Number of Residents: 12 CMG, 7 IMG
Location:  Surrey and Langley
Community: 509,000
Hospitals: Surrey Memorial Hospital, Langley Memorial Hospital, Peach Arch Hospital, Delta Hospital
Distance from Vancouver: 35 km- 50 km

Curriculum Type: Longitudinal and Block Rotations
R2 Elective Time:  12 weeks
Contact: Site Director – Dr. Sandra Derkach / Site Coordinator – Kathleen McIntosh
Lead Residents: Dr. Justin Fernandes and Dr. David Luu

Overview

Surrey is 45 minutes by car or Sky-Train (transit) to Vancouver, and is the second largest city in British Columbia. It has a diverse ethnic and socio-economic population, and urban, suburban, and rural regions to the municipality. Residents would be able to travel to the hospital with ease from any region within Surrey. Given the ease of access via transit, many of our physicians and employees also commute from Vancouver, White Rock, New Westminster, Langley, and other locations across the lower mainland.

The Mission of the Surrey site of the UBC Department of Family Practice Residency Program is to provide a comprehensive education in full-spectrum, community-focused, urban Family Practice. We endeavor to expose the trainee to the full breadth of clinical problems commonly encountered by the Family Practitioner, and to develop a deep sense of collegiality and community-awareness throughout the program.

Program Highlights

• Surrey has the largest hospital in Fraser Health Region.
• Surrey Memorial Hospital provides regional and tertiary services in many areas, including Pediatrics, Ophthalmology, Obstetrics, Cancer Care, Surgical Care, Renal Care, Palliative Care, and Sleep Medicine.
• SMH delivers the second most babies of any hospital in British Columbia, with more than 4,200 births a year, and has the busiest E.R. in B.C. with 115,000 visits a year.
• Expansion of the hospital is in place and it will include a new Emergency Centre, a 48-bed neonatal intensive care unit, enhanced UBC Academic space, and the new Helipad.
• A new comprehensive Outpatient Care and Surgical Centre opened in 2011. This facility houses enhanced diagnostic, pharmacy, laboratory, and specialty services which has been developed around a core of Primary Care and Chronic Disease Clinics to serve the Surrey Community.
• Engagement of the Langley Memorial Hospital and community physicians in providing a broader range of family practice teaching and experience.

Sample Rotation for First Year

• 20 Dedicated Family Practice Clinics/Preceptors
• Bi-weekly full-day academic sessions
• Bi-weekly full day weekly in family practice depending on the rotation
• Longitudinal and Block Rotations

Interview with Previous R2

What made you choose the Surrey-South Fraser Site for your residency training?

I chose Surrey because the program had developed a good reputation amongst residents and medical students. The program was known to provide a high volume of acute care medicine in conjunction with great opportunities in the community. The hospital in Surrey also had a brand new acute care tower with a new resident lounge, simulation center, library and call rooms at the time I applied and these facilities were fantastic to have during residency and much nicer than any other hospital I have worked in.

Surrey is als one of the few programs to truly integrate IMG and CMG learners. We all do the same academic half days and all do the same rotations, which isn’t the case at all residency sites in BC as far as I understand.

Finally the patient population attracted me. There is a great deal of diversity in both patients and staff in the hospital making work more interesting. There is also a great deal of marginalized patients that come through Surrey and there were lots of opportunities to work with underserved populations.

Is the Surrey-South Fraser program strongly service-based? How is the program structured?

The doctors at Surrey Memorial Hospital definitely encourage our learning and education over service provision. One of the great advantages of Surrey is that there are no teams, so whatever rotation you are on it is 1:1 with the preceptor, which allows for a greater focus on teaching and less emphasis on service.

Surrey is a block based residency, but there is some flexibility to work in longitudinal learning within some of the Family Medicine blocks if desired.

We do whole day academic days every second Thursday and then whole day family medicine clinic every other Thursday. This really helps to cut down on commuting time and allows residents to eat lunch together twice a month and socialize.

How is the Surrey-South Fraser training program different from other Lower Mainland residency programs?

Surrey has a great balance of acute care and community care. It gives residents the skills to practice in area of family medicine once they finish. There is enough volume in areas such as obstetrics and hospitalist medicine that most residents feel comfortable entering these fields without further training after their 2 years are completed.

Surrey Memorial is also a tertiary hospital with a lot of pathology and acuity and because there are not many other learners on site the family residents get to be very hands on and involved in the care of these complex patients. This certainly builds skills and makes it much easier to see less complex patients when on community rotations.

The programs leadership has also been very receptive to altering the program in response to what residents see as educational gaps and preceptors are very receptive to this within each rotation and they want you to see things you haven’t seen before.

What are some of the unique learning opportunities in this program?

Surrey has an emphasis on global health and as such there is a 4-week global health elective in R2, which can be customized to whatever aspect of global health the resident wants to pursue (prison medicine, addictions, refugee, HIV/HCV clinics, detox, international experiences).

Surrey also has a strong focus on palliative care (1 month rotation in R1), Geriatrics (1 months rotation in R2) and chronic pain (2 week rotation in R2).

Surrey is a little unique in that the hospitalist service is MRP on most patients with specialists being primarily a consult service. These leads to very interesting medical cases on your hospitalist and CTU rotations. You might be rounding on surgical patients, nephro patients, neuro patients or oncology patients. These are experiences that I don’t think many other family medicine inpatient rotations provide at any other hospital.

Does it get fairly competitive with the other residents?

There isn’t any competition amongst the learners at all — the ratio of preceptors to learners is usually 1:1 (this includes surgical rotations and specialist rotations). Because residents are spread across the different rotations you hardly overlap with any other residents on rotation. There is the occasional sub-specialist resident around on different rotations, but I haven’t heard of them ever affecting a residents learning.

The downside of this is that there are very few teaching opportunities. There are medical students around on pediatrics and CTU, but because of the ratio of learners to preceptors the teaching burden is primarily on the staff and there is again no competition for interesting cases on these rotations.

What kind of facilities are available in the Surrey-South Fraser centres?

Surrey Memorial is the largest hospital in the Fraser Health Region so it’s quite well equipped. As I mentioned before it has a brand new acute care tower which is only a few years old now. This includes lots of resident/academic space, a brand new ER, ICU, HAU, NICU, Neuro and Nephro wards.

Surrey Memorial has the busiest emergency room in the province (one of the busiest in the country) and is the second largest provider of hospital births in BC. So it’s a great place to learn if either of these disciplines is of interest to you.

In general, all of the preceptors are open to teaching and seem to be really happy to have residents in the hospital. It’s a very welcoming and supportive environment.

How is the commute to the hospital? (Surrey Memorial is located about 30 km from downtown Vancouver). Was it difficult for you or the other residents to find accommodations?

I live very close to downtown Vancouver and the commute isn’t too bad. I’m always going against the flow of rush hour traffic which is nice. Depending on the time of day my commute can be as short as 30 mins and as long as 1 hour (usually coming home). Sometimes I take the skytrain to King George Station and walk to the hospital from there and it takes me about 45-50 mins total. Most residents actually live a lot closer to the hospital than I do and would obviously have much shorter commutes.

In terms of accommodations residents from my year were spread out across the lower mainland with people living anywhere from Kitsilano, to White Rock, to Squamish, to Abbotsford and Langley. It’s no secret that housing prices are insane in Vancouver, but they get cheaper once you start to move further east. The ease of finding a rental property will vary a lot depending on where you want to live. The closer to Vancouver you want to be the harder it is, however, if you want to live close to the hospital or a little further up the fraser valley it can be a lot easier and cheaper. I would plan to come at least a week or two in advance to find a place to live if you are moving here.

With regards to affordability the resident salary is more than enough to cover living expenses regardless of where you want to live. Obviously you have to factor in that the cost of living is higher near Vancouver than most other cities and if you choose any program near Vancouver and you may have to wait to pay off loans and LOCs until you’re a staff (which is only a short 2 years away).