Expanding Medical Education in Expanding Medical Education in British Columbia within a Socially British Columbia within a Socially

Responsible FrameworkResponsible Framework

Oscar Casiro, MD, FRCPCOscar Casiro, MD, FRCPC

Head, Division of Medical Sciences, UVicHead, Division of Medical Sciences, UVic

Associate Dean, Island Medical Program, Associate Dean, Island Medical Program, UBCUBC

ChallengesChallenges

Shortage of Shortage of physiciansphysicians

Recruitment and Recruitment and retention problemsretention problems

Maldistribution of Maldistribution of physiciansphysicians

British ColumbiaBritish Columbia BC provides only a fraction of the 300 - 400 BC provides only a fraction of the 300 - 400

new physicians it needs each year.new physicians it needs each year. Only 26% of physicians practicing in the Only 26% of physicians practicing in the

province are UBC graduates.province are UBC graduates. BC has the lowest medical student spaces BC has the lowest medical student spaces

per capita in Canada.per capita in Canada. Shortages of physicians in rural/northern Shortages of physicians in rural/northern

communitiescommunities Growing, ageing populationGrowing, ageing population

B. McBride & J. Cairns, B. McBride & J. Cairns, 20012001

University of Northern BritishColumbia:

Northern Medical Program (NMP)

University ofBritish Columbia:

Vancouver-Fraser Medical Program(VFMP)

University of Victoria:

Island Medical Program (IMP)

The MD Undergraduate Program Distributed The MD Undergraduate Program Distributed

Model of ExpansionModel of Expansion

Changes in Student Enrolment in the Changes in Student Enrolment in the UBC Faculty of Medicine 2003 - 2010UBC Faculty of Medicine 2003 - 2010

N=1024

N=512

Proposed changes to undergraduate Proposed changes to undergraduate enrolment by year 2003 - 2013enrolment by year 2003 - 2013

128

128

128

120

200

128

128

128

224

200

128

128

224

224

200

128

224

224

224

200

224

224

224

224

224

224

224

224

256

224

224

224

256

256

224

224

256

256

256

224

256

256

256

256

Current 04 05 06 07 08 09 10 11 12 13

Year 4

Year 3

Year 2

Year 1

N=504

N=1024

Degrees Of Distribution

University of British Columbia Faculty of MedicineUndergrad Program – Degrees of Distribution

UBC

UVic UNBC

VCHA/FHAVGH/SPH/RCH

VIHAVic Gen/RJH

NHAPGRH

Rural & Remote

PHSABCCWH/

BCCA

Affiliated Regional CentresAffiliated Regional Centres – Types 1 & 2 Phases 5&6

Dispersed Sites - Rural & RemotePhases 3, 5, 6

Clinical Academic CampusesPhase 4, 3rd Year

Partner University Campuses1st & 2nd Year

IHA

KGH

Community Based Sites

Uses of TechnologyUses of Technology

Planning: Planning: • MeetingsMeetings• Team roomsTeam rooms

Administration:Administration:• Curriculum meetingsCurriculum meetings

Faculty developmentFaculty development• Tutor meetingsTutor meetings

InstructionInstruction• LecturesLectures• LabsLabs• PBL groupsPBL groups

Student supportStudent support• Student connectionStudent connection• Student counselingStudent counseling

EvaluationEvaluation• ExamsExams• Faculty/course Faculty/course

evaluationevaluation

Medical Sciences Building: Medical Sciences Building: Home of the Island Medical ProgramHome of the Island Medical Program

Officially opened Officially opened December 2004December 2004

““Green” buildingGreen” building Students have Students have

24-hour access 24-hour access (coded security (coded security cards)cards)

Designed to Designed to accommodate accommodate students and students and staff with staff with disabilities.disabilities.

Medical Sciences Building:Medical Sciences Building: FacilitiesFacilities

Two state-of-the-art Two state-of-the-art lecture theatres lecture theatres

Seven PBL roomsSeven PBL rooms Two research labsTwo research labs Computer labComputer lab Reading roomReading room Gross anatomy labGross anatomy lab State-of-the-art State-of-the-art

multipurpose labmultipurpose lab

Medical Sciences BuildingMedical Sciences Building

Island Medical ProgramIsland Medical ProgramVancouver Island Health Authority (VIHA)Vancouver Island Health Authority (VIHA)

Clinical Academic CampusClinical Academic Campus

Royal Jubilee HospitalRoyal Jubilee Hospital• 656 bed acute care656 bed acute care• Clinical skills facility for Clinical skills facility for

11stst & 2 & 2ndnd year IMP students year IMP students

Victoria General Victoria General HospitalHospital• 379 bed acute care379 bed acute care

Educational Centres in Educational Centres in Central and North Central and North IslandIsland

Class of 2008Class of 2008

The Island Medical The Island Medical Program’s most Program’s most important asset!important asset!

““I had high expectations I had high expectations when I decided to participate when I decided to participate in the Island Medical in the Island Medical Program, and those Program, and those expectations have been expectations have been exceeded! I love being able exceeded! I love being able to study with a small group to study with a small group of students, and I love the of students, and I love the interaction with IMP staff – interaction with IMP staff – they know all the students by they know all the students by name!”name!”

• Pre-Med

• Undergraduate Medical Education

• Postgraduate Medical Education

• Continuing Professional Development (CME)

Continuum of Medical EducationContinuum of Medical Education

Develop core clerkships in Victoria Develop core clerkships in Victoria Build infrastructure to support Build infrastructure to support

medical education outside Victoriamedical education outside Victoria Community-based integrated Community-based integrated

clerkships in Central or North Islandclerkships in Central or North Island Community-based rural electives Community-based rural electives

and selectivesand selectives

MD Undergraduate ProgramMD Undergraduate ProgramYears 3 and 4Years 3 and 4

• Phase III- Community Practice (4-8 week Phase III- Community Practice (4-8 week practicum in rural and underserved practicum in rural and underserved communities)communities)

• Phase IV- (48 weeks) required clinical Phase IV- (48 weeks) required clinical clerkshipsclerkships

• Phase V- selectives and electives (first 16 Phase V- selectives and electives (first 16 weeks of year 4)weeks of year 4)

• Phase VI- Effective Learning Skills for Phase VI- Effective Learning Skills for Medical Practice (16 weeks including a 2 Medical Practice (16 weeks including a 2 week LMCC preparation course and 4 week LMCC preparation course and 4 week senior elective)week senior elective)

Undergraduate Curriculum and Planning Model Undergraduate Curriculum and Planning Model Years 3 & 4Years 3 & 4

III Rural Practice: 4 to 8 week Practicuum in Rural Communities

IVCore Clerkships (Internal Medicine, Surgery, Paediatrics, Obstetrics and Gynaecology, Psychiatry, Emergency Medicine)

V Advanced Clerkships (Electives and Selectives)

VFMP IMP NMP

VIEffective Learning Skills for Medical Practice (weekly themes: Pharmacology & Therapeutics, Health Care & Epidemiology, Health Care Policy, Ethics, Law, Advanced Communication Skills, Palliative Care)

Throughout British

Columbia

Phase

4

Course

3

Location Year