Residents’ Transition to Practice

“Human knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still it is never complete.” ― Paul Kalanithi, When Breath Becomes Air

Recently our Abbotsford-Mission & Chilliwack residents discussed the challenges and opportunities in their transition to practice. The session’s goals were to understand how our program can build on residents’ skills and education as well as provide them the support to explore and determine their path to practitioner. Therefore, we asked participants to identify the resources and vehicles they needed to be successful and then we had them prototype this learning experience.

We initiated the discussion with a live poll to determine how residents currently felt about managing a practice. We then discussed design thinking and its application to medicine. Using this problem-solving method, residents worked in small groups and addressed the following questions:

1. What would help you transition into your role as a practitioner?

Residents indicated that mentorship, business/finance workshops, locum discussions, and hands-on experience in managing a clinic would support their transition to practice as well as provide them the opportunity to ask questions that emerged during their journey. One member recommended that our site create a Practice Management course-pack to be delivered during Academic Half Days. Participants explained that the university and several professional bodies offer courses to assist residents in their transition; however, they described that these classes are in locations that are often inconvenient and offered during times that conflict with their work schedule. Residents also stated that the quality and depth of these sessions vary. One participant suggested that this variance is due to the deficiency in Practice Management curriculum.

2. How would you implement these needs into your educational journey?

Residents identified that their needs would be best met through Practice Management discussions with their preceptors and office staff. Participants also wanted the opportunity to experience running a clinic and suggested designing simulations that would prepare them for an independent practice as well as working their desired schedule. Other ideas included connecting with former graduates to gather pearls of wisdom and increasing our AHD sessions on Practice Management topics.

3. As a group, select one of the ideas and build it as a Resident’s Transition to Practice experience. What would it look like?

Group 1: Simulation Work Week

Group 1 designed a 2-week work simulation that allows a resident to experience her/his preferred schedule. The resident would select the primary preceptor; determine the days/hours that she/he projected working; and design the schedule based on her/his interests. During this simulation, the resident would be exposed to topics such as fees and billing. The rotation would be exempt from the program’s formal evaluation process. The simulated experience appeared to be particularly important for those participants who wanted to work in a variety of healthcare settings and/or were parents that needed to understand how their desired schedule impacted their family.

2. Group 2: Preceptor Practice Management Education & Academic Half Day
Group 2 suggested the residency program educate primary preceptors on teaching management strategies to incoming residents. Residents would then have the opportunity to rotate through these clinics and experience their administrative differences. Preceptors would receive a monetary incentive to participate in this module. Group 2 also recommended a series of Academic Half Day sessions focused on understanding and practicing billing codes. Participants discussed creating a pocket billing guide app to help residents and new graduates traverse this increasingly complex terrain.

3. Group 3: Practice Management Academic Half Day Sessions
Group 3 recommended a series of Academic Half Day topics such as day-to-day financial management; locums: negotiating & finding good ones; independent practice; joining a practice; incorporation; logistics & fees; paternity/maternity leave; family planning; CME & Mainpro; and billing. Group 3 also wanted to dedicate time to connecting with former graduates for Q & A. These sessions would be delivered over the final two months of residency. They also described designing a checklist of the “to-do” items prior to graduation.

Once the groups completed their presentations, we then introduced our recent graduate, Dr. Deep Sidhu, who spent the next hour with our residents fielding questions on his experience opening up a new practice.

I want to thank our residents and Dr. Deep Sidhu for their time and input. It’s your honesty that will make this program better and hopefully serve as a model for others to follow. All graduate programs have a responsibility to assist and support their students/residents in their transition to practice. With your continued input, we are aiming to do just that.

Sincerely,

Jacqueline, Program Coach

Additional Resources:
Canadian Medical Association: Practice Management Modules
Doctors of BC: Resource Centre for Residents
University of British Columbia: Transition to Practice

English, D. (2013). Smoothing the transition from resident to attending physician using mentors. Physician Executive Journal.

Holak, E. (2010). Facilitating the transition to practice: A weekend retreat curriculum for business-of-medicine education of United States anesthesiology residents, Journal of Graduate Medical Education, September 2010. J Anesth 24:807–810.

Lister, J. (2010). Evaluation of a transition to practice program for neurosurgery residents: Creating a safe transition from resident to independent practitioner. Journal of Graduate Medical Education.

#designthinking #transitiontopractice #ubcfamilypractice #practicemanagement

UBC Family Practice Residency Program: Scholarship Day 2017

Join us for the Department of Family Practice Residents Scholarship Day – Friday, June 16, 2017

We invite all members of the Department of Family Practice, including Clinician Scholars, community-based researchers, midwives, clinical and academic faculty, to this year’s Residents Scholarship Day on Friday, June 16, 2017.  Residents from across the province will be presenting their scholarly work on this day.

Location:  UBC – AMS Student Nest, 6133 University Boulevard
Time:  8:00am – 4:30pm (followed by a reception from 4:30pm – 5:30pm)

Faculty and Staff:  Please RSVP through our online registration form: https://goo.gl/forms/HEGaxd99Sd6CmiRp2

The deadline to register is June 9.  We look forward to seeing you in June!

Design Thinking & Healthcare

20170520_083359 copy
Design Thinking Preceptor Session: Design a clinical setting that educates patients on health and wellbeing.

Over the past week, we’ve conducted a series of design thinking sessions with our preceptors and residents to gather their ideas on healthcare and medical education. In our recent Wednesday night session, we explored incorporating patients in the delivery of our medical education; reinforcing health as a life skill in the clinical setting; designing a clinic that educates patients on their health and wellbeing; and how we can use the visual arts to hone our observation skills. Here are a few snippets from our dialogue with preceptors:

How can we effectively incorporate patients in the delivery of our medical education?20170519_204130 copy
Ideas that we proposed included inviting patients to participate in our academic half days, journal club sessions, and to help guide in resident research projects. We also discussed using patients’ narratives in our teaching; incorporating patient feedback in resident performance; and giving patients the opportunity to educate residents on how to perform better physical exams.

How do we reinforce health as a life skill in the clinical setting?
20170519_204543 copyIdeas that emerged included providing educational seminars and counselling on health; posting letters from patients explaining their desire and decision to change unhealthy habits; using visual displays to disseminate health information; bulletin boards in offices promoting upcoming outdoor athletic activities such as races, mountain biking, and hiking; meeting patients outdoors for clinic visits and walking around the block; and collaborating with other health promoting agencies in the community.

Following this brainstorming activity, the preceptors worked in groups to design a clinical setting that educates patients on health and wellbeing.

20170520_083359 copy
Group 1: Created an integrated approach to their clinic that educates patients on their health and wellbeing.

Group 1 designed an integrated model for education where patients and their families may collaborate and learn. The clinic provides zones for patients to read and explore their health interests and concerns; to exercise and experience an active lifestyle such as trying a treadmill or lifting weights (see paperclips!); and to engage in collaborating with other health team members. Physicians’ offices were equipped with balance ball chairs. The setting was a cell phone free zone that included a suggestion box, a yoga room, a community board, anatomy models, and office pets (see two blue circle cats!).

20170517_192017 copy.jpg
Group 2: Emphasized a personalized approach to their clinic that educates patients on their health and wellbeing.

Group 2 created a clinic to provide patients and their families access to education, mindfulness strategies, and therapeutic exercise. This team designed their setting to be personalized for each patient that walked through their doors. Using augmented reality, the patient would have accessible to them specific information regarding their health and any concerns or interests they may have. In this space, they offer patients a meditation area equipped with a fish tank; a room dedicated to spiritual wellness; an exercise room; and a juice bar with fresh fruit snacks.

Our final part of the session focused on the role of the visual arts in refining our observation and analysis. Clinical observation is fundamental in practicing medicine; however these skills are rarely taught in our academies. Furthermore, emerging research on visual arts training indicates that there’s a decrease in subjective descriptions and an increase in the scope of interpretations (Ge, 2013).

How do we use the visual arts in our medical education to hone our observation and analysis?20170519_203843 copy.jpgIdeas we shared included displaying art that encourages patients and visitors to observe for details; to pause and reflect; and to learn about disease states. We discussed toys for children that are designed to have them construct the human body. We also suggested taking trips to art museums and spending more time outdoors assessing our environment and its changes.

A big thank you to our UBC Family Practice Preceptors for their participation and to the Abbotsford Division of Family Practice for providing us with a wonderful dinner and allowing us to use their space for this workshop!

~ Jacqueline, Program Coach
#designthinking #medicaleducation #healthcare #patientcentrededucation

Resources below:
Patient-centred education: What do students think?
Observation: The Importance of Art in Medicine
UBC Faculty of Medicine: Arts in Medicine
Yale Medical Humanities and the Arts
Harvard Medicine: Arts & Humanities
Stanford’s Medicine & The Muse
Street Anatomy

Sea to Sky Preceptor Retreat 2017

Save the Date! We’re excited to announce the 2nd Annual UBC Family Practice Residency Program Sea to Sky Preceptor Retreat hosted by the Abbotsford-Mission, Coastal, and Indigenous sites!

Last year, our 20 preceptors survived a typhoon, juggled raw eggs, and perfected the headstand! We also explored our learning journey, developed a learning plan, discussed how to provide constructive feedback, and how to best incorporate our family in our practice. What will happen this year? What new things will we discover? I can only imagine! Learn more here!

Upcoming Mandatory Program Events

The following events are mandatory – out of town residents should start planning travel and accommodation to avoid the higher costs of last-minute booking.

The Program will cover ONE night of accommodation (June 15) for residents coming from out of town.

  • R1 Academic Day – Thursday, June 15th, 2017 
    • Mandatory event for all R1s
    • Registration/lunch begins at 11:15am, Program starts at 12:00pm
  • Scholarship Day – Friday, June 16th, 2017
    • Mandatory event for ALL residents (R1 & R2)
    • This event begins early, so out of town residents may need to arrive the night before.

Please review the Program Travel Guidelines before making any bookings.