General Pediatric Residency Training Program
The general pediatric residency training program strives to provide a broad inpatient, ambulatory and community educational base to equip modern-day general pediatricians with the skills necessary for practice. Training within the tertiary care setting helps equip graduates with the confidence and skills necessary to treat children with significant and possibly life-threatening problems. This is complemented by time spent each year in community practices and hospitals. Our pediatric residency training program is committed to providing an excellent educational experience within the guidelines of the Royal College of Physicians and Surgeons of Canada.
In July 2015, the program expanded to a second site in Victoria, where two residents each year are accepted into the Vancouver Island Site Program. They are integrated as UBC pediatric residents, but have a fantastic opportunity to be part of building a community-based program. There are many opportunities for residents to gain hands-on experience, guided by an enthusiastic faculty. Additionally, Victoria is a lovely city and easy to live in.
There are approximately 60 residents in the program over the two sites. The training program is four years, of which residents do three core years of general pediatrics. These core years provide exposure to acute care and ambulatory pediatrics, as well as the subspecialties, with a graded responsibility from junior to senior residency. Residents at the Vancouver site participate in the resident continuity clinic for three years, while the Victoria-based residents focus on longitudinal experiences. The fourth year is either a further year in general pediatrics – with sufficient elective time tailored to the individual’s academic interests and career goals – or the first year of a subspecialty training program.
Residents attend mandated academic activities, including academic half-days and Grand Rounds on a weekly basis. These are video-conferenced to our distributed sites throughout the province. There are two mandatory resident retreats and a Careers Night annually, attended by residents from both sites.
Residents also practice resuscitation scenarios in the high-fidelity simulator program, both on acute care rotations (PICU and emergency medicine) and in their longitudinal simulation curriculum in the academic half-day (see page 129 of our 2016 Annual Report). Regular mock codes take place for CTU residents.
All residents are expected to work on clinical (including quality improvement), basic science or medical education research and to present their work at least once, either at the annual research day or at a conference. First year residents take part in a 30-hour research curriculum during the academic half-day. The resident Journal Club is scheduled bimonthly and introduces residents to key clinical research methodologies and critical appraisal of the literature.
The Department of Pediatrics and the pediatrics residency program have an interest in social pediatrics and the health of vulnerable children and youth. Residents have opportunities to engage in resident-driven local health advocacy projects, outreach programs within Western Canada, and global child health initiatives, including social pediatrics electives and electives overseas. Partnerships exist with hospitals in several countries, including South Africa and Australia.
The three core years provide experience in acute care and ambulatory pediatrics. There are rotations in general pediatric inpatients, neonatology, emergency, subspecialties, and community pediatrics. In the second and third years, intensive care is added, as well as elective time. There is graded responsibility from junior to senior residency, with the second year being a transition from junior to senior. Residents participate in the resident continuity clinic for three years (mid PGY1 to mid PGY4).
The general pediatric ward utilizes a Clinical Teaching Unit (CTU) format with the supervisory senior year resident assuming leadership of a resident-medical student team. This team is responsible for all patient care on the CTU. Call commitments are designed to provide residents with further educational opportunities. A night float call system is used for the coverage of the clinical teaching units (CTU) during the weeknights. Residents in years 1 through 3 complete two 2-week night float rotations per year. Night float runs Sunday through Thursday nights with cross covering residents working the weekend. Several rotations (PICU, NICU, IN, etc.) continue to use a traditional call schedule.
The Victoria Pediatrics Residency Program is fully integrated into the Vancouver-based Pediatrics Residency Program. In addition to being part of academic activities taking place in Vancouver (by videoconference or in person), residents will spend 6-14 weeks each years in Vancouver doing rotations that are by necessity in a children’s hospital.
Our program reflects the components of specialty training: the first three years provide exposure to acute care and ambulatory pediatrics as well as the subspecialties, with a graded responsibility from junior to senior residency. Most of the subspecialty education will be via longitudinal experiences with mixed general pediatrics and subspecialty clinics. Some subspecialty rotations will take place at the BC Children’s Hospital in Vancouver. Rural community pediatric rotations will occur for 1-2 months, once during the junior and once during the senior years.
Block rotations in emergency medicine, CTU, NICU, surgery, neurology, and rural experience, with half the year constructed around longitudinal experiences in a range of areas including ambulatory pediatrics, endocrinology, psychiatry, developmental, cardiology, allergy, rheumatology, genetics, social pediatric and others. At least 6 weeks will be spent at BC Children’s Hospital in Vancouver (CTU Junior, night float junior).
PGY2: Transition towards senior
Block experience in complex developmental clinics, PICU and NICU with some elective experience and ongoing CTU and longitudinal experiences that will prepare the trainee for role as a senior resident. Between 4 - 8 weeks will be spent at BC Children’s Hospital in Vancouver (oncology/ emergency) or in a smaller community training centre.
A range of experiences directed at helping the trainee take on a more senior role in clinical reasoning and management, with ongoing longitudinal experience, and a senior rural block. As well as blocks in senior CTU and PICU, NICU, and a diverse clinic experience meant to increase exposure to a range of psychosocial experiences. Up to 14 weeks may be spent at BC Children’s Hospital in Vancouver (CTU Senior, night float senior, BC Women’s level III NICU, PICU) and / or in a rural centre, maximizing community experience.
The Program Director counsels senior residents and works with them to tailor much of their fourth year to meet academic interests, career goals and objectives.
Throughout the residency, developing the trainee’s skills as an educator and scholar, a gifted and skilled communicator, and a reflective medical leader will be an active goal and part of ongoing educational opportunities.
While on mandated BCCH or rural rotations, throughout PGY1-4 years, accommodation is provided.
The Pediatric medical staff in Victoria are a collegial group, interacting frequently with their subspecialty colleagues, other specialities, primary care providers, and with inter-professional team members. Trainees can expect significant hands on experience in a range of settings, and enjoy the opportunity to thrive in a professional environment that is excited about a new training opportunity.
Vancouver BCCH Program Facilities
British Columbia Children's and Women's Hospitals serve as the primary source of pediatric training in the province. A new Acute Care Center opened in late 2017.
British Columbia Children's Hospital (BCCH) is the only tertiary care pediatric hospital in BC. The hospital also provides primary and secondary pediatric care to the pediatric population in and around Vancouver. Virtually all medical and surgical subspecialties are represented at this centre. There is a total of 279 beds with approximately 8,300 admissions per year. The 22-bed Pediatric ICU has approximately 1,100 admissions per year. We also have an active pediatric cardio-thoracic surgery service.
British Columbia Children's Hospital has a Pediatric Emergency Department with approximately 45,000 visits per year. The Ambulatory Care Building hosts over 40 clinics seeing over 153,000 visits per year. There are active medical, surgical and psychiatric daycare programs.
British Columbia Children's Hospital and British Columbia Women's Hospital offer level 2 and 3 nursery experience, and the Sunny Hill Health Centre for Children provides child development and rehabilitation services.
Residents also spend time in a number of other community hospitals in the province, including Surrey Memorial Hospital, the Royal Inland Hospital in Kamloops, Abbotsford Regional General Hospital, Nanaimo Regional General Hospital, Prince George Regional General Hospital, Victoria General Hospital, and Kelowna Regional General Hospital.
Victoria Site Facilities
- Victoria General Hospital, Victoria
- Queen Alexandra Centre for Children’s Health
- British Columbia Children's Hospital, Vancouver
- British Columbia Women's Hospital, Vancouver
- Examples of Regional/Rural Electives (TBC): Campbell River/Courtenay / Comox Port Alberni Nanaimo
Victoria General Hospital is an acute care hospital where the pediatric ward has 23 pediatric beds. A 5 bed Pediatric Intensive Care, a 22 bed neonatal intensive care unit, and a labour and delivery unit where there are 3200 deliveries per year. Outpatient specialized pediatric clinics exist here, in the areas of diabetes, oncology, asthma, cystic fibrosis, genetics, neurology, rheumatology, neonatal follow up and cardiology.
Victoria based residents will do rotations in the Victoria General Hospital Pediatric ICU, ER, NICU and CTU. A range of subspecialty and general pediatric experiences will occur both in a block and longitudinal format in Victoria. With our high volume of neonatology, a significant amount of neonatal experience will be gained in Victoria and augmented experience may take place at one of several hospitals in the Lower Mainland, including BC Women’s Hospital. Some subspecialty electives may be sought at BC Children’s Hospital.
The Developmental Centre of Queen Alexandra Centre in Victoria allows exposure to many complex behavioral and developmental patients in the context of a multidisciplinary team setting. The placement of this hub as a referral center for all of Vancouver Island will allow the resident in training to see a range of developmental issues and appreciate the importance of forging management plans that acknowledge the resources of the referring community. The important social component of pediatrics will also be evident in this setting.
British Columbia Children's Hospital (BCCH) is the only tertiary care pediatric hospital in BC. The hospital also provides primary and secondary pediatric care to the pediatric population in and around Vancouver. Virtually all medical and surgical subspecialties are represented at this centre. There is a total of 279 beds with approximately 8,300 admissions per year. The 22-bed Pediatric ICU has approximately 1,100 admissions per year. We have an active pediatric cardio-thoracic surgery service.
British Columbia Children's Hospital has a Pediatric Emergency Department with approximately 40,000 visits per year. Residents practice resuscitation scenarios in the high-fidelity simulator program, engage in ward-based mock codes and participate in a longitudinal simulation curriculum in the academic half day. The Ambulatory Care Building hosts over 40 clinics seeing over 100,000 visits per year. There are active medical, surgical and psychiatric daycare programs.
British Columbia Women's Hospital offers level 2 and 3 nursery experience with over 7,400 deliveries per year and a 60 bed quaternary NICU. The Sunny Hill Health Centre for Children provides child development and rehabilitation services.
Through its affiliation with the University of British Columbia, BC Children's Hospital serves as the prime source of pediatric training in the province. The Department of Pediatrics, part of the University of British Columbia's Faculty of Medicine, has played a vital role in developing undergraduate and clinical training programs since 1952. The strength of the Department lies in three areas: teaching, research, and exemplary patient care. The hospital's affiliation with UBC designates Children's as a major teaching hospital for pediatricians. The Department of Pediatrics is responsible for the pediatric education of the 150 medical students in each year of the undergraduate program, family practice residents, and external elective students annually.
In addition, many of the subspecialties offer training programs for pediatric graduates. Subspecialty fellows total about 65 per year, while the resident body is over 60 per year. Students of many other disciplines are present in the hospital, including nursing, dentistry, surgical subspecialties, family medicine, psychiatry, medical genetics, etc. Advanced level trainees should feel a special obligation to teach junior colleagues, both on the wards and in didactic presentations. There is no better way to learn than to teach a subject. Research is a high priority of all the divisions within the Department of Pediatrics. Most departmental members are active investigators. All trainees are encouraged to consider research projects; some divisions make this a requirement. Advice in statistics and methodology is available as a service to staff and trainees of BCCH through the office of Research Support Services, located in the Research Institute adjacent to the hospital.
The nineteen divisions within the Department are responsible for 65 percent of all research performed at BCCH. New research developments enhance the outstanding care given to children and youth in British Columbia. The Department shares the philosophy of family-centered care with BC Children's Hospital. As the tertiary care centre for the province, BCCH provides care to children with simple and complex disorders.
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