Across the lifecycle (including prevention, acute, and chronic illness management)
In a variety of care settings (urban, rural, home, ambulatory, as well as emergency, hospital, and long-term care facilities)
To a broad base of patients including those from underserved and marginalised populations
Domains of Care
Family Medicine
By the end of postgraduate training, using a patent-centred approach and appropriate selectivity, a resident, considering the patient’s cultural and gender contexts, will be able to...
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...
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...
By the end of postgraduate training, using a pa ent-centred approach and appropriate selectivity, a resident, considering the patient’s cultural and gender contexts, will be able to...
By the end of postgraduate training, using a pa ent-centred approach and appropriate selectivity, a resident, considering the patient’s cultural and gender contexts, will be able to...
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...
By the end of postgraduate training, using a pa ent-centred approach and appropriate selectivity, a resident, considering the patient’s cultural and gender contexts, will be able to...
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...
Assess and manage pain, nausea, nutrition, bowel management and other symptoms that arise during palliation and end of life
Assess pain effectively using history, physical exam and investigations appropriate to the illness trajectory and goals of care
Prescribe opioids effectively including proper initiation, repeated assessment, dosage, titration Priority Topics: ACLA, Palliative Care, Cancer, COPD
emergency medicine
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...
Manage a patient with an urgent/emergent problemPriority Topics: Abdominal Pain, Allergy, Anemia, Antibiotics, Anxiety, Asthma, Atrial Fibrillation, Chest Pain, COPD, Cough, DVT, Dehydration, Diabetes, Diarrhea, Difficult Pa ent, Domestic Violence, Dyspepsia, Dysuria, Earache, Eating Disorder, Elderly, Epistaxis, Fever, GI Bleed, Hepatitis, In Children, Infections, Ischemic Heart Disease, Joint Disorder, Laceration, Loss of Consciousness, Low Back Pain, Meningi s, Mul ple Medical Problems, Pneumonia, Pregnancy, Prostrate, Rape/Sexual Assault, Schizophrenia, Seizures, Sexually Transmitted Infections, Substance Abuse, Trauma, Travel Medicine, UTI, Vaginal Bleeding, Violent/Agressive Patient
Manage a patient presenting with a mental health concern Priority Topics: Suicide, Crisis, Anxiety, Depression, Eating Disorders, Schizophrenia, Somatization, Personality Disorder
Demonstrate knowledge of emergency resources for psychosocial issues Priority Topics: Family Issues, Domes c Violence, Behavioural Problems, Substance Use, Grief
Assess and manage a patient with acute pain including appraisal and use various methods of analgesia, topical/local anesthesia and sedation Priority Topics: Laceration
Demonstrate basic airway assessment and management skills
Recognize and initiate management in a patient with acute respiratory distress or ventilatory failure Priority Topics: Asthma, Croup, COPD, Pneumonia, URTI
Identify, classify and treat shock Priority Topics: GI Bleed, Abdominal Pain, Allergy, ACLS, Anemia, Atrial Fibrillation, Chest Pain, Dehydration, Diarrhea, Dizziness, Laceration, Loss of Consciousness, Meningitis, Poisoning, Seizures, Stroke, Trauma, Vaginal Bleeding
Obtain appropriate vascular access for drugs and fluids Priority Topics: Dehydration
Exhibit basic skills in interpreting 12 lead electrocardiograms, including identification and management of acute dysrhythmias Priority Topics: Ischemic Heart Disease, Atrial Fibrillation, ACLS
Manage the patient in cardiorespiratory arrest Priority Topics: ACLS
Assess and manage a patient with altered level/loss of consciousness/coma Priority Topics: Loss of Consciousness, Seizures, Meningitis, Trauma, Poisoning
Assess need for and manage resuscitation in adults and children
Priority Topics: Trauma, Newborn
Identify patients who are in crisis and appropriately manage their disposition
Outline the components of the trauma care system in your region
internal medicine
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...
Assess and manage acute and chronic medical illnesses in a variety of settings (hospital, outpatient or emergency room) Priority Topics: (including but not limited to...): Abdominal Pain, Allergy, Anemia, Antibiotics, Anxiety, Asthma, Atrial Fibrillation, Cancer, Chest Pain, Chronic Disease, COPD, Cough, DVT, Dehydration, Diabetes, Diarrhea, Disability, Dizziness, Earache, Eating Disorder, Fatigue, Fever, GI Bleed, Hepatitis, Hyperlipidemia, Hypertension, Immigrants, Immunization, Infections, Insomnia, Ischemic Heart Disease, Joint Disorder, Lifestyle, Loss of Weight, Low Back Pain, Meningitis, Multiple Medical Problems, Neck Pain, Obesity, Osteoporosis, Parkinsonism, Periodic Health Assessment, Pneumonia, Prostrate, Red Eye, Seizures, Sexually Transmi ed Infections, Skin Disorder, Smoking Cessation, Stroke, Thyroid, Travel Medicine, URTI
Recognize the effect of acute and chronic illness on patients
Explain the importance of lifestyle on disease management, appropriate to the patient’s context
Utilize age appropriate screening and periodic/preventive health examination
Describe evidence based guidelines for appropriate investigations and treatments
Outline indication for admission to and discharge from hospital
Utilize appropriate consultants in patient care including appropriate community resources and support systems
Discuss advanced directives and end of life issues
musculoskeletal medicine
By the end of postgraduate training, using a pa ent-centred approach and appropriate selec vity, a resident, considering the pa ent’s cultural and gender contexts, will be able to...
Perform a thorough examination of limbs, joints, back and neck Priority Topics: Joint Disorder, Low Back Pain, Neck Pain
Assess and manage common sports and exercise related injuries Priority Topics: Joint Disorder
Assess and manage acute and chronic repetitive stress injury (including occupational) Priority Topics: Joint Disorder, Low Back Pain
Determine risk of fracture or injury to tendon, ligament, muscle, nerve, vessel etc. based on pattern of injury and results of physical examination Priority Topics: Neck Pain
Order appropriate investigations where risk of fracture exists Priority Topics: Neck Pain
Demonstrate immobilizing techniques such as splints, basic casts and taping
Evaluate vessel and nerve injuries that can be associated with fractures and dislocations
Triage, and where necessary refer, more complex or unstable fractures for surgical consultation
Recognize and initiate management of orthopedic emergencies, arranging referral when appropriate
Assess and manage rheumatological disease including: rheumatoid arthritis, osteoarthritis, bromyalgia, and osteoporosis Priority Topics: Join Disorder, Osteoporosis
Outline common drug therapies, and the use of non pharmacological treatment modalities such as exercise pre- scriptions Priority Topics: Joint Disorder, Bow Back Pain, Neck Pain, Osteoporosis
Demonstrate appropriate medical consultation and shared responsibility of family doctor and consultant to the patient
Recognize and initiate management for infectious musculoskeletal conditions Priority Topics: Joint Disorder
Assess basic orthopedic illnesses in children including gait abnormalities and the limping child Priority Topics: Joint Disorder
Examine for congenital hip disease
Perform joint aspiration and joint injection of selected joints as outlined in Procedural Skills
Participate in the multidisciplinary approach to chronic musculoskeletal disease
Support the special needs of the athlete
Support the orthopedic needs of the handicapped patient, ex: those with contractures or severe muscle imbal- ance
Provide up-to-date information on rehabilitation and recovery expectations Priority Topics: Low Back Pain
Outline what community rehabilitation services are available, e.g. physiotherapy, massage therapy, exercise classes and groups, and independent rehabilitation programs as well as those available through MSP
Explain the use, risks, and bene ts of allied health professions such as chiropractic, massage therapy, acupunc- ture, physiotherapy and occupational therapy to enhance MSK care
Assess and manage patients at risk for falls from a musculoskeletal perspective Priority Topics: Elderly, Trauma
Recognize musculoskeletal-related medication side effects ex: extrapyrimidal symptoms of antipsychotics as well as side effects of medications used to treat musculoskeletal conditions
Assess and manage common neuromuscular disorders: including Parkinson’s disease, essential tremors and epilepsy Priority Topics: Parkinsonism, Seizures
surgical + procedural skills
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...
Provide immediate resuscitative care in patients with major trauma (including placement of chest tubes)
Medically manage long term chronic surgical conditions (ex: amputation, colostomy)
Describe how surgical risks vary depending on patient pro le (ex: elderly, concurrent disease, paediatric)
Explain the role of adequate nutrition to optimize healing in perioperative care
Demonstrate selectivity in deciding whether or not to perform a given procedure (including indications/contrain- dications, personal skills and readiness and context)
Explain indications and contraindications to a given procedure
Choose among several possible approaches to a given procedure
Counsel and educate patients on common surgical procedures including description of the procedure and possi- ble outcomes andcomplications as part of obtaining informed consent
During performance of a procedure, continuously reevaluate the situation, and stop and/or seek assistance as required
Develop a plan with your patient for after care and follow-up after completion of a procedure Please refer to the list of core procedures
addiction medicine
By the end of postgraduate training, using a pa ent-centred approach and appropriate selec vity, a resident, considering the patient’s cultural and gender contexts, will be able to...
We use the term Indigenous to refer to “communities, peoples and nations...which, having a historical continu- ity with pre-invasion and pre-colonial societies that developed on their territories, consider themselves distinct from other sectors of the societies now prevailing on those territories, or part of them. They form, at present, non-dominant sectors of society and are determined to preserve, develop and transmit to future generations their ancestral territories, and their ethnic identity, as a basis of their continued existence as peoples, in accordance with their own cultural patterns, social institutions and legal system.”
We have deliberately used the term Indigenous in our revised objectives to re ect the principle that residents developing competencies in Indigenous health will be learning within a speci c local context depending on their training site (ie. Nanaimo site residents train on Snuneymux First Nation territory, Prince George site res- idents train on Lheidli T’enneh territory etc.). They will have reciprocal educational relationships with the local Indigenous peoples they are serving. In addition to being based on a speci c Indigenous territory, the residents will be expected to care for other Indigenous peoples who currently reside on that territory (ie� Cree or Mohawk people that now live on the West Coast)� The intention of the objectives is for the residents to develop a set of skills, attitudes and approaches to culturally safe care that will assist them to develop therapeutic relationships with Indigenous peoples in their future practice locales, regardless of the speci c geography.
Cultural safety: Cultural safety is the outcome of interactions where individuals experience their cultural identity and way of being as having been respected or, at least, not challenged or harmed. It is determined by the recipi- ent of a service, or the participant in a program or project.
Medical Expert The resident will demonstrate the knowledge, skills and behaviours necessary to providing compassion- ate, culturally safe, relationship-centred care for Indigenous patients, their families and communities. (see de nition of cultural safety above)
Demonstrate awareness of the connection between historical and current government practices towards Indigenous peoples (including, but not limited to: colonization, residential schools, treaties, bills, land claims, segregation and Indian hospitals), and the intergenerational health outcomes that have re- sulted�
• 1.2 Demonstrate an understanding of the impact and correlation of the various medical, social and spiritu- al determinants of health and well-being on Indigenous peoples�
• 1.3 Demonstrate an awareness of the context of patient referrals, especially as it relates to patients trav- elling unaccompanied from remote locations, and engage in effective patient-centered consultation with health care professionals in the patients’ home community to establish and ensure appropriate support systems and follow-up for sustained culturally appropriate care�
• 1�4 Demonstrate an understanding of the cultural diversities of Indigenous peoples that result in a variety of perspectives, attitudes, beliefs and behaviours.
• 1.5 Demonstrate an understanding of the strengths and resilience of Indigenous peoples, families and communities�
Communicator
The resident will demonstrate effective and culturally safe communication with Indigenous patients, their families and peers. (see de nition of cultural safety above)
• 2�1 Demonstrate cultural safety as it pertains to individual Indigenous patients�
• 2�2 Establish positive therapeutic relationship with Indigenous patients and their families� Effective and culturally safe communication encourages reciprocity, equality, trust, respect, honesty and empathy.
2.3 Deliver information to Indigenous patients and their families regarding tests, reports, protocols and diagnoses and treatment plans in a way that is understandable, respectful and encourages participation in decision-making�
Collaborator
The resident will demonstrate the skills of effective collaboration with both Indigenous and non-Indige- nous health care professionals in the provision of effective health care for Indigenous patients/popula- tions�
• 3�1 Demonstrate how to appropriately enquire whether an Indigenous patient is taking traditional herbs or medicines to treat their ailment and how to integrate that knowledge into their care�
Manager
The resident will be able to demonstrate an approach to optimizing the health of Indigenous communities through an equitable allocation of health care resources, balancing effectiveness, ef ciency and access, employing evidence-based and Indigenous best practices.
• 4�1 Describe the complexity of providing health care in context to jurisdictional areas and local health service models�
• 4�2 Understand the discrimination which occurs in allocating medical resources or treatments which impact the inequalities in medical care at the population level�
• 4�3 Practice due diligence in applying a decolonizing approach to measurements of outcomes and in- terpretation of statistical data as it relates to overall improvements in population health for Indigenous populations�
• 4.4 Describe the concepts of community development, ownership, engagement, empowerment, capaci- ty-building, reciprocity and respect in relation to health care delivery in and by Indigenous communities.
• 4.5 Identify and describe key Indigenous community contacts, resources and support structures in the provision of effective health care for Indigenous patients
• 4�6 Research successful approaches that have been implemented to improve the health of Indigenous peoples, either locally or nationally.
Health Advocate
The resident will be able to identify the determinants of health of Indigenous populations relevant to the specialty and use this knowledge to promote the health of individual Indigenous patients and their commu- nities.
• 5.1 Demonstrate an understanding of the inequity of access to health care/health information for Indigenous peoples and factors such as discrimination, racism and assimilation that contribute to it.
5�2 Demonstrate an understanding of the impact of government policies on the healthcare of Indigenous communities
• 5�3 Identify and acknowledge racism towards Indigenous people as a risk factor for illness and health inequity�
• 5.4 Demonstrate ways of respectfully addressing direct, indirect and institutionalized racism towards Indigenous peoples�
Scholar
6�1 Demonstrate appropriate strategies of working with Indigenous populations to identify health issues and needs�
• 6�2 Demonstrate effective sharing and promotion of population health strategies and health information with Indigenous patients/populations.
• 6�3 Demonstrate ways of respectfully acquiring information (in a transparent manner) about Indigenous populations which involves communities as partners� This may include respectfully engaging in local community protocols required to seek knowledge/research.
• 6�4 Critically assess the strengths and limitations of available data used as key indicators of Canadian Aboriginal health and recognize the rights of Indigenous communities relating to self-determination of research agendas and processes�
Professional
The resident will demonstrate a commitment to engaging in dialogue and relationship- building with Indigenous peoples to improve health through increased personal and professional development, aware- ness and insights of Indigenous peoples, cultures, and health practices.
• 7.1 Identify, acknowledge and analyse one’s own cultural values or considered emotional response to the many histories and contemporary environment of Indigenous peoples and offer opinions respectfully�
• 7.2 Acknowledge and analyse the limitations of one’s own knowledge and perspectives, and incorporate new ways of seeing, valuing and understanding with regard to Indigenous health practice.
• 7�3 Understand the importance of reciprocity and exchange with Indigenous communities and engage in opportunities to give back to communities in return for contributing to resident’s learning opportunity�
• 7.4 Demonstrate authentic, supportive and inclusive behaviour in all exchanges with Indigenous individu- als and communities�
Global + international health
By the end of postgraduate training, using a pa ent-centred approach and appropriate selec vity, a resident, considering the pa ent’s cultural and gender contexts, will be able to...
Demonstrate knowledge of where to access travel medicine and tropical medicine information and support
Conduct pre-travel consultations, including providing safety and hygiene information, appropriate immunizations, and prophylaxis and awareness of local resources
Discuss the resources available to meet the speci c needs of new immigrants and refugees (including current national guidelines)
Describe the pathophysiology, epidemiology, and treatment of diseases that have major global health implica- tions (current or historical) both in Canada and internationally (e.g. TB, HIV, malaria, in uenza, Ebola, West Nile, Zika, SARS), and explain how Canada is linked to other countries with respect to these diseases
Initially manage tropical diseases that can be encountered in BC including initiating appropriate responses to dis- eases with public health implications (eg personal protective equipment, rapid noti cation of public health etc)
Describe the public health system of British Columbia and its relation to international health problems
Describe how social determinants of health, distribution of health resources and burden of illness contribute to global health inequities
Describe how con ict/war negatively impacts the social determinants of health on an individual and community level
Identify clinical interventions which have the most impact in resource-constrained environments e�g� immuniza- tions, essential drugs, maternal/infant health programs, health education
Describe how limited access to specialist support and diagnostic technologies changes clinical practice
Discuss ethical implications, both positive and negative, of international health work
hiv primary care
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...
Distinguish the populations and the vulnerabilities of the populations most impacted by HIV/AIDS
Offer HIV testing to all patients as appropriate
Offer vaccinations appropriate for an HIV positive person
Discuss antiretroviral therapy and ongoing monitoring
Demonstrate awareness of the most common opportunistic infections
Manage risk and occupational exposures according to provincial guidelines including post-exposure prophylaxis
Discuss strategies for prevention of mother to child transmission with reference to protocols for pregnant women at risk/HIV+ through pregnancy/labour and delivery, and the postpartum
Describe, investigate for and manage important co-infections (e.g. Hepatitis C, syphilis)
Identify when specialist advice/referral is indicated including how and when to access the BC Centre For Excellence in HIV
rural medicine
By the end of postgraduate training, using a pa ent-centred approach and appropriate selec vity, a resident, considering the pa ent’s cultural and gender contexts, will be able to...
Display increasing independence and responsibility in the comprehensive care of patients across the lifespan
Identify the diversity and variety of procedural skills required by the rural physician
Demonstrate competence in advanced lifesaving skills
Demonstrate how to transport a patient in a timely and effective manner despite signi cant barriers
Identify ways in which successful rural physicians maintain their knowledge, skills, competence, con dence and resilience
Display understanding of the role of a rural physician within a community-based hospital and integrated medical community
Manage acute and chronic medical illnesses in various rural settings (community, outpatient clinic, emergency room, and hospital)
Demonstrate core procedural skills with increasing con dence
Justify the indications for admission of patients to hospital for investigation and/or treatment in a rural setting
Consider the effects of hospitalization on the patient and family taking into account the distance, cost and logis- tics associated with transfer to a higher level of care
Utilize specialists’ guidance appropriately from a remote setting either hospital orclinic, using telehealth, video- conferencing and teleconferencing
Develop and use fallback measures for emergent and clinic care of patients inthe event of telecommunication, technology, or transfer failure
Commit to on-going medical education, with an emphasis on rural healthcare
Describe the advisory role of rural physicians in the management and operations of health care facilities
Demonstrate an awareness for the need to have a heightened sensitivity to patient con dentiality and profes- sional boundaries while practicing in a rural or remote setting
behavioural medicine + resident wellness
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...
Devise a management plan that the patient agrees to and can ful l and provide appropriate follow up for mental health and lifestyle change problems
Demonstrate the con dence and skills to manage dif cult (emotionally intense) interactions
Address all aspects of a person including: physical health, emotional health, life stage and individual development (normative developmental stages), sexuality, spirituality, health beliefs, culture/ethnicity, relationships, work, school, household, money/ nances, leisure time
Differentiate between normal range of experiences and common mental health disorders (normal vs� atypical grief, mood symptoms vs. mood disorders, age-related cognitive decline and dementia etc.) and manage appro- priately
Discuss the effects of abuse, neglect, and psychological/emotional/physical trauma on future health
Recognize the role of advocacy in patient and physician health
transition to practice
By the end of postgraduate training, using a pa ent-centred approach and appropriate selectivity, a resident, considering the patient’s cultural and gender contexts, will be able to...
Perform the basics of fee-for-service billing for full service family practice (including office and out-office billing), and demonstrate familiarity with fee incentives and alternative payment models
Identify local, regional and national Family Medicine professional organizations that support our work as family physicians (ex: CPSBC, Doctors of BC, CFPC/BCCFP, GPSC, PSP, Divisions of Family Practice)
Explain the concept of incorporating your practice, its pros and cons, and the resources required (Accountant, Lawyer)
Demonstrate an understanding of corporate and personal taxation as it applies to professional income and your ling requirements upon graduation from Residency
Discuss what you should consider before joining a practice and common pitfall
Describe strategies for practice management and human resource management in the office
Describe a strategic approach to scheduling that improves efficiency and provides patients access to timely care
Discuss ways to promote teamwork amongst your clinic staff to support your workflow, improve efficiency, and encourage collegiality
Describe the benefits of disability insurance, professional liability insurance, and malpractice insurance
Demonstrate awareness of medicolegal process (i.e., know to call CMPA)
collaborator
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...
Communicate and implement the key components of an appropriate transfer or discharge plan using interdisci- plinary team resources (e.g. accurate documentation and con rmation of accountability)
Demonstrate respect for patient’s choice through support of a patient’s desire to include other health care pro- fessionals in the care team
Incorporate families and other caregivers in the care of patients, while abiding by the ethical standards of patient autonomy and consent
communicator
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...
Illustrate the importance of family meetings and demonstrate a systematic approach to working with families of patients managing their needs and expectation
Use both general and active listening skills to facilitate communication and allow the patient tell their story
Demonstrate awareness of different cultural views of ethics, the birthing process, illness, death and dying
Demonstrate sensitivity to patients who are a different age, gender or cultural group from oneself
Actively elicit and synthesize information from and perspectives of patients and families, colleagues and other professionals
Effectively communicate medical evidence to patients in a manner that respects their autonomy and empowers them to make informed decisions
Provide patients and families with information or sources such as the internet and written literature regarding preventative care and management of illnesses
Use verbal and written language that is understandable by the patient
Demonstrate a process of review with trusted and respected colleagues around ethics when adverse events or “near misses” occur
Demonstrate the ability to disclose medical error to a patient in a timely manner
When confronted with a dif cult patient interaction, seek out information about their life circumstances, current context and functional status to help better understand the patient’ s frame of reference
Demonstrate an understanding of administrative issues associated with transfer of a critically ill patient, and include the patient and family in decision-making, follow-up after transfer
Outline how Electronic Medical Records (EMRs) and other electronic tools can be used in practice and how their use can positively and negatively impact the doctor-patient relationship
Discuss the use and limitations of communicating by telephone, instant messaging and email both from both a clinical and security perspective
Gather information not only about the disease but also about the patient’ s beliefs, concerns and expectations about the illness, while considering the in uence of factors such as the patient’ s age, gender, ethnic, cultural and socio-economic background,and spiritual values on that illness
Express the importance of continuity, trust and relationships especially when working with marginalized commu- nities
Take the time to explore patients preconceived ideas regarding medical care and provide accurate explanations regarding care
Show concern for the effects of patients’ past experiences, coping mechanisms or lay knowledge on a patient’ s expectations of outcomes
Recognize the importance of continuity in patient care and building rapport and earning trust
Use interpersonal skills to effectively manage dif cult situations such as con ict, uncertainty, frustration, fear, and grief be it in the physician, patient, and the healthcare team
Include psychosocial support of patients, families and friends as part of the treatment plan
By the end of postgraduate training, using a pa ent-centred approach and appropriate selec vity, a resident, considering the pa ent’s cultural and gender contexts, will be able to...
Advocate with (or on behalf of when appropriate) individual patients with respect to physical, psychological and social health issues
Incorporate relevant health promotion and disease prevention strategies into the clinical encounter including lifestyle assessment, screening and education
Support public education which promotes health and prevention of illness and injury
Evaluate the health needs of a community and identify at-risk communities
Demonstrate awareness of local culture as it pertains to certain medical conditions (ex: HIV and international work)
Develop meaningful and trusting relationships to become an advocate for community issues
Outline population-based approaches to health care services and their implication for medical practice including impact on individual patients and prioritization to access (ex: mammography, HIV treatment as prevention).
Apply knowledge of the health system and community resources to advocate for change (ex: practice, hospital, community, or policy level) to best care for the people they serve
Manager
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...
Work collaboratively with public health officials, community leaders, alternative health providers, and educators in the promotion of public and preventative health
Identify and manage potential hazards of hospital/institutional care (ex: delirium, falls, immobility, pressure ulcers, incontinence, indwelling catheters, adverse drug events, malnutrition)
Accurately assess local resource limitations and appropriately communicate with specialists at a tertiary care centre and with patient’s families regarding the transfer process if necessary
Justify priority setting in the context of communities with limited resources
Advise on the management and use of scarce resources, based on international evidence
Describe the role the physician in the prioritization, management and utilizations of health care facility resources.
Describe the process of patient transfer network communication and patient transfer logistics
professional
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...
Show a commitment to personal health and seek balance between personal life and professional responsibilities
Demonstrate a mindful approach to practice by maintaining composure/equanimity, even in dif cult situations and by engaging in thoughtful dialogue about values and motives
Act in an ethical and honest manner
Collaborate and facilitate ethical decision making with patients, families and other health care workers/spiritual caregivers when ethical dilemmas arise
Recognize cultural and gender differences in values and demonstrate awareness of how past personal and professional experiences may affect decision making
Consider the role of power in interactions with the patient, the patient’s family, and community
Describe the UBC Policy on Personal Beliefs, Education, and Patient Care
Outline the Canadian Medical Association’s Code of Ethics
Explain the role of professional ethicists and ethics committees and suggest when and how to call on them for assistance
Explain the regulations around terminating physician-patient relationship
Demonstrate knowledge of child protection issues
Demonstrate knowledge about patient con dentiality, informed consent, competence and substitute decision makers, about proper interaction with law enforcement agencies and about the role of the medical examiner’s of ce
Demonstrate knowledge of relevant jurisprudence (ex: Mental Health Act, Duty to Disclose, Apology Act, Health Professions Act)
Discuss the effect of legal considerations in the application of ethics
Scholar
By the end of postgraduate training, using a pa ent-centred approach and appropriate selec vity, a resident, considering the pa ent’s cultural and gender contexts, will be able to... Lifelong learning and continuing professional development: Maintain and enhance professional ac vi es through ongoing self-directed learning based on re ec ve prac ce
Describe the principles in maintaining professional competence and implementing a personal knowledge man- agement system
Recognize and re ect learning issues in practice
Conduct a personal practice audit
Formulate a learning question
Identify sources of knowledge appropriate to the question
Access and interpret the relevant evidence
Integrate new learning into practice
Evaluate the impact of any change in practice
Document the learning process Evidence-based medicine: Cri cally evaluate medical informa on, its sources, and its relevance to their prac ce, and apply this informa on to prac ce decisions
Describe the principles of critical appraisal
Critically appraise retrieved evidence in order to address a clinical question
Integrate critical appraisal conclusions into clinical care Resident as Educator: Facilitate the educa on of pa ents, families, trainees, other health professional colleagues, and the public, as appropriate
Describe principles of learning relevant to medical education and practical strategies to apply these in medical education settings
Co-develop an educational plan with a learner, including strategies to assess identi ed learning goals
Apply learner-centered clinical teaching techniques, such as using questioning, the One Minute Preceptor, or SNAPPS Identify strategies for enhancing the quantity and quality of direct observation of learner performance
Provide effective feedback to a learner
Design and deliver an interactive group learning session
Identify patient-centered strategies to facilitate patient learning
Assess and re ect on a teaching encounter Scholarship: Contribute to the crea on, dissemina on, applica on, and transla on of new knowledge and prac ces
Describe the principles of research and scholarly inquiry
Judge the relevance, validity, and applicability of research ndings to their own practice and individual patients
Describe the principles of research ethics
Pose a scholarly question
Conduct a search for evidence
Select and apply appropriate methods to address the question
In an apparently stable patient with COPD, offer appropriate inhaled medication for treatment (ex: anticholinergics/bronchodilators if condition is reversible, steroid trial)
Refer appropriate patients with COPD to other health professionals (ex: a respiratory technician or pulmonary rehabilitation personnel) to enhance quality of life.
When treating patients with acute exacerbations of COPD, rule out comorbidities (ex: myocardial infarction, congestive heart failure, systemic infections, anemia)
In patients with end-stage COPD, especially those who are currently stable, discuss, document, and periodically re- evaluate wishes about aggressive treatment interventions.
In patients with an established diagnosis of hypertension, assess and re-evaluate periodically the overall cardiovascular risk and end-organ complications:
Take an appropriate history.
Do the appropriate physical examination.
Arrange appropriate laboratory investigations.
In appropriate patients with hypertension (ex: young patients requiring multiple medications, patients with an abdominal bruit, patients with hypokalemia in the absence of diuretics):
Suspect secondary hypertension.
Investigate appropriately.
Suggest individualized lifestyle modifications to patients with hypertension. (ex: weight loss, exercise, limit alcohol consumption, dietary changes).
In a patient diagnosed with hypertension, treat the hypertension with appropriate pharmacologic therapy (ex: consider the patient’s age, concomitant disorders, other cardiovascular risk factors).
Given a patient with the signs and symptoms of hypertensive urgency or crisis, make the diagnosis and treat promptly.
In all patients diagnosed with hypertension, assess response to treatment, medication compliance, and side effects at follow- up visits.
Include psychosocial supports (ex: housing, family support, disability issues, vocational rehabilitation) as part of the treatment plan for patients with schizophrenia.