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16 hours ago, medigeek said:

I always wondered, when it comes to rural training in these places - there just isn't really high volume of pathology? I mean if you spend 2 weeks in a rural ED, you may not even have 1 intubation or line put in on any patient nor any traumas. Simply because the population there did not have any issues. I always of rural training being good but is it just in theory or is it legit? 

Busy community settings seem to provide more in my experience. 

I think residents/students tend to pick up some "bad habits" from the supervising physician too who are less up to date about the new literature. These clinical skills may suffice for independent practice, but may not pass the litmus test when it comes to examination settings. 

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On 12/15/2019 at 1:30 AM, medigeek said:

I always wondered, when it comes to rural training in these places - there just isn't really high volume of pathology? I mean if you spend 2 weeks in a rural ED, you may not even have 1 intubation or line put in on any patient nor any traumas. Simply because the population there did not have any issues. I always of rural training being good but is it just in theory or is it legit? 

Busy community settings seem to provide more in my experience. 

While there are fewer traumas that come in, there is proportionally fewer learners. You also won’t have RT or other supports, so you become quite proficient in the other tasks (draw your own ABG, monitor and change your own vent settings, resource allocation, etc.).

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On 12/15/2019 at 5:43 PM, ArchEnemy said:

I think residents/students tend to pick up some "bad habits" from the supervising physician too who are less up to date about the new literature. These clinical skills may suffice for independent practice, but may not pass the litmus test when it comes to examination settings. 

This isn’t only found in rural settings, you also see this in urban. Everyone should always question what they’re taught and make efforts to stay current on their own.

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On 12/15/2019 at 4:32 PM, bearded frog said:

There is a balance. For instance if you are a family med resident doing an ER rotation in a teaching hospital, there's going to be a fair number of trauma, intubations, procedures, exoctic cases etc. However there will likely be med students/residents/fellows all training as well and so the chances of you doing the procedures are relatively low. On the other hand, if you're the only person in Nowhere's local clinic, traumas/codes/uncommon presentations are going to be rare, but when they do come you'll be doing everything yourself, and so may actually get more overall experience.

The best is probably a receptive busy community setting with no other residents; at least on your shift. 

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Hello! I'm a current CaRMS applicant applying to family medicine and trying to decide between some UBC sites since there are so many! 

I am interested particularly in St. Pauls/Vancouver Fraser/Surrey/Victoria/Abbotsford/Regional Okanagan 

Is anybody able to shed some light on a few questions: 

How much service versus learning is there at each of these sites (genuinely) and also off-service scut work? What are the call schedules like at each site? 

With respect to Surrey/Vic/Abbotsford, what's the city life like? Is the downtown young and active and are there other young professionals in the cities?  

How easy is it to book vacation at these sites? Are there any additional days off for conference/academic leave/flex days like I know some other schools have? 

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Obviously no one has up to date information on all the sites but as a past UBC resident with many friends in the program.

- most call- Kelowna (St. Paul's would be second)

- least call- Abbotsford

 - family medicine in general does tend to be more learning (vs service) based.  A lot of the community sites residents are supernumery for call.  Even sites that call themselves service based call (ie. chilliwack), there is always a family doc back up on call (before the residency program started, these docs just took call from home; most issues a resident gets called to see on night shift, a home call doc probably wouldn't come in for).  A lot of the learning vs service isn't program specific, but preceptor specific.  I recall, a call shift on an off service rotation where the preceptor stayed home and we reviewed by phone every 30min, new consults, test results ect.. he just told me what to order as a lot of the medicine was way out of my comfort zone; and of course he made sure I compiled a patient list (with PHN) of all the patients "we" saw.  Obviously, there is very little learning on a shift like that.

- I did residency at a community program, i recall almost no scut work.  The few electives I did in the city, there tended to be WAY more of this, especially for off service rotations.

- Re: nightlife, there is Vancouver and then everywhere else.  I have lived in most cities in the lower mainland at one time or another and none compare to vancouver for restaurants, bars etc...

- hiking, outdoor activities are everywhere, even vancouver.  I wouldn't say one site is necessarily better than another in this regard.

- vacations- I think that is more UBC vs individual site specific.  basically you have to attend 75% of every rotation.  So you can't take vacation on two week core rotations.  If you want to take a two week vacation it has to span the end and then the beginning of 2 different 4 week core rotations.  Obviously, in second year when you are doing a lot of electives, there is more leeway with booking vacations. 

- flex days, education days etc.. are a part of every site

 

Hope that helps

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