UBC Abbotsford-Mission Family Practice Residency Program

CaRMS 2022-2023

Hi & Welcome!

Thanks for being here–you made the right choice! We’re the Abbotsford-Mission Family Practice Residency Team based out of Abbotsford and Mission, British Columbia, Canada. We’re passionate about medicine, your educational journey, and delivering the best care to our community. We know you have several choices ahead and we’re here to help you in making the right decision for your future. Let’s get started!

Highlights of the Abbotsford-Mission Site

Cardiology’s Bat Signal ❤

Our program admins do a spectacular job matching us up with our family clinics and preceptors. There’s a questionnaire sent out before the start of residency which is almost eerily good at placing you in a clinic with aligned interests–whether that be dermatological procedures, women’s health, long-term care, or anything else that strikes your fancy!

One of the benefits of our program is that our residents complete a 4-week Cardiology rotation with the Cardiologists at their offices and in the CCU. The Cardiologists have a group chat with residents (aka “The Bat Signal“) inviting us to participate in procedures such as cardioversions, central lines, and pericardiocentesis.

We have a Youth Clinic that is part of the Foundry. The Foundry is a centre that provides health care and mental health services to vulnerable youth. We work evening shifts there during our Pediatrics and Psychiatry rotations.

We allow 18-20 weeks of elective time depending on your needs during your R2 year.

We have a weekly Academic Half Day on Thursday mornings, which is always a good time! This includes monthly ECG rounds led by one of the cardiologists, regular SIM lab training so you can navigate emergencies in a reduced pressure environment, and informative presentations from staff and residents.

Academic half day is followed by an afternoon in your family clinic. This allows for continuity of care for many of your patients and gives you the opportunity to see your preceptor and MOA’s friendly face every week! We also have family blocks of 2-6 weeks sprinkled across the year, so you get block-based family exposure.

With the exception of Obstetrics, all of our call shifts end at 2300. This means you get to go home and sleep in your own bed. There’s also an option to do 24hr call, which is great for seeing high-acuity ward emergencies and an excellent option if you’re considering hospitalist medicine.

Abbotsford hosts UBC ICC students from Chilliwack or elective students in the hospital. You will sometimes be on rotation with them or see them in the resident lounge. This provides an opportunity for resident-led teaching.We have our own space in the resident lounge, which comes equipped with a Keurig and snack locker. It’s a great place to catch up with your fellow residents and complete your dictations.

All residents complete two weeks of Nephrology as a core rotation in R1. This is a great rotation to learn about chronic kidney disease, working up AKIs, and better understand how dialysis works. Most residents also get to participate in starting dialysis lines as well.

All residents also complete two weeks in Anesthesia, which comes with practice managing airways for a variety of different procedures and a better understanding of cardiopulmonary physiology/pathology.

We’re convenient! When you move to Abbotsford everyone is able to get to the hospital or their family medicine clinic within a ten-minute drive. We also have our own Walmart and Costco for your shopping pleasure!

2nd year call is “Choose Your Own Adventure“! Residents can choose Hospitalist, Emergency, Peds ER, Youth Clinic, Obstetrics, and CCU.

There’s an Addictions Medicine rotation integrated into the second year core curriculum. This highlights the social context of disease and familiarizes residents with the key principles of managing a complex psychosocial illness.

Special interest opportunities in Youth Medicine, Prison Medicine, Maternity Care, and Telehealth.Generally the only learner on each rotation. This means that you receive 1-on-1 education from staff that is tailored to your skill level and understanding. This also means that you’re first in line for choosing consults, procedures, and all the other cool things you’ll encounter!

Abbotsford and Mission doctors, regardless of their specialty, are extremely kind and love to teach residents. Many of the in-house specialists are happy to have you tag along for practice with procedures and skills – everyone at ARH is extremely nice and happy to make your residency experience the best one it can be!

Abbotsford is a close-knit town that’s easy to integrate into. You’ll find yourself included on all sorts of socials, both in our resident group and with your clinic/rotation. There’s lots to do including many local breweries, delicious dining options, and blueberry/fruit picking in the summer (we’re the blueberry capital)!

We’re happy to answer any questions you may have! Send your emails to abbyresidents@gmail.com.

UBC Abbotsford-Mission Family Practice Residency Program

The Impacts of Flooding on Health

“Flooding is a seasonal hazard that many communities in the BC Interior encounter. It has become, and will likely continue to be, more frequent and more severe. Flooding affects not only health but also infrastructure and communities. Between 80% and 90% of all documented disasters from natural hazards in the last 10 years have resulted from floods, droughts, heat waves, and severe storms. The extreme conditions they generate are expected to increase due to climate change and will impact health.

Flooding impacts health directly, as well as indirectly through infrastructure and community disruption. Although young men are most at risk of mortality due to flooding, those most vulnerable to mental and physical effects are women, the elderly, and children. Individuals affected by flooding are at least 5 times more likely to suffer from anxiety and depression. Those who experience disruption to utility infrastructure or increased floodwater depth have even higher odds of both outcomes. Repeat flooding events lead to a higher prevalence of depression, quality-of-life measures such as chronic pain, and disrupted access to usual activities, with impacts persisting for multiple years.

Our personal clinical experience from living in flooded areas has shown that although Canadians are often spared from the acute effects of flooding, such as death and injury, intermediate effects are pronounced, including impacts on underlying health conditions and damage to infrastructure; long-term effects include worsening mental health, poverty, displacement, and community change. Many individuals in flood-prone areas live in homes that are not insurable against flooding, with studies showing increased mental distress among the uninsured. Flooding in Grand Forks in 2018 led to displacement of an entire neighborhood, further contributing to housing instability for many families. Individuals living there tended to be low income before the flood and after being displaced found themselves largely unable to secure reliable housing in a constricted housing market. In the severe 2021 flooding in Princeton, damage to vulnerable infrastructure resulted in evacuation of long-term care facilities due to inadequate heat as well as a multiweek hospital closure due to water damage. Loss of critical infrastructure, when it is most needed, is a serious health challenge.”

More on the Impacts of Health on Flooding via BCMJ.

UBC Abbotsford-Mission Family Practice Residency Program

Domperidone: Banned in the US & Not Approved for Breastfeeding

Mary Cassatt, Louise Nursing Her Child, 1898, Fondation Rau pour le Tiers Monde, Zürich, Switzerland.

“Domperidone, which blocks dopamine in the brain, is approved in Canada as an aid to speed up digestion, but it also has a side effect: lactation. Doctors and midwives routinely prescribe it off-label for this purpose. More than 120 million prescriptions for domperidone were filled in 2020, according to Health Canada.

Thousands of mothers describe it in online forums as a wonder drug that helped them produce enough milk to breastfeed their babies.

‘It kind of sounded like a miracle drug,’ said Emily Matreal, 29, who lives just outside Detroit and took domperidone in 2021 to help her breastfeed her son, Conner.

Health Canada told CBC that although the agency is aware the drug is routinely prescribed to stimulate lactation, it is not approved for that purpose.

CBC spoke with nine women in Canada, the U.S. and Australia who say they had debilitating psychological side effects when they tried to come off the drug. They described extreme anxiety, panic attacks, insomnia and intrusive thoughts so severe they were left unable to function or care for their children, often for months. Some were forced to stop working or move in with family. At least one attempted to take her own life. They all say no one warned them these things could happen.

Multiple experts interviewed by CBC said they believe such side-effects are rare. 

‘It’s very unpredictable,’ said researcher Janet Currie, who wrote her doctoral thesis on postpartum domperidone prescriptions in British Columbia. She says she’s helped between 15 and 20 postpartum women with severe psychological side effects slowly taper off the drug in the last year.

‘No one can tell you exactly in advance whether you’ll have these symptoms and how intense they will be.’

Domperidone is not approved as a lactation aid anywhere in the world and there are no large-scale clinical trials that shed any light on how often these side effects occur.”

Learn more via Banned in the U.S., not approved for breastfeeding — why are so many moms taking this drug? via CBC News,

UBC Abbotsford-Mission Family Practice Residency Program

Extreme Cold & Warming Centres: December 5th

Environment and Climate Change Canada has issued arctic outflow, winter storm, wind and snowfall warnings for multiple areas in BC.

Warming Centres: In response to this weather event, Warming Centres may be opened for the public at the discretion of local governments and First Nations in affected areas.Temporary Winter Shelters and Extreme Weather Response Shelters are operated by BC Housing and their partners for anyone who is homeless or at risk of homelessness.

Temporary Winter Shelters and Extreme Weather Response Shelters are operated by BC Housing and their partners for anyone who is homeless or at risk of homelessness:

Communities that have opened additional Warming Centres in response to this event, as of December 5th, 2022, include:

Connect with your local government or First Nation for more information about extreme cold resources and supports available in your community.

Extreme cold safety and preparedness

Contact a healthcare provider, or call HealthLinkBC at 8-1-1, if you are experiencing mild, cold-related illness. Call 9-1-1 in case of medical emergency.

UBC Abbotsford-Mission Family Practice Residency Program

JAMA: Role Reversal

The Anatomy of the Brain Artist: Sir Charles Bell

“’Helmet, helmet!’ squealed my daughter, excitedly. I followed behind as she ran to the back door, ready to start the day. The bike ride to her daycare center had become our shared morning ritual, a ritual that I had started long before she entered the world 16 months ago. The bike ride to the research laboratory or hospital had become one of the most cherished parts of my days. The ride gave me time to reflect on the day ahead and to be present. Now it is something that my daughter has come to love as much as I do.

I watched my daughter run inside and then hopped back on my bicycle, heading to the hospital on my first day as a third-year medical student. To say I was nervous was an understatement. I timidly found the neurology resident in the crowded work room. Together with another medical student, resident, and attending physician, we made up the team that treated patients who had been admitted with strokes. The senior resident told me I would be caring for JoAnne, a 92-year-old woman with a left posterior circulation stroke, resulting in almost complete loss of movement, sensation, and pain in the right side of her body.

As a medical student, I was expected to perform a full neurologic examination on this patient in the presence of the entire stroke team. Because I had just been thrust into the medical school clinical period after 4 years of working on my PhD thesis in a basic science laboratory, my confidence in my clinical skills was meager. I internally recited the neurologic examination as I trotted to JoAnne’s room followed by the rest of the team and the patient’s nurse. Am I sweating? What’s the first part of the neuro exam again? I walked in to find a small, frail-appearing woman lying on the bed. She looked somber with glassy blue eyes staring off into the distance. I introduced myself as the third-year medical student who would be taking care of her. She turned to me and gave me the smallest nod. Was that a smile? I started the examination with what I knew best, the cranial nerves. I watched her eyes move slowly from side to side and then up and down. Did I see neglect of the right side? Now to the deep tendon reflexes. As I swung the reflex hammer and met her biceps tendon, she winced in pain. Should I keep going or should I stop? I needed the information… right? I stopped with the reflex hammer in mid-air and looked to my attending physician for an answer as I cut the reflex examination short.”

Read more on Role Reversal via JAMA A Piece of My Mind.

UBC Abbotsford-Mission Family Practice Residency Program

New Family Physician Payment Model

“One million people in British Columbia do not have a family doctor. In response to this crisis, Doctors of BC, BC Family Doctors, and the provincial government have been in discussions since May to develop a new payment model that will help to address the challenges in primary care.

The new payment model, which will launch February 1, 2023, is based on what physicians told us they need to stabilize and strengthen longitudinal family practice. The hope is this new model will not only stabilize longitudinal family practice, but begin to make it both sustainable and rewarding. Everyone deserves a family doctor, and Doctors of BC believes the new model is a significant step forward to achieving that goal. There is still much more work to be done, please watch for updates in the coming weeks and months.”

New family physician payment model to help doctors and patients via Doctors of BC.

UBC Abbotsford-Mission Family Practice Residency Program

Plan to License More Internationally Trained Doctors

“British Columbia announced several new measures to bring more doctors to the province, amid an ongoing shortage of physicians and strained emergency departments.

Premier David Eby says the province is tripling the number of seats in the Practice Ready Assessment program, going from 32 spots to 96 by March 2024.

The program allows internationally-educated family doctors to become licensed to work in B.C, placing them in rural and urban communities who need more physicians and requiring they work that placement for at least three years. 

Eby says the pandemic has exposed challenges and added further strains in the health-care system, with too many British Columbians struggling to find a family doctor.

Some, he said, are proposing to respond to that stress by undercutting the principles of universal public health care and promoting an approach that would allow the wealthiest to buy their way to the front of the line. He insisted the public system is the only way forward, calling it one of Canada’s greatest achievements.

“‘We can’t privatize our way to a better health-care system and we can’t cut supports and get more doctors,’ Eby said.”

B.C. announces plan to license more internationally trained doctors via CBC News.