Coastal

Site Director Message

The Coastal Family Practice Residency site evolved in a unique manner, with high aspirations. Family physicians from the North Shore, Pemberton, Whistler, Squamish, Sunshine Coast, Powell River, Bella Bella, and Bella Coola planned this site, to develop exceptional clinical skills – for rural, remote and urban environments.

We see our residents as an important part of our health communities, and key members of the team.

We also see the program as an opportunity to consider ‘big picture’ issues in health: to foster an awareness of the social determinants of health, through the diversity of our participating communities, and through opportunities in public health, First Nations, electives, high needs populations, and more.

First year, on the North Shore, encompasses a wide range of urban Family Practice settings, along with acute care experience at Lions Gate Hospital. The new HOpe Center, beside LGH, provides teaching rooms, library, call rooms, a simulation center, and a great deal more, to support resident learning needs.

In second year, Residents spend four months in a rural community, making our program “rurally strong”, and creating an excellent opportunity to work, learn and live in a rural environment. Each community offers a broad range of clinical experience with committed practitioners. We feel these communities offer some of the best primary care learning opportunities around.

The Coastal Family Practice site offers something for everyone. Vancouver is a multicultural city with all of the urban perks, including an incredible range of recreational opportunities including sailing, kayaking, golf, great cycling, and lovely green spaces such as the renowned Stanley Park. Our Coastal Communities offer a variety of outstanding clinical and recreational opportunities. The communities range from a 45 minute to 2.5 hours’ drive from Vancouver, while some are a short ferry or flight away.

The North Shore has rental accommodations, including apartments, houses, suites in houses, etc. During the second year, 4-month rural rotation, funding support is provided for accommodation.

We’re confident that our wide range of clinical and academic environments, and exciting lifestyle opportunities, will attract strong Residents who want to work hard, benefit from the recreational and cultural activities in our communities, and gain skill and insight in all aspects of Family Practice and health care.

Dr. Dean Brown

dvbrown@shaw.ca

Lead Resident Message

Welcome to Coastal! As a rurally-enhanced site, located in beautiful North Vancouver, our site aims to train full-service Family Physicians who will be prepared to work in any setting upon graduation. Our home-base is Lions Gate Hospital, along with a number of outpatient clinics located throughout the North Shore region (including North Vancouver, West Vancouver, Deep Cove, and Horseshoe Bay). Lions Gate Hospital is a community hospital with incredible collegiality amongst the team of physicians, including a strong family medicine presence in various departments such as hospitalist, obstetrics, emergency, and surgery. We are the only core group of residents based out of Lions Gate Hospital, and as such work directly with staff from all disciplines and have ample opportunity for hands-on experiences. Knowing that we are Family Medicine residents, the specialists are all keen to teach us about their fields from a Family Medicine perspective. This applicability has been key in our training.

At Coastal, the first year of residency consists of working with a primary Family Medicine preceptor which is matched based on residents’ interests, along with various core rotations at Lions Gate Hospital. In second year, we complete a combination of core rotations, self-arranged electives, and a 4-month rural rotation in communities extending from the Sea-to-Sky Corridor, Sunshine Coast, and all the way up to Bella Bella.

Our Coastal cohort consists of 9 residents per year, 5 CMG residents and 4 IMG residents. We are a small close-knit group who work and train together as a unified cohort. We get to know each other well and support one another throughout residency and beyond. We frequently plan additional education sessions for the cohort, as well as regular simulation days in our advanced SIM center. Our Site Director, Dr. Dean Brown, and our enthusiastic team of faculty leads go above and beyond for the program and its residents. We are also incredibly supported by our amazing administration team of Tamar and Zoe, who ensure that the administrative aspects of residency are always taken care of. We are excited to welcome our next cohort to the Coastal family!

Good luck with CaRMS, and we look forward to meeting you!

Dr. Nora Tong & Dr. Mackenzie Howell

Coastal Site Lead Residents

Number of Residents: 5 CMG, 4 IMG
Location: North Shore, Vancouver, various Coastal Communities
Community: 250,000
Hospitals: Lion’s Gate Hospital, Pemberton Health Centre, Squamish General Hospital, St. Mary’s Hospital, Powell River General Hospital
Distance from Vancouver: 13 KM

Curriculum Type: Partially Integrated
Elective Time: 
10 weeks with 2 weeks of selectives (Cardiology/Infectious Diseases/Gastroenterology) in R2, 2 weeks in R1
Contacts: Site Director – Dr. Dean Brown / Site Coordinator –Tamar Haytayan
Lead Resident: Dr. Mackenzie Howell & Dr. Nora Tong

Overview

Introduction

The Coastal Family Practice Residency site evolved in a unique manner, with high aspirations. A group of physicians from the North Shore, Pemberton, Whistler, Squamish, Sunshine Coast, Powell River, and ‘the Bellas’ planned this FP Residency, to develop exceptional clinical skills for rural, remote and urban environments, across a full spectrum of clinical care settings.

Purpose

The Coastal site has been developed for Residents who are excited about becoming leaders in Family Practice.  The site focuses on strong clinical skills and exposure to all aspects of Family Practice. This is a “rurally strong” program with excellent urban exposure, so our Residents work across the full range of Family Practice settings. They also gain awareness of ‘social determinants of health’ in different communities.

The first year, spent entirely on the North Shore, starts with a common time together, to learn fundamentals and create a support network. Second year includes a 4-month rotation in a rural Coastal community, plus 10 weeks of Electives, which can be tailored to suit individual interests. We create a strong academic learning environment, enabling Residents to gain skills and knowledge for success in all aspects of Family Practice. Our residents also develop strong collaborative relationships, supporting one another as learners, friends, and colleagues over the two years and beyond.

Curriculum Highlights

There are many opportunities for clinical skill development. Some examples:

  • Regular Simulation sessions at Lions Gate Hospital’s Simulation Centre
  • Extensive rural practice experience
  • Varied Family Practice office setting exposure, from private office to group settings
  • Obstetrics experience – full spectrum from prenatal visits, labour, delivery (including c-sections) and post partum care
  • HealthConnection – a ‘high needs’ clinic providing team-based primary care to people with complex clinical and social needs
  • Surgical rotations, with surgeons and specialists keen to support the development of core skills in Family Practice Residents, including anaesthesia and airway management
  • Mental health and addictions experience.
  • Internal Medicine, Hospitalist and Critical care
  • Exposure and training in First Nations/Aboriginal Health
  • A strong commitment to academic development, with academic and clinical leaders providing content delivery and interactive sessions

First & Second Year Curriculum

First year, on the North Shore, encompasses a wide range of urban Family Practice settings, along with acute care experience at Lions Gate Hospital. The new HOpe Center, situated beside LGH, provides teaching rooms, a simulation centre, library, call rooms, and a great deal more, to support resident learning needs.

In second year, Residents spend part of the year on the North Shore, 10 weeks in electives, and four months in a rural community, making our program “rurally strong”, and creating an excellent opportunity to work, learn and live in a rural environment. Each community offers a broad range of clinical experience with committed practitioners.

Rotation Duration Location/Notes
Family Practice 46 weeks Including 16 weeks of Rural
Emergency 8 weeks
Obstetrics/Gynecology 6 weeks
Pediatrics 10 weeks
Internal Medicine + Hospitalist 10 weeks
Surgery 6 weeks
Mental Health 4 weeks
Palliative Care 4 weeks
Electives 10 weeks

Seminars & Research

Residents attend mandatory academic activities – usually a half day per week. This includes academic teaching with a mix of clinical case discussions and core topics. Residents are also expected to do presentations. Throughout the program, we stress “Evidence-Based Medicine” in both academic and clinical areas.

Once a year, residents from all sites will come together for a program wide R1 Academic Day and Scholarship Day. These events are “required attendance” days.

In the first year, residents complete a Practice Improvement Project. Throughout the two years, residents complete a scholar project and present their work at Scholarship Day.

International Electives

Residents can do one month of interprovincial or international electives during their training.

Further Training

Third year training positions are available in Emergency Medicine, Care of The Elderly, Anesthesia, , Palliative Medicine, Sports and Exercise Medicine, Clinician Scholars program and a wide range of other Category 2 Enhanced Skills programs.

Training Sites

Resources

North Shore:  The North Shore, where the main training hospital is located, is 20 minutes from Vancouver.  It boasts three local ski mountains, internationally acclaimed mountain biking trails, hiking, sailing, many local beaches and a vibrant urban core.  Lions Gate Hospital has 238 acute care beds, serves the North Shore, and provides specialty services for all of Coastal (North Shore, Sea to Sky corridor, Sunshine Coast, Powell River, and the Central Coast).  A recognized trauma centre, one of 5 BC Neuro surgery centres, it has a large orthopedic trauma service.  LGH provides full maternity, pediatric, medicine, critical care, surgical and emergency services.  It has one of the most advanced MRI’s in Canada, and is the 4th busiest hospital in the Lower Mainland.  Family Practitioners are a strong presence, as Attending Physicians, and also as Hospitalists.  In the community, there are many group and individual Family Practice offices providing both full-service care, and focused practices.

Pemberton:  Pemberton is a strong and vibrant community, located 30 minutes North of Whistler, and 2.5 hours from Vancouver.  There are many outdoor recreational opportunities, including mountain biking, hiking, river rafting, etc, plus many Provincial Parks, and hot springs to visit.  The Pemberton Health Care Centre services a large geographic area at the north end of the Sea to Sky corridor, including Pemberton, Mount Currie, D’Arcy and the InShuck communities down the Lilloet Lake Road.  The Centre provides 24/7 emergency care, palliative care, diagnostic imaging and laboratory services.  A group (shared) Family Practice is co-located on site.  All care is provided by a small group of physicians and a team of very skilled nurses. The ER sees all types of injuries and illnesses, maternity care, critical care, etc.   Approximately 45% of the patients are First Nations.  One GP visits remote First Nations communities weekly by helicopter.  There are initiatives providing telehealth support to these communities.

Squamish:  Celebrated as “The Outdoor Recreational Capital of Canada”, Squamish has an active population with an average age of 36, and a large proportion under age 10.  Squamish is situated half way between Whistler and Vancouver, an enjoyable 45 minute drive either way.  Squamish General Hospital is a 22 bed acute care facility with a 9 stretcher Emergency Room.  Hospital services include general medicine, surgery, obstetrics, psychiatry, palliative care, physiotherapy, pharmacy, diagnostic imaging, laboratory, ambulatory care, chemotherapy and dialysis.  Family Practitioners provide a variety of services including GP anesthesia, inpatient care, and maternity care, with support from a general surgeon and visiting specialists.  Squamish General Hospital is the community hospital for the Sea to Sky corridor including Mount Currie and the First National’s communities along Lilloet Lake.

Gibsons/Sechelt:  The Sunshine Coast runs approximately 180 kilometres from Langdale to Lund, with many beautiful small communities along the way, including Gibsons and Sechelt.  The Sunshine Coast, a short 40 minute ferry ride from West Vancouver’s Horseshoe Bay, is home to the highest per capita population of artists, artisans and crafters in Canada.  It boasts spectacular hiking, kayaking, diving, beach combing, and  a myriad of other outdoor pursuits.  St. Mary’s Hospital, a 42 bed acute care facility serving over 100 km of the Sunshine Coast, is located in Sechelt, and serves a number of communities along the coast.  This facility was recently renovated and expanded with new acute care patient rooms, ER department, diagnostic imaging and a new special care unit for high acuity patients.  There is a newly renovated ambulatory care area.  Family Practitioners are an integral part of St. Mary’s, providing ER and inpatient care.  While there are several consulting specialties available, including General Medicine, General Surgery, Psychiatry and Obstetrics, the Family Physician is always the most responsible physician.

Powell River:  Powell River is located on the Northern Sunshine Coast at the gateway to Desolation Sound, has outstanding mountain biking, kayaking and hiking and is a destination for tourists from around the world because of its natural beauty, music and facilities.  Powell River General Hospital is a modern self-sufficient 33 bed facility supporting many services including oncology, dialysis, cast clinic, endoscopy full time GP anesthesia, medicine, surgery, and OB Gyn coverage.   Family physicians practice full service medicine, and are the most responsible physician for medical and obstetrical patients. Residents provide in-patient care, palliative care, extended care and nursing homes, and gain experience in sports medicine, geriatrics, and chronic disease management.   The ER is moderately busy and a great venue to become increasingly comfortable with emergency care.  There is excellent GP, specialist and anesthesia back up. Residents will be exposed to truly ‘full service’ family medicine in a friendly community where accommodation is readily available.

Bella Bella and Bella Coola: These small remote central coast communities are largely Indigenous (90-95%) and offer exceptional primary care learning opportunities. They have Family Physicians and resourceful care teams that support populations distributed over surprisingly large areas.

Resident Life at Coastal

Coastal has eight residents per year, which has provided for an amazingly tight-knit group. Everyone at Coastal is extremely supportive and always seems to go the extra mile for one another.  We are constantly taking advantage of all that the North Shore has to offer, including skiing, hiking, snowshoeing, kayaking, and more.

Many of our residents also have families, and the North Shore is a great place to enjoy family life and/or to raise children. Our rural placements in second year range from Squamish to Bella Coola, providing people with a wide array of rural experiences depending on their interests. Coastal offers the best of both worlds, with a great blend of urban and rural training, and a close-knit North Shore community that still has close proximity to the rest of the Lower Mainland. Come join us at Coastal and see what the beautiful North Shore has to offer!