Royal Columbian Hospital and Eagle Ridge Hospital
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Program Highlights - Fraser

Quick Facts

Candidates should apply to all 4 UBC EM sites separately, selecting whichever locations appeal to them. 

The Fraser Program accepts two residents per year, for a total of ten across the 5-year program. 

The Fraser Program is based out of Royal Columbian Hospital in New Westminster, BC, with rotations in other Fraser Hospitals such as Surrey Memorial. 

As you might expect, in an expanding program we realize that the exact distribution of learning events will likely evolve over the coming years. 

Here are some key points about Fraser:

  • The Fraser Health Region is part of the Lower Mainland of British Columbia.  It consists of 12 hospitals serving 1.7 million people.  Across the region, there are 700,000 emergency visits/year. 
  • The Royal Columbian Hospital is a 450 bed hospital that sees 75,000 EM visits/year.  It is also the referral centre for many services across the Fraser region.  Therefore, our hospital sees high volume and acuity, yet because of the relatively smaller number of learners, there is ample opportunity for learning. 
  • Royal Columbian Hospital is the Trauma referral centre for all of Fraser, and is among the busiest trauma hospitals in all of Canada.  We recently received the designation of a Level-One Trauma Centre.  The Trauma Service is run jointly by Emergency Physicians, Surgeons, and Anesthesiologists.  Despite having a designated team, however, when a trauma comes to the department, the resuscitation is often done jointly with the trauma team as well as the emerg team.  There is a trauma fellowship at our site, and both of our R4s are currently pursuing that area of expertise. 
  • We see approximately 15 – 20% pediatrics in our department at RCH.  We also send our residents to Surrey Memorial to do peds EM, because they have a designated peds shift there. 
  • Royal Columbian Hospital also is the referral centre for Cardiac Surgery and cardiac catheterization.
  • We are the regional stroke centre. 
  • Some services, such as PICU, Burn Unit and Spinal Cord rehab are only located downtown, in Coastal Health Region.  As a result, UBC residents from all 4 sites are able to do rotations in Coastal to gain exposure to these specialized areas as required.  
  • Surrey Memorial Hospital is the other large hospital within Fraser, and sees 150,000 EM visits/year.  The facility is brand new, and our residents do Pediatric EM as well as ICU there.  There is a state-of-the-art sim centre there, and our residents do approximately 6 sessions per year each in small groups. 
  • RCH and VGH are geographically quite close (about 30 minutes).  This means that residents from Fraser and Vancouver are closely integrated.  They are easily able to do rotations at each others’ sites.  Academic day activities take place both downtown and at RCH, so residents from VGH and Fraser are often together at these times. 
  • Most of our residents live downtown and can easily take the skytrain, bike or drive to Royal Columbian Hospital.  The fabulous city of Vancouver and all its wonderful amenities are within easy reach.
  • Many of the staff at RCH (both EM and off-service) are recent grads themselves and are very happy to be involved with teaching Specialty Emergency Medicine residents.  Our residents are made to feel welcome and every effort is made to make sure their learning needs are met. 
  • In their first year, our EM residents form part of the group of first-year interns at Royal Columbian Hospital.  This program has been running for decades and has graduated more than a thousand interns. 
  • In contrast, there are only two FRCPC Royal College Programs being run out of Fraser at this time (the other is Psychiatry), so beyond first year, our residents have much less competition for learning opportunities than they might in other centres. 
  • One of the biggest benefits of being a resident in a distributed program like ours at UBC is that it is very easy to do rotations at other UBC sites.  As a Fraser Resident, not only do you reap the all the benefits listed in this description about Fraser, but you can easily take advantage of learning opportunities available at the other UBC EM sites. If you read on in our curriculum section below, you will see that this concept is built into our program.  

 

Program Curriculum

This residency program is 5 years duration. The UBC FRCP emergency medicine program curriculum is currently under revision, as similar to other programs across the country, we will be transitioning to a Competency by Design (CBD) format for July 2018. 

 

The anticipated rotations under the new program are as follows: 

Year

 

Emergency Medicine

Off Service

Specialty Rotations

PGY 1

(13 blocks)

Transition to Discipline

(3 blocks)

3 blocks (one PEM)

 

 

 

Foundations

(10 blocks)

2 blocks

  • Internal Medicine (2)
  • General Surgery
  • Obstetrics and Gynecology
  • ICU RCH
  • Psychiatry (EM)
  • Trauma

1 block POCUS/ Ultrasound

PGY 2 – 4

(39 blocks)

Core

17 EM

4 PEM

 

 

 

  • Jr ICU at SMH
  • Sr ICU at VGH (2)
  • CCU RCH
  • CCU (Coastal)
  • Anesthesia (2)
  • Ortho
  • Neurology
  • Plastics
  • Toxicology
  • Pediatric ICU (Coastal)
  • Pediatric Anesthesia (Coastal)

 

1 block each of:

  • Emergency Health Services
  • NERD/ Research

 

3 blocks electives

 

PGY 5

(13 blocks)

Transition to Practice

5 blocks + 1 block pediatric EM

 

 

6 blocks Area of Concentrated Expertise (ACE)

 

1 block MERIT/ Education

 

ACE – Area of Concentrated Expertise

Under the previous curriculum, UBC residents have pursued many areas of interest, including: sports medicine, disaster medicine, wilderness medicine, clinical epidemiology, public health, medical education, pre-hospital care, hyperbaric medicine, ICU and anaesthesia. Our goal is to tailor the program to the needs and expectations of the senior resident, with an emphasis on subspecialty interest and future career goals, while continuing to fulfill the CBD curriculum. 

 ACADEMIC DAYS AND VIDEO-CONFERENCING

Residents get protected full academic days on Wednesdays. The lectures are video-conferenced with Vancouver and other UBC training sites. Each UBC site takes turns hosting academic day.  RCH hosts once/month, and VGH residents usually attend in person.  Fraser residents usually attend downtown in person as well, except when we’re at SMH for Sim. 

Academic Sessions include: Tintinalli based junior resident seminars, Rosen’s based senior resident seminars, Radiology Rounds, Pharmacology Rounds, Trauma Rounds, Simulation Sessions, Research Rounds and Provincial Grand Rounds.

 

ELECTIVES

Residents can choose from a wide selection of electives. Electives in the past have included research, 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, many residents elect to complete this rotation at the New York City Poison Centre or at Oregon Health and Science University.

 

JOURNAL CLUB

Journal Clubs are held locally on a monthly basis. Recent relevant emergency medicine articles and topics are review, critiqued and discussed.  We follow a province wide curriculum for article selection and review, and collaborate with the other UBC sites in critical appraisal.

 

ACADEMIC FUNDING

  • $1500 from UBC for conferences and courses
  • $500 from the RCH EM Staff fund for textbooks and courses

 

PRACTICE EXAMS

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.  Recently we have implemented a UBC based practice written exam in the spring season.  Practice oral exams are given twice per year. Senior residents will receive more practice oral exams as they approach the end of their training and prepare for the Royal College exams.

  

RESEARCH AND SCHOLARLY ACTIVITY

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 or topic review with an analysis of the literature, and one piece of original clinical or educational 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 Conference or the annual UBC Department of Emergency Medicine research day.

 

ULTRASOUND TRAINING

First year residents go to Vancouver in July to complete the introductory ultrasound course. Our residents are CEUS IP certified at the end of their ultrasound rotation in first year.  They are also given the opportunity to learn more advanced ultrasound skills.

 

MEDICAL EDUCATION

A four-week elective in medical education was successfully 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.

 

TRAINING SITES

THE ROYAL COLUMBIAN HOSPITAL (RCH)

The Royal Columbian Hospital is a large (450 bed) community hospital located in New Westminster, southeast of Vancouver. The emergency department census is in excess of 75,000 per year with a full spectrum of all types of adult and pediatric emergencies. 

Our hospital was recently awarded the designation of a Level One Trauma Centre.  We are among the busiest trauma centres in Canada. 

There are only two Royal College Residency Programs based at our site – Fraser Psychiatry and Fraser Emergency Medicine.  Residents from other programs rotate here as well. 

Royal Columbian Hospital is the referral center for Stroke, Cath Lab, and Cardiac Surgery and Trauma. 

There is a Clinical Teaching Unit service for Internal Medicine, and there are often senior residents on GenSx and OBGYN, but other services, such as Neuro and Plastics, are run by attending physicians so our residents get one-on-one teaching with a focus on learning rather than service.

Royal Columbian Hospital is in the midst of a major site redevelopment with a new Emergency Department planned for 2020 – 2024.

  

SURREY MEMORIAL HOSPITAL (SMH)

Surrey Memorial Hospital has an annual census of 150,000 patients.  Fraser Residents go there for Peds EM because their recently renovated emergency department has designated peds shifts.  Fraser residents also do rotations in the ICU there. 

The hospital has a state of the art sim centre and Fraser residents do sessions there regularly. 

 

Residents will have opportunity to complete rotations at other UBC Emergency medicine training sites. Please see each site’s description for details about the respective hospitals. 

            Vancouver General Hospital

            St. Paul’s Hospital

            BC Children’s Hospital

            Victoria General Hospital and Royal Jubilee Hospital

            Kelowna General Hospital

As all training sites are part of the UBC program, electives at any site are easy to arrange.

 

ADDITIONAL INFORMATION

If you choose to come to Fraser for your EM Residency, rest assured that you will gain the skills necessary to practice EM anywhere, and have a great experience at the same time.  UBC is a large program, but we’ve managed to maintain the “family” feeling both within each site, but also across the program as a whole. 

 

If you’d like to know more about our program, or would just like to talk to someone on the ground, feel free to email!

Dr. Caroline Tyson, Associate Program Director, Fraser site:

drcarolinetyson@gmail.com

 

Dr. Adrianna Rowe, PGY2 and contact resident for Carms.

adrianna.rowe@alumni.ubc.ca