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I'll be back. Currently meditating...

UBC Objectives: Family Medicine, UBC Objectives: Maternity Care, & Priority Topic: Learning (Self Learning)

1/6/2018

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By the end of postgraduate training, using a patient-centred approach and appropriate selectivity, a resident, considering the patient's cultural and gender contexts, will be able to...
  • Demonstrate strategies for lifelong learning given that the knowledge of family medicine is vast and rapidly changing
  • Describe accepted guidelines for perinatal and obstetrical care (ex: SOGC)

Key Feature 6: Continuously assess your learning needs.
Skill: Professionalism
Phase: N/A

Key Feature 7: Effectively address your learning needs.
Skill: Professionalism, Selectivity
Phase: N/A

Key Feature 8: Incorporate your new knowledge into your practice.
Skill: Professionalism
Phase: N/A

"The struggle is real." There is a reason I titled the page that covers my learning objectives as such. Medicine is constantly changing: Evidence-informed medicine is perhaps the most knee jerk example of this. New research regarding current approaches to identifying and managing disease brings about novel ways of practicing medicine, sometimes reinforcing current methods, but oftentimes challenging the status quo. And this evolution goes beyond refining criteria for definition of disease states and choice of treatment in managing disease, it also fuels drifts and shifts in the culture of how we practice medicine, such as in how we steward resources or what we deem acceptable ethically. And now, more than ever, research in family medicine is establishing itself as a pillar in the construct of family medicine as a field that promotes best practice approaches to patient care. (http://www.cfpc.ca/Research/)

So how is a resident to cope, given the need to get up to speed with current standards of practice, while also considering the barrage of new evidence that challenges these standards? UpToDate. 

I joke, but like many jokes, there is truth in my response. There are a bazillion medical resources available to physicians' (and patients') fingertips. It's quite overwhelming in fact. Throughout the first 6 months of residency I have managed to hone in on a few that I find particularly useful as they are comprehensive, evidence-based (being regularly updated by new evidence), and relevant to the practice of medicine in Canada. My list will constantly evolve; new useful resources will be developed, and maybe new ways of learning altogether. As it stands currently, my gold star sources of general medical information and keeping up with new information in my field of medicine are: 
  1. UpToDate
  2. Canadian Family Physician
  3. Clinical practice guidelines that come from various provincial and national medical bodies (ex: the Society of Obstetricians and Gynaecologists of Canada*)

Honourable mentions are the annual CFPC's Family Medicine Forum (my favourite method of learning but obviously not accessible year-round), Procedures Consult (for approaches to performing procedures), and Self Learning by CFPC (an engaging question-based approach to learning). I'm also always on the hunt for new awesomer podcasts, and my current and residency specific favourite is Dr. Mike Kirlew Presents (a wacky podcast that covers the 99 Priority Topics in preparation for the qualifying Canadian College of Family Physicians examination). Oh and my favourite drug compendium is Tarascon Pocket Pharmacopoeïa (I carry this one in my doctor bag no matter what rotation I am on).

Peer-based group learning is something I am also wanting to explore more, particularly using the Peer Based Small Group (PBSG) McMaster Modules. At the 2017 Family Medicine Forum I took a workshop and became certified as a peer resident facilitator for these modules, and I am working on coordinating the first PBSG session for my cohort in late winter this year.

All this talk, not enough learning. Time to get back to my Self Learning quiz!

*Okay so I totally name-dropped the SOGC into this post. Yes, it is part of one of my learning objectives to describe accepted guidelines for perinatal and obstetrical, and yes the objective points to that as the example, but honestly, it's the example I choose to go with because this organization is just so dang good. Their information is seriously up-to-date, comprehensive, and Canadian in context. They also put out the ALARM course which has provided the backdrop to my core understanding in obstetrics, and they are responsible for my favourite sexual health and pregnancy counselling website that I refer almost any patient with related issues to, sexandu.ca. While it's always good to diversify your sources of information so you don't get too biased, the clinical practice guidelines are peer-reviewed. If UpToDate is God, the SOGC is Jesus. And to that, I say "Hallelujah!"
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