Quw’utsun

Co-Site Directors’ Message

We acknowledge that we are privileged to work, live, and play in the unceded traditional lands of the Quw’utsun, Malahat, Halalt, Lyackson, Stz’uminus, Penelakut, and Ts’uubaa-asatx First Nations. We are learning to respect this land that we are guests on and serve our communities’ health care needs with commitment and respect.

Are you ready to be part of something new and exciting by being the inaugural class of 2024 at the Quw’utsun site?

We cannot wait for you to discover the hidden gem that is the Cowichan Valley, situated mid-way between Nanaimo and Victoria (each a 45 min drive away). It combines the perks of small-town living (lower cost of living, no traffic, surrounded by nature) with the benefits of a big city (major retailers, grocers, craft breweries). You can enjoy numerous hiking & mountain biking trails, watersports, BCHL Cowichan Capitals hockey games, our many wineries, and numerous community events.

The Quw’utsun medical community is well equipped to provide exceptional experience in full-service family medicine, including ER, urgent care, hospitalist, addictions, palliative/hospice, and obstetrics. Specialist exposure includes general surgery, pediatrics, orthopedics, gynecology, anesthesia, urology, and internal medicine subspecialties. You’ll find we are a close-knit community, happy to help out (no fear necessary in calling a consult). As one of the integrated clinical clerkship sites for third year med students, our preceptors are well versed in teaching and eager to welcome residents into the fold.

With the largest First Nation in BC, Quw’utsun Tribes, there is a rich Indigenous history here. We are committed to building and maintaining trauma-informed relationships to support and sustain local Indigenous culture and wellness. These principles will be embedded in our curriculum.

Of note, the Cowichan Valley covers a vast amount of land from Mill Bay to Ladysmith with most medical locations located just off the highway, meaning a car is essential to getting around. Having a bike is nice for local trips, but ill-advised for commutes from Cowichan District Hospital to Chemainus Health Care Centre.

We know you’ll love it here and where you’ll receive a wide breadth of medical experiences combined with the beauty of the Cowichan Valley. We look forward to welcoming you to our beautiful home.

Dr. Kirsten Yip & Dr. Tom Rimmer, Co-Site Directors

Quw’utsun Working Group Team

RESIDENT’S LIFE FAQ

Dr Erin Carruthers, UBC Indigenous Site – Quw’utsun, Resident Grad 2021:

My experience doing residency in the Cowichan Valley was beyond my expectations. The preceptors are fantastic, the medical community is so welcoming, and there is so much to see and explore in the valley. My learning was always the number one priority, and self care was valued and respected. I was treated like an equal in both the hospital and clinic, and given the flexibility to tailor my learning to my interests. CDH is still primarily run by family physicians, so you’ll get extensive hands-on inpatient care experience, but with a team of friendly specialists to call on. I would highly recommend this site for anyone looking for an immersive learning-based program in a beautiful semi rural location. 

Frances Perry, UBC 4th Yr Med Student, ICC Grad 2023:

The Cowichan Valley itself is a hidden paradise and it is only made all the more wonderful by the incredible community that call it home. I feel very lucky that I got the chance to spend an entire year under the tutelage of the medical staff there. At each step, I felt supported by my teachers and the medical community as a whole. It was a safe environment to try new things, make a mistake and learn from the experience to be a better clinician. Being one on one with staff was so great for my learning and clinical judgment that I feel I am ahead of my peers in some ways.

Kevin Gill, UBC 4th Yr Med Student, ICC Grad 2023:

The Duncan medical community is incredibly welcoming to learners. Physicians and staff go out of their way to say hi to you in the hospital, or even provide teaching from important cases.

The primary care experience in Duncan is incredible, with opportunities to follow patients throughout their entire journey of care. You may see your family practice patients in clinic for routine care, while working in Emergency, while rounding in the hospital, or even in specialty clinics.

Alex Benny, UBC 4th Yr Med Student, ICC Grad 2023:

In Duncan you very quickly feel like a valuable member of the community. All of the staff at the site are really focused on making sure you are consistently improving your medical knowledge, all while facilitating a safe learning environment. If you are looking to have medical independence while having a supportive group of staff to back you up, then Duncan is the place to be. Duncan itself is a nice town, with a good mixture of local cafes, stores, and a decent variety of cuisines. There are also many beautiful sights to see around the area. Some of the most beautiful sunsets I have seen were in Duncan, either at nearby Stoney Hill, Cowichan Bay, and even outside of my front door. As a previous learner in Duncan, I strongly recommend the site to anyone with a passion for non-urban medicine


Number of Residents: 4 CMG
Location: Duncan, BC
Community: 22,200
Hospital: Cowichan District Hospital
Distance from Vancouver: 141 KM

Curriculum Type: Hybrid model including longitudinal and block curricula

R1 Elective Time: 6 weeks
R2 Elective Time: 
12 weeks
Contact: Site Co-Directors – Dr. Tom Rimmer & Dr. Kirsten Yip / Site Coordinator Selena Martin – selenam@uvic.ca

Program Curriculum

Located on the traditional unceded territory of Quw’utsun Hwulmuhw (Cowichan Tribes), this new family medicine residency site,  aims to set a new precedent for providing a comprehensive family medicine curriculum rooted in the principles of equity, diversity, and inclusion with particular focus on our local Indigenous population. Acknowledging our history of harm, we recognize anti-racism is an active ongoing process to which we remain committed. All preceptors in addition to our residents will be provided with cultural safety training through various resources including our local Indigenous Elders.

The Cowichan Valley medical community is close-knit and collegial with multiple group family practice clinics. Physicians from all specialties casually catch up during rounds in the hospital where “hallway consults” occur and clinical information is exchanged in a friendly and collaborative manner.  With healthy engagement in the Cowichan Valley Division of Family Practice (CVDFP) and the Cowichan District Medical Society (CDMS) most practitioners are on a first-name basis.

As a long-standing successful location of one the UBC Integrated Community Clerkship programs for 3rd year medical students, and as a UBC Indigenous Residency site, the Cowichan Valley medical community is well poised to take on its own family medicine residency program.

Purpose/Objectives

The vision of the Quw’utsun Valley Family Practice residency site is to provide residents a supportive and expansive learning experience that produces curious, community-engaged, and compassionate family physicians.

The mission of the Quw’utsun Valley Family Practice residency site will be built on the strong tradition of collegiality and cohesiveness for which the Cowichan medical community is well known. The site will offer a learner-focused comprehensive interdisciplinary and collaborative educational experience incorporating multiple medical specialties, allied health professionals, and community members in a supportive and respectful learning environment. This site will partner with local Indigenous communities and Elders to build a trauma-informed and culturally sensitive curriculum that honours the expanded tenants of equity, diversity, and inclusivity. Graduates will be highly skilled, confident, community minded physicians who have a deep sense of compassion for patients and themselves.

PGY1 & PGY2 Overview

A hybrid model which includes longitudinal and block curricula will ensure consistent exposure to the many facets of family medicine. In addition to dedicated weeks, residents will also spend a half-day per week at their family practice offices to maintain continuity.

Residents will have four weeks of vacation per year.

R1 year

Rotation Duration Location/notes
Intro to FM 4 weeks Settle in at FP preceptor’s office, academic sessions, procedural bootcamp
Family Practice 10 weeks With FP preceptor, hospitalist, urgent care, maternity clinic
Indigenous Longitudinal Dedicated academic and experiential time engaging with local Indigenous communities
IM 4 weeks At Cowichan District Hospital (CDH) ward consults, cardiology lab, and ICU
Emergency 4 weeks CDH
Ob 4 weeks Low-risk deliveries
Peds 4 weeks 2 weeks at Victoria General Hospital (VGH) and 2 weeks in outpatient clinics
Psych 2 weeks At CDH and outpatient clinic
Gen Surg 2 weeks CDH
Addictions 2 weeks 1 week at VGH, and 1 week at Duncan OPS
Anesthesia 1 week CDH
Ortho 2 weeks CDH
Electives 6 weeks

R2 year

Rotation Duration Location/notes
Family Practice 16 weeks With FP preceptor, hospitalist, palliative, includes transition to independent practice
Rural 8 weeks As part of rural selective match
Indigenous Longitudinal Dedicated academic and experiential time engaging with local Indigenous communities
IM 2 weeks CDH
Gyne 2 weeks Outpatient Gyne clinics
Psych 2 weeks Nanaimo Regional General Hospital (NRGH) ER Psychiatric Emergency Service
Surg selective 2 weeks CDH
Addictions 2 weeks At VGH, and Duncan OPS
Anesthesia 1 week CDH
Electives 10 weeks

Academic Weeks

Academic weeks are an interactive time to strengthen experience and knowledge in components of family medicine. These may include didactic sessions, simulation, procedural skills workshops, and wellness sessions.

Scholar

In the first year, residents complete a quality improvement project and academic curriculum in patient safety and evidence-based healthcare. Throughout the two years, residents complete a scholar project and present their work at a local Scholarship event.

Electives

With 16 weeks of elective time available, a resident can dedicate more time to various interests according to their educational preferences.

Training Sites

Duncan/Cowichan Tribes:  Duncan is the heart of the Cowichan Valley, located midway between Victoria and Nanaimo on Vancouver Island. It has a population of 5,000 and a larger catchment area population of 38,000.  Quw’utsun Tribes is the largest First Nation in BC. Quw’utsun Tribes are part of a larger group of First Nations, the Coast Salish people.

Cowichan District Hospital (CDH) is an acute care facility with 148 beds. It serves a population of 84,000 people. In February 2018, there was approval for a new hospital which began construction in 2023 and is projected to be completed by 2027. The new facility will have 204 beds. For UBC learners, there will be a state-of-the-art simulation centre, innovation lab, learner lounge, private call rooms, study space, meeting rooms, and kitchen.

Cowichan Hospice House is a beautiful facility in Duncan that opened in 2022 equipped with volunteers, palliative care nurses, palliative physicians, and community family physicians who follow their patients through their sacred end of life journey.

Chemainus/Stz’uminus/Snuneymuxw:  Chemainus is located on the east coast of Vancouver Island with a population of ~4000. Stz’uminus First Nation’s traditional territory on east Vancouver Island includes four reserves of more than 1,200 hectares, much of it bordering the Strait of Georgia and Ladysmith Harbour. Stz’uminus First Nation has 1,300 members.

The Snuneymuxw are a vibrant First Nation of the Coast Salish People, residing in the centre of Coast Salish territory on the eastern coast of Vancouver Island, with villages on the Fraser River and waterways in the Gulf Islands. Snuneymuxw territory encompasses one of the most productive and resource rich areas at the heart of the Salish Sea.

The Chemainus Health Care Centre is an Urgent Care Unit open 8am-8pm with 5 beds staffed with nurses and one family or ER physician. Since the COVID-19 pandemic, the unit has seen patients from the entire Cowichan Valley and even from Nanaimo. The level of acuity and volume of patients has expanded accordingly.

Cowichan District Hospital opening in 2027