung ca http://t.co/enwdc0iR  & http://www.bmj.com/content/328/7455/1529.reprint

For video content http://www.bmj.com/multimedia/video/2009/05/21/man-who-stopped-smoking

Martin

The department has been incredibly active over the last few months. Issues have ranged from the postgraduate expansion program, undergraduate curriculum renewal updates, and research. Willa Henry and Diana Chang (the recently appointed postgraduate expansion director) have been extraordinarily busy working on how we can meet government targets for expansion. At the latest post graduate meeting of the site directors I was very impressed by the positive attitude all the directors were showing in the face of the requests to take more residents. The meeting of site faculty responsible for evidence based medicine, research and informatics in sites was also extraordinarily positive. We heard ideas of EBM curriculum development from Cam Ross and the willingness to share, develop, and evaluate ideas for improving scholarship in the residency program. The undergraduate students all use one method of critical appraisal of the literature thanks to the input of Ruth Martin. This is a major advance in creating an updated  undergraduate curriculum for EBM. Meanwhile the major renewal of the whole undergraduate curriculum has been put back by one year to ensure adequate time for the whole four years to be completely developed. This definitely takes the pressure of a lot of faculty.

The conference season has started and Family Medicine Forum is looming in a couple of weeks. The BC college meeting was a great affair with BC CFP awards of excellence going to Drs. Steve Beerman (Community Family Physician), Sean Ebert (Rural Family Physician), Wendy Norman (Researcher), Joanna Bates (Teacher) along with Dr. Goulzhar Cheema and Valerie Tregillus for Exceptional Contribution to Family Medicine.  CFPC Reg L. Perkin Family Physician of the Year, Dr. Stan Lubin. The BCCFP was on the same day as the Canadian Diabetes Association. The news from there is that the target for HBA1C is going to be raised to 8.5% for certain groups of individuals. St Paul’s conference is coming up, as is the North American Primary Care Research group meeting. I am pretty confident none will have food as healthy as the Canadian Hypertension meeting. This is the first meeting I have been to where a nutritionist was working so closely with the conference center to ensure that the food was healthy. It just shows it is possible.

Martin

Welcome back those who have been away and I hope you have had enjoyable holidays. I was going to write that the summer was ending but as it is  29 degrees that is not really true! It is difficult not to make associations between the heat and the rapidly decreasing Arctic ice . That blue line is quite worrying  and is definitely something to keep one’s eye on. This will be easier than watching the asteroid, attractively named QG24,  predicted to make a  near pass  of  earth this coming week. It will only be just over 1.7 million miles away and 800 feet across so you need a large telescope of more than 10 inches to see it clearly. However that is enough of potential climactic disasters. This summer was definitely not a disaster and in fact allowed me the opportunity to really appreciate primary care in British Columbia.

I had the opportunity to drive to the Kootenays. The purpose was to visit a practice in Trail who are working with us on a randomized controlled trial to prevent diabetes. On the way across I met with family physicians in Osoyoos. The trip gave me the pleasure of seeing the stunning beauty of the regions we passed through  and an appreciation for the scale of the province. We came back through the Okanagan buying fruit, both fresh and fermented! A few weeks later  I visited a practice in Chilliwack and one in downtown Vancouver,  again for the purpose of the research trial. In all these practices I was impressed with the team, the buildings and equipment,  the organization, and the enthusiasm for improving practice. This research project is giving me the privilege of visiting busy practices, speaking with the teams, and learning about their local solutions and how they provide high quality health care.

The summer was also busy writing grants. We were fortunate in succeeding at the letter of intent stage for a major team grant to study the use of genomic medicine within primary care. We now have to write the definitive grant as well as an operating grant to study how we store and use genomic information within the practice. The major operating grants are submitted in the middle of September so many researchers find their summers are occupied! However I did manage several days fishing in eastern Québec, a week in England, and will be taking a cruise up to Alaska once the operating grants are submitted so definitely time for relaxation as well.

We also have been working on the expansion of the residency program and I am delighted to announce the appointment of Diana Chang as the director of the expansion program. We are increasing the number of family medicine residents by more than 50% over 5 years. I realize this will increase the demand on faculty and administrators as we expand current sites and create new sites. At the same time we will have our college accreditation as well as introduction of the new curriculum and I want to recognize the work that everyone in the department, and particularly those working the residency program are undertaking to ensure success.

Enjoy the rest of the summer weather!

Martin

You know summer has come when  the cyclists turn up at UBC. As part of the BC Superweek UBC hosts a GrandPrix race of a 1Km lap. You won’t be surprised to hear that Jack Taunton is behind this promotion of fitness and activity, and that the event includes not only extraordinary athletes from all over the world but also has a children’s event and a corporate event for amateur teams. Profits from the event go directly to  BC Sports Medicine Research Foundation. What an excellent way to raise funds for research.

Tuesday was a terrific event with bright sunshine, happy families enjoying the party atmosphere and at the end of the day some of the most intense athletic performances. A group of over 120 cyclists coming down East Mall at over 40 MPH was extraordinary. The sharp turns and the fact they did 50 laps in just over an hour was remarkable. Thanks Jack for putting on such a great event…

Higgs Boson … maybe not first on your list of things to look for. However UBC has had a major part in the discovery and I met with some of them yesterday in relationship to our own research. They have some of the most extraordinary computational capability and they also are incredibly collaborative. The whole of the project of looking for the particle is an illustration of how collaboration is done to enable discovery. Working with groups across Canada and across the world they shared information and jointly worked on the analysis so that the discovery was made. This sort of scientific collaboration is an illustration to us on how in primary care research we can share and collaborate and groups have started to do this.  One example is the The Canadian Primary Health Care Research Network which can be found on LINKEDIN and here,   Who knows what may happenen if we start to share and work together as well as the physicists.

Enjoy the great weather.

Martin

Starting with the David Snadden. Dave as you may remember was appointed Executive Associate Dean, Education, in the Faculty of Medicine in November last year. In his new position he is providing strategic leadership for all education programs within the Faculty of Medicine. It is good news for family practice to have a family physician in this position. He was a full time family physicians in Beauly in the North of Scotland (picture to the right) for over ten years so he is well qualified to be able to realize the training opportunities good comprehensive primary care can provide at the undergraduate and postgraduate level. The purpose of bringing him to your attention again is that he has just been awarded the  2012 Honorary Medical Alumni Award in recognition of his services to UBC and the community. Congratulations.

Next is a list  of very successful family doctors

BC 2012 Community Family Physician Stephen Beerman (Nanaimo)

BC 2012 Family Physician Teacher Joanna Bates (Vancouver)

BC 2012 Family Physician Researcher Wendy Norman (Vancouver)

Congratulations to all – huge commitments of time and energy as well as plenty of scholarly activity have led to these awards. 

I will focus a little on Wendy Norman. She has just won an extraordinary award. A family doctor since 1987 with a varied and dedicated career including Medecins Sans Frontieres  she joined the clinical scholar program in 2009 supervised by Janusz Kaczorowski in the department of family practice. In 2010 she gained her first grant, a Sue Harris Research award, and she was off and running. She then undertook a Masters of Health Science Epidemiology. Since then she has had another eight grants including a CIHR grant for over $600,000 all while she had a clinical appointment in the department funding her research time herself in the last two years. This rate of grant success, along with her publications, is enviable for a full time academic let alone a person who only has a small fraction of her time paid to do research. In the fall of last year she applied for and gained a grant-tenure position in the department. This meant that she was now eligible to apply for a “research investigator” award and should she be funded would have an academic position in the department. We have two thirds of our 34 academic faculty as grant tenured whose positions are supported by competitive awards.

This spring she applied to Michael Smith and amongst incredibly tough competition has won a MSFHR Career Investigator Award. 22 investigators from over 100 applicants gained these awards. I am really proud of Wendy in gaining this achievement. Her career demonstrates that there are paths for clinicians to do research, though not easy paths. Congratulations. For more details on her work I would encourage you to look at her research site.

Last but not least is Karim Khan. I won’t repeat the article but just point out that The Lancet is not an easy journal in which to win praise for your scholarly endeavours. Yet Karim has done just that. Follow the link to see the justly deserved praise for Karim

Congratualations to all of you. Family practice is in good hands with role models such as you.

Martin

A quite amazing couple of days last week. At the research day held on UBC campus we heard presentations covering very variable aspects of community based comprehensive care research. The presenters were a mixture of professionals including academic faculty, CIHR funded researchers, clinical scholars and unfunded family doctors. Then on Friday we heard the presentations from the residents. I realize it is unfair to pick on one presentation but let me assure you this is just an example of the standard of presentations. Imagine taking 6 home based exercise for common musculoskeletal problems. Then you identify the evidence that supports them and ensure that they are effective; next you create a video of those exercises and a simple text to accompany this. After all that work you then test this by creating a web site and evaluate the impact of this on professionals referrals to conventional sources of management. This was all achieved by one of the UBC residents and presented at the residents research day on Friday. The amount of collective work that went into all the residents scholarly projects is worthy of public recognition and I sincerely applaud ALL the residents for their presentations and the work that went to that day.   Congratulations and good luck as you approach the end of the residency program.

From those starting their careers as family physicians to one who is reducing his involvement. Stan Lubin has been awarded Clinical Professor Emeritus status as he steps down from the UBC clinic where he has been a valued clinical teacher and we wish him well for the future.

I had the privilege to take part in the Chilliwack faculty development day on Saturday. Sunshine and evidence based medicine was the order of the day. I partnered with James McCormack as we went over the critical appraisal and doing evidence based practice for real – it can be done in ten minutes! I came away impressed by the knowledge and enthusiasm of this group of preceptors and am grateful for the opportunity to share positive discussions about the future of family practice.

Martin Dawes

A weekend for celebration and an excuse for some flag waving. I am of course talking both about the Ambleside centennial celebrations just down the street from my home, as well as recognizing many who may also be celebrating the Queen’s jubilee. Both of these events remind us of our history but also the importance of waterways and boats in our lives. One of our own faculty will be on the water this weekend on the Thames. Don McKenzie set up Abreast In A Boat in Vancouver in 1996 to test the myth that repetitive upper-body exercise in women treated for breast cancer encourages lymphedema. As a result of his research Dragon boat racing became a symbol of breast cancer survivorship but more importantly enabled survivors to resume active lives without the fear they were causing themselves harm. His research and dedication have led to an invitation to be on one of the pageant of boats on the Thames as part of the 1000 boat flotilla today and we wish him well on that voyage!  Don is an example of the excellence that this department embodies and the impact the research we undertake has on the communities we serve. The Allan McGavin sports medicine centre is continuing to provide leadership in both education and research and the department administration are working closely with the unit to develop a solid funding stream for their work, and potentially to find a way for them to say goodbye to their trailer units.

This week there was a very productive meeting of the full time academic faculty where groups tackled issues of merit, research support, Café Scientifique, and mentorship. Several briefing papers have come from this meeting to help the department move forward with full time faculty taking more active roles in the running and support of the department. These meetings, that happen three times a year, are a valuable opportunity to network and share ideas as well move forward on developing the departmental strategies.

As we approach the residency research day and the departmental research day it is remarkable how much work is being undertaken across the province and we should reserve some of the celebration for self congratulation. The list of grant achievements continues to expand with two Wall Institute awardees this week, Shafik Dharamsi gained a visiting scholar abroad award and Raina Elley (a visiting fellow starting in September) received an International Visiting Research Scholar award.

To the residents who have all just handed in their scholarship assignments, well done.  It is probably a feeling of relief but tempered with the other work that still lies ahead. Maybe looking at Don’s career might provide some inspiration as one sees the clinical practice, teaching, and research all combined and enjoyed successfully over a lifetime of achievement.

Martin Dawes

A wet and cold weekend after two weeks of sunshine. I hope your Victoria weekend has not been too dampened.

Congratulations: We are celebrating  Dr. Andrew McLaren from the Island Medical Program, Family Practice who received The UBC Faculty of Medicine Clinical Faculty Award for Excellence in Community Practice Teaching . Andrew has been instrumental in the development of the Nanaimo Regional General Hospital Human Factors Lab and Simulation Program.

Postgraduate Expansion: We have had two meetings about expansion of the postgraduate program. Already we have increased the program in response to federal and provincial requests for more international medical graduates and more distributed training. Now we are working on the strategy for expansion and will be hiring a director and project manager over the next few weeks.

Palliative Care: As some of you may be aware, Dr. Patricia Boston, long-time member of our Department and Director of the Department of Family Practice Palliative Care program will be stepping down as Director of the Palliative Care program as of June 30, 2012.

Dr. Patricia Boston has been a tireless leader in Palliative Care over the years and has grown the Division with her wisdom, insights and passion.  Thankfully , this is not a good-bye as we are happy to report that Dr. Boston will be remaining in the Department as a Clinical faculty member to pursue her passions and interest in research.  We thank Dr. Boston for her many years of leadership and look forward to working with her in her new capacity.

To replace Dr. Patricia Boston, the Department of Family Practice is delighted to share that Dr. Peter Kirk has been offered and has accepted the position of Interim Director of the Department of Family Practice Palliative Care Program.  This is a six month position that commences in May 2012 to provide overlap with the current Director, Dr. Pat Boston.  Dr. Kirk is charged with providing leadership to the Palliative Care Program and for developing a strategic plan for Palliative Care for the Faculty of Medicine.

We are delighted to be welcoming Dr. Peter Kirk back to UBC and to the Department of Family Practice.  We expect him to continue the legacy of strong and effective shown by out-going Director, Dr. Pat Boston.

Martin Dawes