Rural Family Medicine Residency Program

“It was a pivotal moment in James Card’s life — one that he reflects on often. After a challenging day of tree planting near MacKenzie, in northern British Columbia (B.C.), he piled into his company truck and flicked on the radio. The news segment was covering a health care rally in nearby Prince George, where thousands of people were protesting the lack of doctors in the North.

Card found himself listening intently. He loved the North, but he needed a change. He wanted to do something different, something that would give him the meaning and stability he craved.  

As he drove through the rugged and beautiful landscape, listening to the broadcast, he decided he would become a doctor.

In 2004, UBC began to expand and distribute its MD undergraduate program with support from the Government of B.C. and its academic partners. The expansion stretched across the province, reaching regional, rural, remote and Indigenous communities to help meet the growing healthcare needs of British Columbians.

When UBC opened the doors to the new Northern Medical Program (NMP), which is delivered in partnership with the University of Northern British Columbia in Prince George, Card applied and was accepted.

His student number was 0001.”

Read more on UBC Faculty of Medicine launches new rural family medicine residency program via UBC Faculty Medicine News.

Beyond Crisis: Working on the Continuum of Care

“The 4th Annual British Columbia Concurrent Disorders Conference: ‘Beyond Crisis, Working on the Continuum of Care’ was a dynamic virtual event aimed to address the complex intersection of mental health and substance use disorders. This conference serves as a platform for professionals, researchers, policymakers, and advocates to explore innovative approaches, share best practices, and collaborate on strategies that extend beyond crisis intervention.

We welcome 1200+ virtual registrants and 50 expert speakers to dive into discussions about holistic care models, integrated treatment approaches, and community-based initiatives to support individuals navigating concurrent disorders. With a focus on the continuum of care, this conference aims to foster dialogue, inspire action, and drive positive change in the field of mental health and addiction services across British Columbia and beyond.”

Conference Recordings are now available via BC Mental Health, Centre for Learning.

Access Your Best Self: Dr. Martha Beck


“In this episode, my guest is Dr. Martha Beck, Ph.D., a Harvard-trained sociologist, bestselling author, and one of the world’s foremost experts on personal exploration and development. Dr. Beck shares specific frameworks and practices to tap into your unique and deepest desires, core truths, and best life direction—all elements that comprise your authentic self. She also explains how to align your work and relationships of all kinds with your true self and how to embrace the discomfort and process of leaving unhealthy relationships. We discuss how to deal with negative thoughts and emotions, grapple with societal norms, and improve body awareness to gauge your inner truth. We also discuss codependency and self-abandonment – and how to exit and recover from these experiences. By the end of the episode, you will have learned numerous practical tools to access your best self and live a richly fulfilling life.”

Learn more via Huberman Lab.

Genetic Testing: Clinical, & Ethical Considerations

KEY POINTS

  • Health care providers in Canada across all specialties are increasingly able to order industry-sponsored genetic testing at no cost to their patients or to the health care system, which seems like a solution to prevailing inequities in access to testing but comes with several important ethical, legal, and health care system–related considerations that must be addressed.
  • Most sponsored tests offered to people in Canada are performed in American laboratories, with the majority offering gene panel tests.
  • Whereas many of Canada’s provinces have centralized laboratories or programs that ensure the quality and appropriateness of any publicly funded genetic testing, including those sent internationally, sponsored genetic testing may not be subject to similarly rigorous quality assurance.
  • Despite benefits to patients in terms of simplifying access, broadening testing options, and potentially advancing research into genetic diseases, privacy risks related to data sharing and other downstream harms and costs require careful attention.
  • The Canadian College of Medical Genetics and Canadian Association of Genetic Counsellors recently published a position statement to outline key considerations; now is the time for health care jurisdictions to consider this important issue and to support the development of comprehensive guidance to help practitioners navigate this next generation of genetic testing and data sharing.

Learn more here on Free genetic testing is not free of clinical and ethical considerations via CMAJ.

Waiver of Training in Family Medicine

On behalf of Dr. Dominique Pilon, outgoing Chair of the College of Family Physicians of Canada (CFPC)’s Board of Examinations and Certification (BEC), I am writing to advise you that, effective immediately, the BEC is no longer accepting requests for a waiver of training in family medicine using the special form and process introduced during the COVID-19 pandemic. This process allowed a program director to waive up to 12 selected weeks of a resident’s educational experience out of the required 24 months of training in family medicine, holidays excepted, if that resident was unable to gain certain educational experiences due to a COVID-19 illness or restrictions. 

The BEC has reinstituted the waiver of training process used prior to the pandemic. A program director must apply directly to the BEC, via a written submission through ccfpexam@cfpc.ca, for consideration of any waiver of training, which will only be granted under exceptional circumstances. The maximum allowable training time that can be waived for any resident is four weeks.

A resident transferring into a family medicine residency program from a Royal College specialty residency can still have up to six months (i.e., 24 weeks) of training recognized as equivalent. This is not considered a waiver of training by the BEC. The decision of equivalency rests with the family medicine program director and does not need to be reviewed by the BEC. 

For any questions or guidance, please contact me at bkvern@cfpc.ca.

Sincerely,

Dr Brent Kvern
Director, Certification and Examinations

Inhibition of IL-11: Healthspan & Lifespan

“For healthspan and lifespan, ERK, AMPK and mTORC1 represent critical pathways and inflammation is a centrally important hallmark1,2,3,4,5,6,7. Here we examined whether IL-11, a pro-inflammatory cytokine of the IL-6 family, has a negative effect on age-associated disease and lifespan. As mice age, IL-11 is upregulated across cell types and tissues to regulate an ERK–AMPK–mTORC1 axis to modulate cellular, tissue- and organismal-level ageing pathologies. Deletion of Il11 or Il11ra1 protects against metabolic decline, multi-morbidity and frailty in old age. Administration of anti-IL-11 to 75-week-old mice for 25 weeks improves metabolism and muscle function, and reduces ageing biomarkers and frailty across sexes. In lifespan studies, genetic deletion of Il11 extended the lives of mice of both sexes, by 24.9% on average. Treatment with anti-IL-11 from 75 weeks of age until death extends the median lifespan of male mice by 22.5% and of female mice by 25%. Together, these results demonstrate a role for the pro-inflammatory factor IL-11 in mammalian healthspan and lifespan. We suggest that anti-IL-11 therapy, which is currently in early-stage clinical trials for fibrotic lung disease, may provide a translational opportunity to determine the effects of IL-11 inhibition on ageing pathologies in older people.”

Read more on the Inhibition of IL-11 signalling extends mammalian healthspan and lifespan via Nature.

Life Expectancy in India & COVID-19 pandemic

“Global population health during the COVID-19 pandemic is poorly understood because of weak mortality monitoring in low- and middle-income countries. High-quality survey data on 765,180 individuals, representative of one-fourth of India’s population, uncover patterns missed by incomplete vital statistics and disease surveillance. Compared to 2019, life expectancy at birth was 2.6 years lower and mortality was 17% higher in 2020, implying 1.19 million excess deaths in 2020. Life expectancy declines in India were larger and had a younger age profile than in high-income countries. Increases in mortality were greater than expected based on observed seroprevalence and international infection fatality rates, most prominently among the youngest and older age groups. In contrast to global patterns, females in India experienced a life expectancy decline that was 1 year larger than losses for males. Marginalized social groups experienced greater declines than the most privileged social group. These findings uncover large and unequal mortality impacts during the pandemic in the world’s most populous country.”

Large and unequal life expectancy declines during the COVID-19 pandemic in India in 2020 via Science Advances.

Malaria Vaccinations & Africa

“Côte d’Ivoire will become the first country to roll-out the new R21/Matrix-M™ vaccine with the first child vaccinated in Abidjan, marking a critical step and historic milestone in the global fight against malaria.

Every year 600,000 people die of malaria in Africa, according to the World Health Organization (WHO). Children under five years of age make up at least 80% of those deaths. Although the number of malaria-related deaths has fallen from 3,222 in 2017 to 1,316 in 2020 in Côte d’Ivoire, the mosquito-borne disease kills four people a day, mostly small children, and “remains the leading cause of medical consultations, according to the Ministry of Health.

R21/Matrix-M™ was co-developed by the University of Oxford and Serum Institute of India, leveraging Novavax’s Matrix-M™ adjuvant technology. In December 2023, the WHO granted R21/Matrix-M™ prequalification status, following a rigorous regulatory process and clinical assessment. Trials also demonstrated that the vaccine was well tolerated, with a good safety profile, with injection site pain and fever as the most frequent adverse events.”

Read more on Côte d’Ivoire makes history as first nation to deploy R21/Matrix-M™ Malaria Vaccine via Oxford News & Events.

Toxic Metals & Tampons

“’Despite this large potential for public health concern, very little research has been done to measure chemicals in tampons,’ said lead author Jenni A. Shearston, a postdoctoral scholar at the UC Berkeley School of Public Health and UC Berkeley’s Department of Environmental Science, Policy, & Management. ‘To our knowledge, this is the first paper to measure metals in tampons. Concerningly, we found concentrations of all metals we tested for, including toxic metals like arsenic and lead.’

Metals have been found to increase the risk of dementia, infertility, diabetes, and cancer. They can damage the liver, kidneys, and brain, as well as the cardiovascular, nervous, and endocrine systems. In addition, metals can harm maternal health and fetal development.

‘Although toxic metals are ubiquitous and we are exposed to low levels at any given time, our study clearly shows that metals are also present in menstrual products, and that women might be at higher risk for exposure using these products,’ said study co-author Kathrin Schilling, assistant professor at Columbia University Mailman School of Public Health.”

Read more on First study to measure toxic metals in tampons shows arsenic and lead, among other contaminants via Berkeley Public Health.