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CaRMS 2012: Welcome to UBC Psychiatry
Program Overview from a Resident’s PerspectiveJanuary-February 2012
Vancouver, BC
Agenda• Welcome
• The ‘Who,’ ‘What,’ ‘Where’ of UBC Psychiatry
• The ‘How’: Program Overview PGY1-5
• Life After Residency
• Special Interests
• Life Beyond Residency
• Questions
Welcome: 2012 CaRMS Candidates!
• Congratulations, you made it!
• Thanks for coming
• Now Relax ...
• Introductions
Getting to know UBC Psychiatry
• The Anatomy of a Psychiatry program:
• The “What”
• The “Who”
• The “Where”
• The “How”
UBC Psychiatry: The “What”• Vision:
• To be the leading academic Department of Psychiatry in Canada and be internationally recognized in Psychiatry, Addictions and Neuroscience
• Strategic Plan:
• Continued commitment clinical and basic to research
• Enhancing clinical care through knowledge translation
• Investing in educational programs to develop exceptional teachers
• Continued commitment to the community
• What’s exciting:
• An already outstanding Division of Basic Neuroscience
• A cutting-edge Centre for Brain Health in the works
UBC Psychiatry: the “What” you need to know
• Medium sized program:
• Second largest psychiatry residency in Canada diverse and expansive educational opportunities
• But distributed so each site feels like a small program
• UBC has been a trailblazer with respect to the distributed site model
• A very responsive and supportive program:
• Many avenues to elicit resident contributions to build a better program
• Residents encouraged to design learning opportunities to meet their needs
• Recent FUNDED initiatives in International Psychiatry, BrainTalks, Teaching Skills Elective, Homeless Soccer League
• Cohesive and social resident body
UBC Psychiatry: the “Who”
• UBC Psychiatry Departmental “Who’s Who”
• Impassioned and accomplished faculty
• Resident Body
• Residents from far and wide and spanning life stages
Departmental “Who’s Who”• Dr. William G. Honer, MD, FRCP(C)
• New UBC Psychiatry Department Head
• Appointed after a rigorous selection process in which residents participated
• A research leader with >200 publications
• Contributing author to the Canadian Clinical Practice Guidelines on the treatment of Schizophrenia
• Selection reflects Department’s commitment to being a research leader
Departmental “Who’s Who”
• Dr. Jon Fleming, MD, FRCP(C)
• UBC Psychiatry Residency Program Director
• After today he will only make your life better - he owes you, already :)
• One of the very best things about our program
Departmental “Who’s Who”• Dr. Raymond W. Lam, MD, FRCP©
• Director of Scholarly Activity
• Internationally recognized as a clinical expert in depression with 6 books and over 250 articles
• Lead author CANMAT treatment guidelines for Depression
• Involved teacher and computer nerd
• Dr. Lakshmi N. Yatham, MD, FRCP(C)
• Lead author CANMAT treatment guidelines for bipolar disorder
• President of the International Society for Bipolar Disorders
• On editorial board for many peer reviewed journals
Departmental “Who’s Who”
• Dr. Bill MacEwan, MD, FRCP(C)
• Director of the Schizophrenia Program
• Research and Outreach Psychiatry in Vancouver’s downtown east side
• Lives in the country with a big family and menagerie of animals
• Has a donkey named “Pedro”
Resident Demographics
Year TotalAge
range ♂ ♀ PT/ML/FT UBC Children
1 22
2 23 27-40s 9 14 0/3/23 11/23 15
3 22
4 15
5 17
Resident Distribution: 2012 R1s• Vancouver Stream
• 12 Residents(including 2 Research Track and 2 IMGs)
• Vancouver Island Stream
• 3 Residents
• Fraser Health Stream
• 6 Residents
• Prince George Stream
• 1 Resident
UBC Psychiatry: The “Where”• Downtown Training Sites: “The Veterans”
• Vancouver General Hospital
• UBC Hospital
• Saint Paul’s Hospital
• Richmond Hospital
• Children’s Hospital
• Distributed Tracks and Sites: “The Up and Comers”
Downtown Training Sites: Vancouver General Hospital
• aka. “Mordor” aka. “the death star”
• Why it’s special: Trauma hospital and tertiary care centre for the province
• Why it’s special to us: Cutting edge 20-bed Psychiatric Assessment Unit off of the ER
• What we do there:
• Inpatient, Outpatient, Geriatrics, Consult Liaison
• Electives in Sexual Medicine, Sleep, Concurrent Disorders
• Associated with UBC Hospital: Mood Disorders, Outpatient, Neuropsychiatry
• Call ~ 1:10 or less
Downtown Training Sites: St. Paul’s Hospital
• Why it’s special: Inner City Hospital with HIV/AIDS Centre of Excellence
• Unique population
• Internship site (only downtown hospital)
• What we do there:
• Inpatient, Outpatient, Geriatrics, Consult Liaison
• Electives in Eating Disorders, Reproductive Psychiatry, HIV Psychiatry, Urban Psychiatry, Chronic Pain
• Call 1:10 or less
Downtown Training Sites: BC Children’s Hospital
• Why it’s special: Tertiary care pediatric hospital for the province
• What we do there:
• Core site for Child/Adolescent rotation
• Outpatient, ER (CAPE)
• Electives in inpatient, CL and specialty clinics (Infant Psychiatry, Eating Disorders, Concurrent Disorders, Dual Diagnosis, Mood DO, Anxiety DO, ADHD)
• Training in Family Therapy, exposure to Play Therapy
• Call 1:8-12
Downtown Training Sites: Richmond Hospital
• Why it’s special: Community hospital
• Why it’s special to us: Harry Karlinsky and super psychotherapy supervision
• What we do there:
• Inpatient, Outpatient, PAU, strong psychotherapy focus (group and individual)
• Electives in Geriatrics, Infant Psychiatry, Reproductive Psychiatry and Psychotherapy
• Call – 1:7 or less
Distributed Tracks
Prince George
VictoriaFraser Valley
Distributed Tracks: The Vancouver Island Program
• Accepting 3 in dedicated match plus 2-3 more for Internship
• Based in Victoria
• Training at Royal Jubilee Hospital, Victoria General Hospital
• Main medical centre on Vancouver Island
• Beautiful Psych ER facility
• Opportunities for rural/community rotations: Nanaimo, Comox
• Psychiatry Residents have been training here for years into senior level residency, now designated stream
• Academic days videoconferencing + return to Vancouver once per month
21
*Brand new* Hospital at
Royal Jubilee site
Vancouver Island Strengths• Site of Vancouver Island Medical Program = lots of
Residents and Medical Students in various disciplines
• Many opportunities to get involved in teaching
• Kind staff, smaller community feel to hospitals; closer relationships with staff
• Staff keen to teach and supervise psychotherapy
• Continuity of care
• Unique lifestyle
23
Vancouver Island Strengths
• Cost of living is less
• Amazing social life – very close-knit group of family practice and specialty residents
• Very active community: kayaking, mountain-biking, lake swimming, hiking, white-water paddling, kite-surfing, rock-climbing, triathlon training heaven, mountaineering, gulf-island excursions, fun restaurants, coffee shops, local music, relaxed down-town, can get everywhere on your bicycle
• Lots of opportunities to discover your granola side: yoga, meditation groups, veggie restaurants etc
• Almost 50% less of this:
• Annual Rainfall Victoria: 24 inches
• Annual Rainfall Vancouver: 44 inches
Vancouver Island Strengths
• The view from your seaplane when you fly to Vancouver once a month for academics:
26
A few more reasons to come to the Island...
• Surfing in Tofino
• Skiing Mt Washington
Distributed Tracks: Prince George Program
• Accepting one resident in a dedicated match
• Regional hospital (large catchment)
• Full rotations provided for years 1-3, residents complete senior years in Vancouver
• Expenses paid for monthly trip to Vancouver for Academic day and Social events
• Actively involved in weekly teaching of medical students
• Lots of opportunity for outreach psychiatry
• Socializing with family practice and visiting specialty residents
• Call – 1:7
Prince George Fast Facts• 313,000 population (including surrounding areas)
• Average cost of purchasing a home in Prince George in 2007 was $240,245
• Lots of sun between May and September and lots of snow between November and March. Average January temperature is -10°C and average July temperature is 22°C
• International Airport
• University
• Very Family Friendly, Outdoor recreation, all the amenities of a city!
Reading “Prince George” Style
Distributed Tracks: Fraser Health Program
Royal Columbian Hospital
Fraser Region:From Burnaby to Hope
20 minute skytrain from
downtown
Fraser Health Program• Accepting six PGY1 residents in dedicated match
• PGY1 and PGY2 at Royal Columbian Hospital, PGY2 Peace Arch Hospital
• PGY3 to PGY5 various treatment settings, including hospitals, community mental health centres, tertiary care facilities within the Fraser Health Authority
• Psychiatry Residents have been training in Fraser Health for years, just not as a designated stream
• Call 1:10
• Strengths: Community based, Psychotherapy supervision, Cohesive group of residents
Fraser Health Program• Training Sites:
• Royal Columbian Hospital
• Surrey Memorial Hospital – 45 bed inpatient unit, 10 bed Adolescent IPU, Adolescent Day Tx Program, Adolescent Crisis Response Program
• Abbotsford Regional Hospital
• 2 EPI teams
• Burnaby Centre for Mental Health and Addictions
• Peace Arch Hospital - 11 bed inpatient unit
Fraser Health Program• BC’s fastest growing health authority
• Serves 1/3 of BC’s population (1.5 million)
• 12 acute care hospitals and 13 community MHTs
• 25-70 km East of Vancouver
• Encompasses- Surrey, White Rock, Delta, New West, Coquitlam, Abbotsford, Mission, Chilliwack
• Majority of time spent at RCH, PAH
Program Overview: Year-by-Year
• The anatomy of a psychiatry residency program:
• Clinical Rotations
• Academic Days
• What’s Special
PGY1: The “Internship”
• Nobody said it would be easy!
• 3 potential sites for those not in a designated track:
• Royal Columbian Hospital (New Westminster) - 6 ish
• St. Paul’s Hospital (Vancouver) - 4 ish
• Royal Jubilee (Victoria) - 3 ish
• Program aims to get everyone his/her first or second choice but this doesn’t always happen
PGY 1: Royal College Core Rotations
• “PGY1-Basic Clinical Training” = Internship without all the blood and guts!
• Rotations differ slightly between training sites but include blocks of: Medicine and/or Family (3) Peds (1) Neurology (1) Special psych focused neuroimaging course (1) Emergency (1) Emergency Psychiatry (1) Psychiatry (2)
• 3 months of electives!
PGY 1: Academic Days
• Academic day provided monthly at the home program
• All residents flown to encourage class unity
• Curriculum aimed to introduce residents to a variety of topics in psychiatry
PGY 1: What’s Special
• A monthly academic day with your class
• No more exams until your PGY2 year
• CaRMS is OVER!
• You get PAID to do Internal Medicine this time! Salary for PGY1: $48,565.20
PGY2: Royal College Core Rotations
• “PGY2-General Adult Psychiatry” = Finally doing what you want to be doing and nothing else!
1. 6 months inpatient
2. 6 months outpatient
• Training Sites for Vancouver Residents include: Vancouver General Hospital, Richmond Hospital, St. Paul's Hospital and Peace Arch Hospital.
PGY 2: Academic Days
• Weekly academic days so videoconferencing begins!
• Aims to provide an overview of the major psychiatric disorders, prepare for first year clinical rotations and on-call experiences
• Longitudinal courses in:
Emergency Psychiatry, Mood Disorders, Ethics, Anxiety Disorders, Schizophrenia, Geriatric Psychiatry ,Religion and Spirituality, Personality Disorders, Addiction Psychiatry, Somatoform Disorders
PGY 2: What’s Special
• Weekly academic days taught by the best and brightest “Who’s Who”
• Developing autonomy and Skill in your chosen profession
• Still getting PAID! PGY2 Salary: $54,177.71
PGY 2-5: Long Term Psychotherapy• From PGY 2-5 requirement for one long term
psychodynamic psychotherapy patient
•Weekly appointments and weekly supervision by assigned supervisor
• Given one afternoon off a week to do this
• Can carry more patients and for longer/do an elective if this is an area of interest
• Psychotherapy Journal Club
PGY 3: Royal College Core Rotations
• Two six month blocks:
1.Child and Adolescent Psychiatry
2.Geriatric Psychiatry
PGY 3 Rotations: Child and Adolescent Psychiatry
• Three sites : BCCH, Richmond and Surrey (also Victoria and Prince George)
•Mix of Inpatient and Outpatient
• Opportunities to specify areas of interest (eg. afternoon in eating disorders)
• Introduction week of lectures, weekly teaching rounds
• Exposure to wide variety of cases
PGY 3 Rotations: Geriatric Psychiatry
• Sites: VGH, SPH, MSJ, LGH, PAH, RCH (Also Victoria and Prince George)
• Integrated mix of inpatient and outpatient at most sites
• Opportunity for ECT, TMS exposure in addition to a unique one week training course in ECT
• Exposure to home visits, geriatric C/L work, mental health teams etc.
PGY4: Royal College Core Rotations
1. Consultation-Liaison (3-6 months) - VGH; St. Paul’s; BCCH
2. Collaborative/Shared Care (2-3 months)
3. Chronic Care (3-6 months) - Community mental health team; Maples; Riverview; Inner City Youth Mental Health Program
4. Addictions (1-3 mo) - Burnaby Centre, Concurrent Disorders Unit, Methadone Clinics, DTES clinics
PGY 3/4: Academic Days
• Full day every Thursday
•Morning: Child Psychiatry, Forensics, Mood Disorders, Psychotic disorders, Anxiety disorders, Geriatrics, Psychopharmacology
• Afternoon: Psychotherapy (formalized course) with exposure to psychodynamic, CBT, IPT, Group, Brief Dynamic Therapy etc.
PGY 3/4: What’s Special
• Starting to figure out what you actually want to do
• Setting up electives
•Mentorship opportunities
• Salary PGY-3: $59 038.36; PGY-4: $63 549.53 with ‘on call’ pay of $400.90 per month
PGY 5: Royal College “Core” Rotations• 12 months of Electives:
• Neuropsychiatry, forensics, sexual medicine, HIV psychiatry, sleep disorders, eating disorders, mood disorders, reproductive psychiatry, infant psychiatry, psychotherapy, urban psychiatry, research etc.
• International electives:
• Adolescent Addictions, Australia
• Crystal Meth Psychosis, Hawaii
• Sleep disorders, Belgium
• Forensics, Maudsley Hospital, England
• Neuroimaging, Australia
• Beijing, China
• Uganda, Africa
International Electives• Ilana Shawn PGY 4 In Uganda
PGY 5: “Academic” Days
• Curriculum: Independent Study Day weekly
• Preparation for practice curriculum
• Royal College Review Courses – Ottawa, London, Kamloops
• Mock Orals
PGY 5: What’s Special
• Salary PGY-5: $68 341.81 with ‘on call’ pay of $400.90 per month
• Call is half-time from Jan - April in preparation for Royal College exams and is site specific
PGY1-5: What’s ‘Kind-of’ Special• Not-so-Special = EXAMS
• Kind-of Special = Not high-stakes, Not for marks, For OUR Benefit
• Goal is for your own self assessment and to guide reading – we see these informal exams as a positive :)
• In Training Evaluations:
• PRITE Exam yearly (US Exam)
• COPE Exam yearly (Canada)
• Mock OSCE PGY 2-4
• Short Case Assessments by Supervisors
• Some residents write the USMLE
Life after Residency
Life After Residency: Subspecialty Training at UBC
• Clinical Investigator Program
• One Year Fellowship Programs:
• Forensic Psychiatry
•Geriatric Psychiatry
•Child Psychiatry
• Additional Fellowship opportunities through UBC: Neuropsychiatry, Consult-Liaison, Psychotherapy, Mood Disorders, Choose-your-own-adventure
Life After Residency: Job Opportunities
• No shortage!
• Recent Grads being hired at tertiary centres in Vancouver
• New Psychiatric Facilities being built at VGH, LGH and renovations at others
• Opportunities in all subspecialties
• Plethora of rural jobs
2011 Recent Graduates• BC Children’s Hospital: Dr. Ryan Chan, Dr. Matthew
Chow, Dr. Jennifer Yeh
• SPH: Dr. Jen Wide
• RCH: Dr. Janel Casey
• VGH: Dr. Cameron Anderson, Dr. Summer Telio
• Vancouver EPI: Dr. Nicole Tsang
• CIP and ECT: Dr. Fidel Vila-Rodriguez
Special Interests
Special Interests: Research and Scholarly Activity
• Research is not mandatory but it is very much encouraged and supported
• ½ day a week for research PGY 2-5 (for non-research track residents)
• Large resident representation at conferences, workshops
• Grand Rounds at least once a year starting in PGY2
• Popular monthly Journal Club at a local restaurant is department funded
Research and Scholarly Activity
• Formal Research Track
• 6 residents currently
• Full research day/week from PGY 2-5
• Individual mentoring and guidance
• Conferences
• Opportunity for Masters/PhD or CIP
Current Resident Research Areas
• Brain Injury
• Neuroimaging
• Reproductive Mental Health
• Social Networks
• Street Soccer
• Mindfulness
• Cognitive Training for Psychosis
• Cross-Cultural perspectives on Eating Disorders
Special Interests: Rural Opportunities
• Outreach with Staff
• 2 trips PGY2-5
• Elective opportunities
• Prince George Program
• Duncan, Comox, Nanaimo, Penticton, Vernon, Nelson/Trail, Kamloops
Special Interests: Marginalized Groups
• Strong cross-cultural emphasis in our training
• Exposure to immigrant issues and training in work with translator services
• First Nations population
• Downtown Eastside of Vancouver –HIV, substance use
• Street Youth – Covenant House
• Specialized clinics in Vancouver
Life Beyond Residency
Life Beyond Residency: Getting to Know Your UBC Family
• Faculty Supported Social Events:
• Summer Welcome BBQ
• PGY1 - 2 Welcome Mixer
• Staff vs. Residents Soccer Game
• Resident Retreat
• Department Christmas Party
• Monthly Movie Nights (Frames of Mind)
• Other Group Activities:
• Monthly Resident Meetings, periodic Town Hall with Program Director and Resident Business Day
• Entire day to systematically review program
• Conferences, Meetings and Academic Days are social too! (shhh .. don’t tell anyone)
Life Beyond Residency: Leaving Work at Work
• There’s time for other parts of life too!
• The department actively encourages work-life-balance
• A number of residents have children
• A number of residents have pets
• Residents and staff are involved in arts, sports, music etc.
Welcome BBQ
70
PGY1-2 Evening
Social
Faculty vs. Resident Soccer Match
Resident Retreat 2011: Whistler HI
Resident Holiday Party 2011: Sanafir, Vancouver
APA Conference Honolulu 2011
Life Beyond Residency: Beautiful British Columbia
Beautiful British Columbia ...
The West Coast Trail
...and Beyond
Banff
Just a Hop, Skip and a Jump to ...
and a short flying Jump to ...
UBC Psychiatry: more PERKS• Educational Fund - $400 for PGY1, $900 for PGY2-5
• 5 days Conference leave, often partial expenses paid
• 2 weeks paid vacation every 6mo, flexible distribution
• Journal Clubs funded
• Flexibility- great balance for family life
• Annual Retreat, Business Meeting, Resident Research Day
• Call Frequency
• Heavily Education Oriented vs. Service Oriented
• Full Academic Day (!!)
• Regular Resident Evaluation (monthly logs, short case assessments, PRITE and COPE exams (anonymous), orals)
Questions?• Social event TONIGHT 6pm at Milestones (Cambie and 8th)
• Vancouver questions: Willough Jenkins [email protected] or Patricia Nolan [email protected]
• Victoria questions: Jeanine Marshall [email protected]
• Fraser questions: Salina Chan [email protected]
• Prince George questions: Ashley [email protected]