Site Directors Message
The UBC Postgraduate Family Medicine Residency Program’s – Nanaimo Site, started in 2007. Nanaimo Site has 16 positions, 8 in the R1 year and 8 in the R2 year. The R1 and R2 residents who have matched to Nanaimo have had a great learning experience centered at our Nanaimo Regional General Hospital (NRGH) and the surrounding community. NRGH has 320 acute care beds and a medical staff of more than 200 physicians. All patients admitted to this hospital are admitted under a primary care physician. There are more than 100 faculty members involved in the academic and experiential teaching at this site.
Nanaimo’s central Vancouver Island location makes it an ideal community for Family Medicine learning. Close proximity to Victoria, Vancouver make connections quick, economical and convenient. The Nanaimo medical community provides a warm welcome to Family Practice residents. Nanaimo is a convenient hub for travel to and from many island adventure activities.
Family Practice residents at the Nanaimo Site are matched to a community family practice clinic. They will follow patients within that family practice clinic during their 2 year Family Practice Residency.
Nanaimo is an ideal Family Practice Residency Program Site for those not wanting to be in a big city every weekend. The cost of accommodation rental and ownership in Nanaimo compares favorably to other British Columbia locations. Short and easy commutes to the hospital, clinics and home allows Nanaimo residents to have a healthy lifestyle. Ample social, recreational and cultural activities are available in all four seasons of the year. Our mild climate and adventure culture provides great opportunity for a balanced lifestyle.
Nanaimo is the site of few, but valued Royal College specialty training residents. The specialty residents do not share or conflict for patient care experiences with the family practice residents.
Nanaimo has a strong palliative care program delivered by skilled family physicians. Nanaimo has an ICU that is friendly to family practice learners. Nanaimo has a high volume emergency room that provides excellent teaching and experience for learners. Surgery, Internal Medicine, Low Risk Obstetrics, Child and Youth Health and Mental Health and Addictions are all strong rotations at this site. There is lots of opportunity in subspecialty electives in ENT/plastics, cardiology, dermatology, and others (other common choices?). There is an abundance of role models and mentors to meet residents’ program support needs. We continue to develop an effective musculoskeletal educational experience and improved access to marginalized at-risk populations. Residents at this site have outreach opportunity in this region and in other culturally unique experiences in Canada and in the global health network. We are in the process of building and opening up new hospital based state of the art/modern library adjacent to resident site office.
Our academic activities are done in 1-week academic blocks throughout the year to allow a strong focus on the academic curriculum in family medicine. Examination preparation is facilitated effectively. The site has excellent academic space including high definition video conferencing facilities, resident sleeping rooms, a resident lounge and a human performance laboratory (Simulation Lab). The impressive academic space in a central and strategic location within NRGH is a strong statement about the importance of Family Medicine education in Nanaimo.
The Nanaimo Site will ensure that you will become a competent, confident, healthy and resilient family physician ready to practice in any Canadian community.
Dr. Tony Zuccaro, MD, CCFP & Dr. Marcia Fukunaga MD, CCFP
Lead Resident Message
Welcome to Nanaimo! This residency site began in July 2007 and has 8 residency positions per year. Our residents are a close-knit, independent, and active group who take full advantage of the flexibility this site provides. We have a close relationship with our site administration; they are very receptive to our suggestions, so change comes quickly!
Unique Aspects of the Curriculum
Longitudinal Family Practice Time
There is greater emphasis on longitudinal time in the family practice clinic than in other Canadian family medicine residency programs. Throughout specialty rotations, we spend one full day a week back at the family practice clinic in which we have a two-year placement.
As part of the philosophy of the program, rotations are very flexible. Each resident has both the responsibility and the freedom to tailor rotations around their specific needs. The R2 year specifically is meant to be shaped to your needs and wishes!
Academic time is concentrated in one-week blocks. During this time, we are all excused from our rotations and are never on call. We gather as a group with our education as the sole focus. The R2s are responsible for planning one day a week of academic time for themselves, which allows them to focus on CCFP exam preparation. Academic weeks are also a great time to reconnect and recharge with other residents!
- The program has a strong emphasis on education over service – you can mostly determine your own call schedule and have a lot of input into all educational activities!
- Community Family Practice Clinics – All have keen preceptors who pursue a variety of interests including obstetrics, addictions, geriatrics, palliative care, Indigenous health, women’s health, cognitive behavioral therapy and MSK/sports medicine.
- Inpatient Rotations – We are based out of Nanaimo Regional General Hospital (NRGH) –where specialty residents are rare, so we get to see and do almost everything! NRGH is large enough to have most specialties, but patient care is still largely directed by family doctors and hospitalists – which allows for an educational focus on full-service family medicine. We are getting the occasional medical student to work with as well, so teaching learners is something that is growing here!
- Inpatient Family Medicine – Your inpatient evening call with GPs and hospitalists throughout the two years means you will feel confident with inpatient medicine.
- Specialty Services – All specialists, in both surgery and medicine, are incredibly enthusiastic about education and tailor their teaching to what Family Practitioners need to know most.
- Palliative Care – We are one of the few programs in BC with a mandatory rotation in first year. We receive the opportunity to work with an interdisciplinary team of nurses, social workers, spiritual health and outpatient liaison workers, as well as physicians from palliative care, family medicine and oncology. All of our residents have enjoyed this rotation and found that it is immensely beneficial to our careers in family medicine – where difficult conversations with patients and families, and discussions around goals of care occur on a daily basis.
- ICU – Similarly, we are one of the few UBC sites which get ICU exposure as an R1. Unlike ICU rotations on the mainland however, we typically are not saturated with other residents so we get first dibs for many different procedures that come our way! The exposure to sick patients and multidisciplinary teamwork is great to have prior to rural rotations and/or independent practice.
- Addictions Medicine – In response to resident feedback, the first-year psychiatry curriculum was amended to integrate 2 weeks of addictions medicine, both inpatient and outpatient. This change was implemented immediately and would not have been possible without an extremely receptive program administration.
- Musculoskeletal Rotation – We receive the opportunity on this rotation to work closely with orthopedic surgeons, physiatrists and rheumatologists, and will soon be able to also work with our local pain service run by anaesthesiologists Another evidence of how our site is always evolving and growing!
- Emergency Medicine – NRGH has a beautiful emergency department opened in 2012 – with an estimated 60,000 visits yearly, it is the busiest emergency department on Vancouver Island. The ER physicians are highly motivated and enthusiastic about teaching residents. The city is also a hub for PoCUS training and research, providing many opportunities to practice these skills in a clinical setting with support.
- Simulation Sessions – We have a state-of-the-art simulation lab, where we practice scenarios with nurses in a low stress, supportive environment relevant to family practice, acute medicine, pediatrics and obstetrics on nearly a weekly basis. We had over 35 simulations last year and know that there is huge potential for simulating a wide range of presentations in this lab! Residents are also welcome to participate in in-situ SIM’s in the ED.
Wellness takes on a whole new significance in Nanaimo. The physicians who run the program have our well-being at the top of their priority list. We are encouraged to be healthy, support one another, become involved in the community and to pursue interests outside of medicine.
We do our best to facilitate intercohort connection and facilitate community building amongst all 16 residents in Nanaimo, plus a few in the Vancouver Island Indigenous program. This is done through dedicated time for social activities, weekend trips as well as check-ins during our academic weeks to discuss any issues, cases, concerns, milestones and achievements!
Nanaimo and Surrounding Communities
Nanaimo is a beautiful and diverse community of 90,000 residents. The downtown and waterfront area has undergone significant improvements over the last 10 years and is now ripe with restaurants, cafes, and independent shops. Contrary to popular belief, Nanaimo’s inhabitants are of a wide variety of ages and come from many different socioeconomic backgrounds. Temperatures are moderate throughout the year. Yes, it rains, but mostly in the winter months! Nanaimo is also a very affordable place to live.
In Nanaimo and the surrounding areas, there is an abundance of outdoor activities: hiking, sailing, windsurfing, kayaking, mountain biking, rock-climbing, and scuba diving are plentiful and at our doorsteps. Skiing and surfing are only a short drive away. Fun fact: We are the closest UBC residency site by car travel time to Tofino!
Who Are We Looking For?
We welcome everyone who loves to learn and loves to live! To get the most out of this program, you must be self-motivated and confident in your ability to identify your academic and psychosocial strengths and weaknesses, so that you can shape the program to suit your educational needs.
Academics aside, we are a supportive, fun-loving and adventurous group and would love to have other residents who enjoy building community, whether it be through discussing difficult moments in life, celebrating birthdays or exploring the great outdoors together. We look forward to meeting you, your partners, fur babies, and families next year! Please feel free to contact us with questions at any time.
Dr. Nora Penty & Dr. Katherine Coupland
Number of Residents: 8 CMG, 1 IMG
Location: Nanaimo, BC
Community: 85,000 – 90,000
Hospital: Nanaimo General Hospital
Distance From Vancouver: 86 km, includes Ferry Travel
Curriculum Type: Partial Integrated
R2 Elective Time: 2-9 Weeks
Contacts: Co-Director – Tony Zuccaro/ Co-Director – Marcia Fukunaga/ Coordinator – Lisa Ripka
Lead Residents: Dr. Isabelle Chaput & Dr. Caitlin Blewett
The Nanaimo Site offers a good balance of responsibility and education. A wide spectrum of family physician and specialist colleagues offer preceptor based experiential learning in an environment of mutual support and respect. Each resident is assigned a family practice clinic with multiple family physician preceptors. Residents achieve their own patient population and follow patients throughout their year program. The academic curriculum is accomplished during full weeks of academic activity throughout the year. Residents are not in rotations and are not on call for another discipline during academic weeks. There are generous elective opportunities in the R2 year and learner-centered flexibility to the schedule of rotations.
- Residents start with 4 weeks in their community Family Medicine clinic
- Academic weeks during the year with complete academic content focus (no call, no rotations and no Academic Half Days)
- Residents focus on education
- Learner-centered flexibility
- Ensure residents will have the skills, knowledge, and attitude to practice in an urban, regional, rural or isolated practice
- Family Medicine taught by family physicians whose philosophy and practice are consistent with the aims and aspirations of family medicine
- Community network of health care providers and will become skilled at collaborating as team members and team leaders
- Nanaimo Regional General Hospital provides service at the primary care and secondary referral level. It serves an immediate population of 94,000 and a referral population of 160,000. Current acute care bed allocation is 320 and annually there are 76,487 acute patient days, 12,828 admissions, and 11,116 in-and-outpatient surgical operations, 48,000 visits to emergency and 1,179 deliveries. There are more than 200 physicians on active staff.
AW = Academic Week
MH = Mental Health
C&Y = Child and Youth
R = Rural
What do you enjoy most about the Nanaimo Site?
The overall well-roundedness. Its medical community is small enough that it doesn’t take long to get integrated into but large enough that we have most specialists so that care is comprehensive. For the hospital, that means family doctors still play a significant role but there is also a large patient-volume with high acuity. It’s not a big city so we have lots of access to nature and the cost of living is reasonable; we still have a beautiful downtown with Victoria and Vancouver just a short commute away. The program itself is new enough that we are able to stay flexible, yet old enough that we have the kinks worked out.
What learning opportunities are available at the Nanaimo Site?
The program here is longitudinal and the emphasis is on exposing residents to many different types of cases. The residents provide input into a call-protected academic week every two months so there is a lot of opportunity for us to shape the curriculum. We decide together what we want to learn about. Nanaimo also offers residents the option to travel to and train in other facilities to broaden their experiences. You can easily travel to Duncan, Courtney/Comox, Port Alberni and Vancouver (or beyond) for your electives.
Is there a large service component to your residency?
Our program was designed to fit into a hospital and a community that was well-functioning before residents. Care is taken to arrange our schedules so that there are times when every service is without a resident so that they do not become dependent on us. As a result, our focus when we are there is on participating in whatever is of highest educational value. This also means we are given significant flexibility in our schedules, which is a huge step toward achieving a good work-life balance.
Does it get fairly competitive with the other residents?
Our group is very supportive of one another and we’re very collegial, both amongst current residents and recent graduates. Support and help is easy to find. Most rotations have only one learner at a time; learning opportunities are abundant, yet the hospital is small enough that you see colleagues almost daily. Family practice residents make up the majority of learners at NRGH, and occasionally there are some Royal College residents or medical students who are studying sub-specialties at the hospital – and our experiences working with visiting learners has been great.
Is the community very welcoming of residents?
Both the medical and larger communities in Nanaimo are exceptionally welcoming. As hinted at previously, the medical community is not overburdened with residents which means preceptors are keen to teach and allied health are excited to have us here. Specialty residents are not common so when working with specialists we are generally viewed as residents rather than “off-service” residents. The medical community is small enough that you get to know almost all other physicians in town and are frequently invited to social gatherings. As for the community at large, Nanaimo is excited to have residents. There are lots of events, sports and social groups to get involved with.
What are the facilities like at Nanaimo Regional General Hospital?
The hospital is the primary referral centre for the North Island. It covers the same volume as Victoria and has the third busiest ER in BC. NRGH has many new and/or renovated units that are a joy to work in, including ER, renal, palliative and maternity. The residents’ area is really nice, quiet, and easy to access and includes a lounge, private call rooms, showers, lockers, and kitchen.
What traits should incoming residents have to appreciate the Nanaimo program?
Self-directed learners do best given the amount of freedom and flexibility we are given. If you’re interested in full-scope family practice or are interested in several focus areas this will be a good fit for you. Loving the outdoors means you will love Nanaimo.
What kind of lifestyle do you have in Nanaimo?
Even though it’s small, Nanaimo is definitely a city. There’s a thriving arts community and there are some great restaurants. A lot of outdoor activities are easy to get to – hiking, biking, kayaking, and diving. Nanaimo has extensive parks and recreation facilities as well as an interconnected path system within the city. Surfing and skiing are a short drive away. The city is large enough to have all the amenities but still small enough to have a community feel to it. If you want to visit Vancouver, there are two ferries to the Lower Mainland that run regularly, or a quick twenty-minute float plane ride. Victoria is only 100km drive from Nanaimo so everything truly is really close.
What do you think is the biggest strength of the Nanaimo program?
Some of our biggest strengths/unique features are:
- Choose your own call schedule plus significant flexibility in your schedule otherwise
- Opportunity to do international electives (such as palliative care in Nepal)
- Simulation sessions with nurses on a range of presentations relevant to family practice, acute medicine, pediatrics and obstetrics on nearly a weekly basis
- Lots of work with the hospitalists throughout the 2 years
- Opportunity to follow your patients from community clinics when they are admitted to hospital