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Building on Past Success for the Future Faculty of Medicine Family Medicine

2011–2012

Positioning Ourselves


Mission Statement To provide a diverse educational environment that develops excellent family physicians We will be recognized as leaders and innovators in education and research in the discipline of family medicine Vision: Three-Year Picture of Excellence 2009–2012 We envision being leaders of comprehensive clinical care, medical education, family medicine research, and scholarly activity. The department will provide a supportive environment that fosters collaboration and encourages all members to develop their areas of interest and expertise.

Positive Core The strengths, values, competencies, and successes on which we have built the Department of Family Medicine’s heart, soul, and excellence: We are knowledgeable, experienced teachers who maintain a diverse scope of practice. We endorse respectful and compassionate communication with all professionals, colleagues, and patients. Through dynamic and enthusiastic learning environments, we contribute to the well-being of patients, learners, and our community.

Four Principles of Family Medicine Family physicians in Canada are guided by four principles, developed by The College of Family Physicians of Canada. 1. The family physician is a skilled clinician. 2. Family medicine is a community-based discipline. 3. The family physician is a resource to a defined practice population. 4. The patient-physician relationship is central to the role of the family physician.

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Cover: Dr. Teresa Cavett, Dr. Jamie Boyd, Dr. Susan Hauch, Dr. Michael Harlos

university of manitoba faculty of medicine


Building on

mission statement

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Past Success

2011–2012 organization chart

Positioning

accomplishments

Ourselves for the Future

Faculty of Medicine Family Medicine

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message from department head

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Project Highlights introduction

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undergraduate program postgraduate program research unit

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enhanced skills

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shantou university medical college academic exchange

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family medicine annual report | 2011–2012

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2011–2012 Department of Family Medicine

Organizational Chart Department Head

Dr. Jamie Boyd Administrative Director

Associate Head

Brenda Catchpole

Dr. David Ross Associate Head, Distributed Medical Education

Dr. Don Klassen

Educational Supervisor

Beth Lloyd Administrative Assistant

Carolyn Major

A. Golondrina S. Snusher S. Rankin S. Froese D. Anderson

J. Thiessen C. Philippe D. Prysizney C. Higham

Manager, Policy & Program Development

Kelly Lukaszewski Business Manager

Colleen Gallagher Financial Assistant

Program Evaluation Officer

Brittney Bowman

Lola Apoeso Communications Officer

Faculty of Medicine

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Family Medicine

university university of manitoba of manitoba faculty faculty of medicine of medicine

Jill Sexsmith


Research Director: Dr. Alan Katz Postdoctoral Fellow: Masoud Khawaja Research Associate: Gayle Halas Data Manager: Bill Peeler Office Assistant: Collette Philippe

Undergraduate Director: Dr. Susan Hauch (Pre-Clerkship) Associate Directors: Dr. Clayton Dyck and Dr. Mark Boroditsky (Clerkship) Education Asst., Preclerkship: Debi Prysizney Education Assistant, Clerkship: Cathy Higham

Distributed Medical Education

Enhanced Skills Programs Associate Director: Dr. Brent Kvern

GP-FP ANESTHESIA Assistant Director: Dr. Anthony Wiens CCFP EMERGENCY Medicine Assistant Director: Dr. Al Buchel Program Assistant: Monica Wilgosh Care of the Elderly Assistant Director: Dr. Mary Jane Jamieson Sports Medicine Assistant Director: Dr. Swee Teo Education Assistant: Dana Petelski FP Oncology Assistant Director: Dr. Jeff Sisler Palliative Medicine Assistant Director: Dr. Christian La Riviere

Associate Head: Dr. Don Klassen

Postgraduate Director: Dr. Tamara Buchel Education Assistant: Sylvia Froese Program Assistant: Shannon Rankin

Faculty Development Director: Dr. Teresa Cavett Assistant: Brittany Bowman

Section of Palliative Medicine Section Head: Dr. Mike Harlos Undergrad Coordinator: Marcelo Garcia Rotation Coordinator: Fiona Crow

Residency Streams URBAN Stream Family Medical Centre

RURAL Stream - Parkland Family Medicine Residency Unit

Unit Director: Dr. Gerald Konrad Asst. Director, Education: Dr. Mary Jane Jamieson Education Assistant: Susan Snusher

Unit Director: Dr. David O’Hagan Asst. Director, Education: Dr. Scott Kish Education Assistant: Michelle Jubenvill Residency Clerk: Bernice Boyechko

Kildonan Medical Centre Unit Director: Dr. Tunji Fatoye Asst. Director, Education: Dr. Mark Kristjanson Education Assistant: Audrey Golondrina

BILINGUAL Stream - Centre de santé Assoc. Director: Dr. Frances Berard Education Assistant: Suzanne Dupuis

NORTHERN/REMOTE Stream Northern Connection Medical Centre Unit Director: Dr. Joanna Lynch Asst. Director, Education: Dr. Teresa Cavett Education Assistant: Donna Anderson Education Assistant: Jacquie Thiessen Office Assistant: Collette Philippe

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family family medicine medicine annualannual reportreport | 2011–2012 | 2011-2012


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university of manitoba faculty of medicine


dear colleagues, Welcome to the Department of Family Medicine 2011–2012 Annual Report— a summary of our activities from July 1, 2011 to June 30, 2012. Throughout the year our faculty—the heart and soul of our department—accomplished many great things. Please take time to review their achievements, which include numerous teaching awards, award nominations, publications, and scholarships. Our faculty is a dedicated and talented group who make a valuable contribution toward the success of our students and residents. This year, forty-five capable family physicians graduated from our two-year residency program and ten graduated from our Enhanced Skills program. I am confident they received the very best education in our department and am proud that over 30 will remain in Manitoba, where their care is needed more than ever. Our program continues to have an impact at home and abroad. In March 2012, five members of our department and from the Shantou University Medical College participated in the Canada-China Family Medicine Forum at the Canadian Embassy in Beijing. Representatives of Chinese universities and government departments and nine Canadian Family Medicine programs attended. At the forum, delegates discussed ways to collaborate in family medicine training and care delivery in both countries. Collaboration with China has long been a priority for our department with 2011 marking the tenth anniversary of the exchange program between Family Medicine and the Shantou University Medical College. In September, we hosted a one-day symposium to celebrate this important work. Closer to home, we are working on many projects that build on our past success and will position us for the future. Dr. Sarah Kredentser is making strides toward building a Family Medicine Obstetrics Network—a collaborative of family physicians committed to the principles of family medicine and comprehensive maternity care. All network doctors will take University of Manitoba Family Medicine learners, which will build the capacity of family doctors to provide obstetrics care in their own practices. Another exciting development includes the expansion of our research program. Under the guidance of Dr. Alan Katz, a research planning retreat was held in February. Using input from this event, a strategic plan has been developed and will be used to provide future direction.

A major milestone this year was the one-year anniversary of the Northern Connection Medical Centre (NCMC). Located in the core of Winnipeg, this clinic opened its doors in December 2010, and accepted its first residents in July 2011. In the capable hands of Dr. Joanna Lynch, NCMC, which supports the Northern/Remote stream of our program, has grown quickly and is key to the long-term success and sustainability of this stream. On behalf of the department, I extend heartfelt congratulations to Dr. Lynch and her team who have embraced each challenge that has come their way and have demonstrated exemplary teamwork. With over 100 learning sites throughout Manitoba and beyond, we continue to work on ensuring our learners receive the same quality of education, regardless of where they study. Through the work of Dr. Don Klassen, our newly appointed Associate Head of Distributed Education, we are doing just that. Over the past year, Dr. Klassen has put a lot of energy into building relationships with our community preceptors, establishing valuable connections, and giving preceptors a voice at department meetings. As part of this work, three Family Medicine Enhanced Distributed Education Centres were created: Steinbach (Dr. Karen Toews), Brandon (Dr. Joanne Maier), and Winkler/Morden (Dr. Bob Menzies). I would like to thank Dr. Klassen and the lead doctors at these centres for their hard work. Family medicine, like many aspects of health care, is changing in ways that are not always straightforward or easy to navigate. I appreciate the dedication and flexibility of everyone who works for the department and contributes to our success. Please read on as we share more information about our projects, program, and faculty.

Sincerely,

Dr. Jamie Boyd Professor and Head, Department of Family Medicine, Faculty of Medicine, University of Manitoba

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family medicine annual report | 2011–2012


Dr. susan hauch

Dr. Alan Katz

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Dr. Rakesh Gera

Dr. Hang Trinh

Not pictured here: Dr. Michael Penrose, Dr. Jana Pilkey, Dr. Kanwal Brar, Dr. Margaret Hesom, Dr. Larry Reynolds, Dr. Brent Kvern

university of manitoba faculty of medicine

Dr. Michael Harlos

Dr. frances berard

Dr. Holly Hamilton


accomplishments PROMOTION

CANADIAN HEALTH INFORMATICS ASSOCIATION

Dr. Alan Katz: promotion (full professor)

Dr. Michael Harlos: Clinician Leadership Award, awarded to a clinician who has shown outstanding leadership in advancing the use of health information communication technology and informatics in clinical practice resulting in improved provider and patient experiences and outcomes

MANITOBA RESEARCH CHAIR in PRIMARY CARE Dr. Alan Katz: appointed Manitoba Research Chair in Primary Prevention (fiveyears, $100,000 per year to champion primary prevention research in Manitoba; province’s first ever appointment)

DEPARTMENT OF FAMILY MEDICINE TEACHER AWARDS Dr. Rakesh Gera: Undergraduate Teaching Award (Clerkship) for teaching excellence, outstanding mentorship as a family physician, and commitment to undergraduate education

WINNIPEG REGIONAL HEALTH AUTHORITY COMMUNITY SERVICE AWARD Dr. Kanwal Brar, co-chief resident of the Urban Family Medicine program: WRHA 2012 Community Service Award, which recognizes volunteer and humanitarian work completed during residency

OUTSTANDING RESIDENT AWARD

Dr. Hang Trinh: Gary Beazley Medicine Educator Award, which recognizes an outstanding family medicine teacher, as nominated by undergraduate medical students

Dr. Kanwal Brar: 2011 Most Outstanding Resident Award for the Faculty of Medicine

Dr. Holly Hamilton: Undergraduate Teaching Award (Pre-clerkship) for teaching excellence, outstanding mentorship as a family physician, and commitment to undergraduate education

Dr. Susan Hauch: Teaching Excellence, Medicine I (nominees)

PROFESSIONAL ASSOCIATION of RESIDENTS & INTERNS of MANITOBA

Dr. Rakesh Gera: Most Outstanding Clinician, Clerkship (nominees)

Dr. Michael Penrose: PARIM Off-site Educator of the Year Award for quality of patient care, quality of and commitment to teaching, interest in trainees’ development, and service as a positive role model

Dr. Margaret Hesom

Dr. Jana Pilkey: Professionalism and Mentorship Award for excellence in patient care, commitment to teaching, and service as a positive role model

SCHOLARSHIP

The Manitoba College of Family Physicians

MANITOBA MEDICAL STUDENTS’ ASSOCIATION NOMINEES Dr. Alan Katz Dr. Michael Harlos: Teaching Excellence, Medicine II (nominee)

Dr. Larry Reynolds

Dr. Brent Kvern: Faculty of Graduate Studies Advanced Degree Education Scholarship in Medicine ($35,000) awarded to physicians who want to develop their careers and are engaged in postgraduate education

Dr. Frances Berard: Manitoba Family Physician of the Year Award Dr. Michael Harlos: Manitoba College of Physicians Award of Excellence

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family medicine annual report | 2011–2012


Project Highlights Distributed Medical Education - Not Distributed Students Distributed medical education (DME) encompasses a broad range of medical educational activities that take place at multiple sites beyond (and often distant to) the walls of institutions traditionally associated with Faculties of Medicine. DME at the University of Manitoba’s Department of Family Medicine is defined as the education of medical students and/or residents that takes place outside the three dedicated Family Medicine teaching units within Winnipeg (i.e., Family Medical Centre, Kildonan Medical Centre, and Northern Connection Medical Centre). To a considerable degree, DME has been an integral part of medical education within the department for decades.

While challenging to implement and administer a DME program, it allows the department more environments in which to educate our students and better allows us to graduate family physicians to meet the needs of the province. The critical factor, and one we are concentrating efforts on, is to ensure our students, regardless of where they learn, receive the same standard of education.

Objectives and Principles Accepted by the Department

Current Distributed Medical Education Activities and Sites

• Develop a comprehensive system of DME that considers all aspects of the educational process and is not merely a distribution of students/residents to sites outside our teaching clinics • Develop a curricular program that not only meets the educational objectives and core competencies of The College of Family Physicians of Canada, but provides an understanding and appreciation for the unique aspects of practicing Family Medicine in rural and remote Manitoba • Assist in building site capacity for distributed education placements in collaboration with communities and Regional Health Authorities • Create a framework for the recruitment and retention of preceptors and faculty for all learner streams • Provide ongoing faculty development and preceptor evaluation on a regular basis • Develop and implement consistent policies and practices across all sites with respect to issues such as accommodations, travel, and preceptor remuneration • Ensure that appropriate facilities and infrastructure are available at each site (e.g., teaching equipment, communication technology, accommodations, transportation) • Employ principles of equity and transparency across all teaching sites

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• Secure appropriate and sustainable funding in support of all DME activities within the department

university of manitoba faculty of medicine

At this time, distributed sites include... • The longstanding Parkland Family Medicine Residency program (based in Dauphin) - Dr. David O’Hagan • Northern/Remote Family Medicine Residency program (with an urban base at Northern Connection Medical Centre) - Dr. Joanna Lynch • Bilingual program (with rural experiences in Ste. Anne and Notre-Dame-deLourdes) – Dr. Fran Berard • The more recently created Family Medicine Enhanced Distributed Education Centres in Steinbach (Dr. Karen Toews), Brandon (Dr. Joanne Maier), and Winkler/Morden (Dr. Bob Menzies) • The provincially mandated Brandon Medical Education Study was presented to the steering committee who met in early July and sent their recommendations to the Minister of Health and the Minister of Advanced Education and Literacy. The ministers have accepted all of the committee’s recommendations, which will have further implications for the Department of Family Medicine’s DME activities. With content from Dr. Don Klassen and Beth Lloyd


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Project Highlights Electronic Medical Records Leading the Way in Manitoba and Beyond Regional and Provincial

National

The Department of Family Medicine achieved its goal of implementing electronic medical records (EMR) in all three of its academic teaching units in Winnipeg by the end of 2011. The Kildonan Medical Centre and the Family Medical Centre both implemented EMR in late fall of 2011 and the Northern Connection Medical Centre opened in 2010 with EMR in place. The EMR implementation was completed in partnership with the Winnipeg Regional Health Authority Community EMR Implementation Team. Residents, faculty, and staff have been adapting to new clinic workflows for patient care as well as clinical teaching, such as changing from dictation and transcription to entering patient information at the time of the appointment.

Department of Family Medicine faculty members have been busy developing a national EMR working group currently seeking endorsement and funding from The College of Family Physicians of Canada.

Department of Family Medicine faculty are leaders in the clinical use of EMR and its ongoing refinement through work on the Winnipeg Regional Health Authority Community EMR Clinical Advisory Group. They provide peer support and participate in professional development opportunities provided by the Primary Care Information Systems office at Manitoba eHealth. Faculty and staff participate in the eHealth Clinical Advisory Committee and eHealth peer support group, both of which are helping to set regional and provincial priorities for EMR use. Kildonan Medical Centre has stepped forward and has been approved as one of four pilot sites for Diagnostic Services Manitoba labs and diagnostic imaging interface. The project is scheduled to begin in the summer of 2012.

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university of manitoba faculty of medicine

A research project on the topic of EMR optimization was implemented in partnership with researchers from the University of British Columbia and the University of Victoria eHealth Observatory. Pending revisions, an article will soon be published in an upcoming edition of the Canadian Family Physician. A poster presentation entitled Quality Improvement Leveraging a Newly Implemented Electronic Medical Record has been accepted for the research day of the upcoming Family Medicine Forum 2012, held in Toronto and the upcoming eHealth conference in October 2012. EMR presents many opportunities to improve patient quality assurance. Increasing numbers of resident and student projects are focused on improving patient care through the use of EMR. With content from Dr. Alex Singer and Carol Styles


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family medicine annual report | 2011–2012


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university of manitoba faculty of medicine


introduction Our Program The University of Manitoba Family Medicine program is a pathway to a flexible and rewarding profession in medicine. The full training program is accredited by The College of Family Physicians of Canada and strives to teach wholeperson medicine through a combination of patient-centred care and structured seminars. The university offers students the chance to learn in partnership with an interprofessional faculty, which includes dieticians, pharmacists, nurse practitioners, and other health care professionals. This collaborative learning model teaches our students and residents the basic principles of other health care professions, when to use them in their care of patients, and how and when to make appropriate referrals.

After completing the four-year undergraduate program in Medicine, students who enter the two-year Family Medicine residency choose between four learning streams tailored to their practice interests: Urban, Rural, Bilingual (French/English), Northern/Remote. Each stream provides broad and balanced experience that prepares well-rounded family physicians who can practice with confidence in a variety of settings. The Department of Family Medicine Research Unit provides an exciting opportunity to perform research with practical outcomes on the health of Canadians. This unit promotes and supports the development of research skills and provides workshops to all Family Medicine residents to support the development of a capstone scholarly or research paper, which is presented on Research Day. In addition to the postgraduate program, the department offers enhanced skills training in six areas: Anesthesia, Care of the Elderly, Emergency Medicine, Oncology, Palliative Medicine, Primary Care Sports and Exercise Medicine. These enhanced skills require an additional 6–12 months of study and allow Family Medicine doctors to continually shape and reshape their careers. Family Medicine residents finishing their second year and practicing family physicians can apply.

family medicine annual report | 2011–2012


Our sites

Our Staff

Within Winnipeg, there are three dedicated training clinics: Kildonan Medical Centre, Family Medical Centre, and Northern Connection Medical Centre.

The Family Medicine team includes:

Throughout the city, province of Manitoba, and beyond, there are over one hundred hospitals and health centres that support Family Medicine’s various programs.

41 Academic Family Physicians (15 full time) 21 administrative support staff (combination of full and part time)  0 clinical and administrative staff 4 (working in the urban teaching clinics)

nunavut

yellowknife

350 community preceptors

churchill

hudson Bay

Our Students Undergraduate (Pre-clerkship First- and Second-year Medicine)

Undergraduate (Clerkship Third- and Fourth-year Medicine)

io

thompson

ta r

flin flon

on

saskatchewan

Medicine I: 115 Medicine II: 110

the pas

legend dauphin

undergraduate site northern/remote (N/R) site (N/R) Fly-in site

portage la prairie winnipeg brandon

rural site bilingual site urban site

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united states

university of manitoba faculty of medicine

Medicine III: 110 Medicine IV: 110

Postgraduate Year Two (PGY 2)

Urban: 17 Rural: 11 Northern/Remote: 17 Bilingual: 4 Total: 49

Enhanced Skills

Urban: 23 Rural: 9 Northern/Remote: 14 Bilingual: 3

Oncology: 0 Anesthesia: 2 Care of the Elderly: 1 Palliative Medicine: 2 Emergency Medicine: 5 Primary Care Sports & Exercise Medicine: 1

Total: 49

Total: 11

Postgraduate Year One (PGY 1)

The Canadian Resident Matching Service Students from around the world who apply to the Family Medicine Residency program do so through The Canadian Resident Matching Service known simply as CaRMS. For the 2011–2012 academic year, the department received 3,083 applications, from a total of 1,055 applicants (note: applicants interested in multiple program streams must submit separate applications). Of the 1,055 applicants, 163 were Canadian Medical Graduates and 892 were International Medical Graduates. The department offered and held 250 interviews. We matched 18 Urban, 8 Rural-Parkland, 11 Northern/Remote, 3 Bilingual, 2 Brandon, 2 Steinbach, and 2 Boundary Trails.


Statistical Report Graduate Retention Manitoba: Two-Year Program GRAD YEAR UNDERGRAD MED SCHOOL NUMBER OF GRADS Number Practice MB NUMBER OF PGY3 MB

% OF RETENTION MB NUMBER OF PRACTICE / PGY3 OOP NUMBER OF UNKNOWN

2011 TOTAL IMG UM CMG Other

32 17 14 1

12 4 8 -

6 2 4 -

56 35 86 -

14 9 4 1

-

2010 TOTAL IMG UM CMG Other

34 18 12 4

20 6 11 3

6 4 1 1

76 56 100 100

6 6 - -

2 2 -

2009 TOTAL IMG UM CMG Other

31 22 6 3

10 7 3 -

7 4 1 2

55 50 67 67

11 8 2 1

3 3 -

2008 TOTAL IMG UM CMG Other

35 10 22 3

20 1 18 1

4 2 2 -

69 30 91 33

11 7 2 2

-

2007 TOTAL IMG UM CMG Other

25 14 11 0

- 2 8 -

- 3 2 -

60 42 91 -

- 7 - -

2 1 -

2006 TOTAL IMG UM CMG Other

21 5 13 3

- 3 6 3

- 1 3 -

76 80 69 100

- 1 4 -

-

2005 TOTAL IMG UM CMG Other

22 6 10 6

- 2 8 4

- 2 2 -

82 67 100 67

- 2 - 2

-

2004 TOTAL IMG CMG/UM

20 4 16

- 1 14

- 2 -

85 75 88

- - 2

1 -

2003 TOTAL IMG CMG/UM

20 7 13

- 0 10

- - -

50 0 77

- 6 3

1 -

Legend: CMG: Canadian Med Grad IMG: International Med Grad UM: U Manitoba Grad OOP: Out of Province PGY3: Postgrad Year 3

Prepared for Michele Mathae-Hunter Director, PRCO, Manitoba Health

family medicine annual report | 2011–2012

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Department of Family Medicine

undergraduate program Pre-clerkship The University of Manitoba Department of Family Medicine provides instruction to first- and second-year medical students (Med I and Med II) in the pre-clerkship years. In this academic year, such education was provided to 115 Med I and 110 Med II students. These students learn a variety of skills in keeping with the department’s desire to educate well-rounded doctors.

Courses taught in 2011–2012 include:

Summer Work Experience & Training (SWEAT) Program

Clinical Interviewing: This series of seven sessions introduces Med 1 students to the skills of interviewing using the patient-centred method.

SWEAT is a paid ten-week program available to Med 1 and Med II students. Successful applicants are given their first real opportunity to acquire and practice the clinical skills they will develop later in training. This placement also provides students with a firsthand view of what it might be like to live and work in a rural community. In 2011, there were seven positions available in the program. Placements included Ste. Rose du Lac, Hamiota, Morris, Selkirk, and Notre-Dame-de-Lourdes.

Clinical Skills: These sessions, including surface anatomy and clinical skills labs, introduce students to a foundational approach to surface anatomy and basic examination skills. Community Practice Exposure: Med 1 students spend two to three hours in a family physician’s office, shadowing a family physician, and practicing their interview and basic clinical skills. Comprehensive Patient Assessment: Med II students are observed by a family physician while interviewing a patient, performing a focused physical exam, sharing the diagnosis, and sharing recommendations for further investigation and treatment. Feedback is provided to the student by the patient and the session family physician. Male Urological and Rectal Teaching Associate (MURTA) program: This program introduces students to the examination of the normal male uro-genital and rectal exam. To provide students with the very best education, the curriculum in the preclerkship years is being revised to include expanded student exposure to Clinical Skills and the introduction of a Longitudinal Clinical Office exposure that spans the Med I and Med II years.

18 With content from Dr. Susan G. Hauch, MD, CCFP Associate Professor, Undergraduate Director, Department of Family Medicine

university of manitoba faculty of medicine


clerkship The Family Medicine Clerkship program provides an excellent and innovative educational experience for physicians in training. Med III and Med IV students are given broad exposure to medical situations, incorporating urban, rural, and northern medicine, emergency and internal medicine, obstetrics and gynecology, pediatrics, surgery, dermatology, and psychiatry. They also have experiences with other aspects of health care, such as exposures to public health nurses, pharmacies, laboratory facilities, and office management.

The clerkship program comprises a series of clinical rotations designed to provide third- and fourth-year medical students with broad exposure to core disciplines (including Family Medicine), as well as opportunities for electives and exam preparation. The Family Medicine clerkship rotation is six weeks long (including a one-week Community Medicine rotation) and is one of the eight core rotations. During the 2011–2012 academic year, approximately 110 students were placed at over 20 sites throughout the province. The clerkship program continues to facilitate elective rotations at community Family Medicine sites for University of Manitoba students and additional electives for out-of-province and international students. The program participated in a review and renewal of the Introduction to Clerkship rotation. During this rotation, Family Medicine provided teaching sessions on the periodic health review and dermatologic diagnosis. As well, Family Medicine faculty assisted in the development and implementation of emergency skills workshops at the Clinical Learning and Simulation Facility. Department of Family Medicine faculty continue to teach at clinical skills sessions held during the obstetrics and gynecology rotation. Faculty and residents continue to facilitate and organize the emergency preparedness simulation course within the Clinical Learning and Simulation Facility. Members of the department are active participants on the Faculty of Medicine’s curriculum renewal working group, whose mandate is to envision and develop an innovative, more effective undergraduate curriculum model for implementation in the fall of 2013. Our program continues to work with The College of Family Physicians of Canada national undergraduate education committee to develop a national webbased clerkship curriculum in Family Medicine. In April 2011, the University of Manitoba Undergraduate Medical Education Program underwent an accreditation review by the Committee on Accreditation of Canadian Medical Schools and the Liaison Committee on Medical Education. In October 2011, these committees jointly recommended to continue full accreditation of the program.

With content from Dr. Clayton Dyck, Dr. Mark Boroditsky Associate Directors, Clerkship, Department of Family Medicine

family medicine annual report | 2011–2012

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Department of Family Medicine

postgraduate program The two-year Family Medicine program at the University of Manitoba is a pathway to a flexible and rewarding profession in medicine. Program sites in rural, bilingual, northern, and urban community and tertiary care hospitals provide broad and balanced experience that prepares residents to be well-rounded family physicians who can practice with confidence in a variety of settings.

Our core residency program offers four streams tailored to different practice interests:

Urban

In 2011–2012, the number of residents studying in each stream is indicated in the tables below.

Postgraduate Year One (PGY 1) Family Medical Centre, Kildonan Medical Centre

Urban: 23 Rural: 9 Northern/Remote: 14

Rural

Parkland Family Medicine Residency Unit

Bilingual

Bilingual: 3 Total: 49

Postgraduate Year Two (PGY 2) Urban: 17

Centre de santĂŠ

Northern/Remote 20

university of manitoba faculty of medicine

Rural: 11 Northern/Remote: 17

Northern Connection Medical Centre

Bilingual: 4 Total: 49


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Dr. Tamara Buchel, Postgraduate Director

family medicine annual report | 2011–2012


Urban Stream The Urban stream is based out of two teaching units in Winnipeg: Kildonan Medical Centre at Seven Oaks General Hospital and the Family Medical Centre at St. Boniface General Hospital. Residents train at these clinics during their Family Medicine block time (units of study).

Kildonan Medical Centre Residents at Kildonan Medical Centre benefit from an interdisciplinary team that includes a nurse practitioner, primary care nurses, a pharmacist, dietitian, social worker, psychologist, and psychiatrist, as well as stellar administrative and clinical support staff. The clinic is also a training site for international exchange students from Shantou University in China. Many international medical students choose Kildonan Medical Centre as an elective site during their undergraduate medical training. With this diverse group of learners, Kildonan Medical Centre has become an excellent role model and site for the advancement of interprofessional education and patient care. Developments: Kildonan Medical Centre provided provincial leadership as a pilot site for the implementation of eChart Manitoba—a secure electronic system that provides health care professionals with patient information in a single location. The electronic medical records system was officially launched at a news conference in March 2011 at the clinic. The event received local, national, and international media attention. Kildonan Medical Centre, along with Centre de santÊ, served as a provincial role model as an early adopter of Advanced Access, a training and implementation process that enables patients to see a physician or other primary care practitioner at a time and date that is convenient for them. Statistics: Between July 1, 2011 and June 30, 2012, there were 17,259 patient visits.

Staff

The teaching and clinical duties of Kildonan Medical Centre are supported by:

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Dr. Tunji Fatoye, unit director

Dr. Mark Kristjanson

Dr. David Ross, education director

Dr. Charlene Smelsky

Dr. Jamie Boyd

Dr. Jennifer Potter

Dr. Tamara Buchel

Barb Daien, social worker

Dr. Sarah Kredentser

Jamie Falk, pharmacist

Dr. Clayton Dyck

Simone Jones, nurse practitioner

Dr. Mark Boroditsky

Bernadette Mulvaney, office manager With content from Dr. Tunji Fatoye, MD, CCFP Associate Director

university of manitoba faculty of medicine


Family Medical Centre The Family Medical Centre (FMC) provides postgraduate training for Family Medicine residents in their two-year residency program as well as training for psychiatry residents, community medicine residents, undergraduate medical students, nurse practitioner students, physician assistant students, and pharmacy students. The dual mandate of the clinic is to provide an appropriate educational experience for learners in the context of excellent patient care. Developments: The electronic medical records system implementation at FMC went very smoothly with excellent support from faculty, staff, and residents. The clinic is running a dual system involving both paper and electronic records but plans to move to electronic records alone in late 2012. Several faculty members remain involved with the regional Bridging Generalist and Specialty Care (BGSC) project, the Uniting Primary Care and Oncology (UPCON) project, and Artemis. These important projects are described below.

Staff

The teaching and clinical duties of the Family Medical Centre are supported by: Dr. Gerald Konrad, unit director

Dr. Larry Reynolds

Dr. Mary Jane Jamieson, education director

Dr. Shawn Thomas

Dr. Susan Hauch

Diane Labossiere, nurse practitioner

Dr. Brent Kvern

Colleen Rogers, dietitian

Dr. NenĂŠ Rush

Donna Sutherland, social worker

Dr. Alex Singer

Joanne Parker, clinical nurse specialist

Dr. Alan Katz

Michelle Allard, advanced practice nurse

Dr. Jeff Sisler

Gloria Elgar, office manager

The BGSC project aims to improve interactions between family physicians (or other referring clinicians such as nurse practitioners) and specialist physicians. The project facilitates agreements between specialists and family physicians on issues such as what course of treatment family physicians should provide before considering a referral, what tests are required as a prerequisite for a referral, and what preparation may be needed prior to treatment by the specialist (e.g., surgery). The UPCON Network is dedicated to promoting and supporting the shared care of cancer patients. Using a technology and education strategy, UPCON supports more than 350 primary care providers in communicating more easily with cancer care specialists about their patients. UPCON ensures that people with cancer experience better coordination of their care. FMC participated in the development of the Artemis obstetrical call group, in which academic and community family physicians partner to care for obstetrical patients and the teaching needs of residents. This group is serving as the launching point for a citywide obstetrical network. As part of this, the Artemis group anticipates accepting referrals for late pregnancy management and intrapartum care from community physicians in the near future. Statistics: Between April 1, 2011 and March 31, 2012 there were 16,610 (estimated) patient visits at FMC.

23 With content from Dr. Gerald Konrad

family medicine annual report | 2011–2012


rural Stream

Residents spend their first year based at either one of the urban sites, Kildonan Medical Centre or Family Medical Centre, or at the rural unit based in Dauphin. Those who spend their first year at an urban site spend one week of their Family Medicine block time in Dauphin, a city of 8,000 people, approximately 300 kilometres northwest of Winnipeg. Their second year is based in Dauphin.

Since 2005, the department has offered rural stream residents the opportunity to spend a large portion of their first year based in Dauphin. In 2011–2012, five residents chose this option. Residents spend some rotations (pediatrics, ICU) in Brandon. They also spend two months of their Family Medicine time in the town of Ste. Rose du Lac, a town of 1,000 people, located 45 kilometres east of Dauphin.

Parkland Family Medicine Residency Unit Since its inception in 1991, 126 residents have graduated from the rural program and almost 100 have chosen to practice medicine in rural communities throughout Manitoba and beyond. The number of Parkland graduates who went into rural practice as their initial place of employment (including 2012) is outlined below.

Practice location

total

Rural Manitoba

61

Rural Canada

21

Rural Manitoba (after third year)

12

Rural international

1

In the class of 2012, eight out of eleven Parkland graduates went into a Manitoba rural practice (Portage la Prairie, Brandon, Dauphin, and Treherne); three plan to further their education through the Enhanced Skills program.

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university of manitoba faculty of medicine

Department of National Defence - Military Physician Assistants: Since 2003, Parkland has maintained a special relationship with the Department of National Defence (DND) to train their physician assistants. Through this unique program, Family Medicine residents and physician assistants learn side by side. Parkland is the only rural Manitoba site accommodating DND’s rural Family Medicine rotation; as such, Parkland hosted all 19 military physician assistant students for their six-week Family Medicine rotation. After training, military physician assistants work under a supervising physician and can provide primary and emergency care. Physician assistants are employed in underserviced and isolated locations, UN peacekeeping and disaster relief missions, as well as Canadian military operations around the world. The military remains extremely supportive of the physician assistant training in Parkland. Their feedback has shown this rotation to be evaluated as the highest during their national training.


Curriculum and Educational Activities: With the increased number of residents choosing to complete both years in Parkland, a two-year curriculum was developed to ensure topics are not repeated. Academic day sessions are complemented with special events, such as farm day and traditional medicine teachings, which continue to be a highlight of training. This year, for farm day, residents and faculty drove to Swan River and were shown the variety of farming practiced in the area. Safety concerns and injuries commonly seen on farms were discussed as well as issues more commonly seen in rural settings, such as children and seniors as farm workers, financial issues, and rural isolation. Communication: Parkland is working hard to ensure the quality of education in the Rural stream does not suffer because of the distance to a major urban centre. Within Parkland, opportunities exist to use technology such as teleconferences, webcasting, and Skype. A Manitoba Telehealth unit was recently installed in the residency training room and has already improved residents’ attendance. Web conferencing increases connectivity to residents and potentially saves significant funds by reducing mileage and accommodation costs. It also gives rural residents access to urban faculty seminars.

Staff

The teaching and clinical duties of the clinic are supported by: Dr. David O’Hagan, unit director

Dr. Anthony Wiens

Dr. Scott Kish

Dr. Shaun Gauthier

Dr. Mike Penrose

Michelle Jubenvill, education assistant

Dr. Trina Mathison

Bernice Boyechko, residency clerk

Dr. Jason Scott

Erin Stoesz, dietitian

Dr. Fred Fjeldsted

Rev. Margaret McCallum, social worker

The unit draws on the expertise of many part-time faculty including family physicians, specialists, nurses, therapists, dentists, optometrists, and audiologists as well as support from the community at large.

With content from Dr. David O’Hagan, unit director and Michelle Jubenvill Parkland Family Medicine Residency Unit

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family medicine annual report | 2011–2012


Bilingual Stream The Bilingual stream accepted its first residents in 2005 and currently accepts three residents per year. First-year Family Medicine block time is spent at Centre de santé, a francophone clinic in St. Boniface. Off-service rotations are completed in English at either Health Sciences Centre or St. Boniface Hospital. In their second year, residents spend a total of five months in two largely francophone rural communities—Ste. Anne and Notre-Dame-de-Lourdes. Outside Quebec, there are very few francophone residency programs in Canada.

Staff Centre de santé Dr. Mélanie Saint-Hilaire Dr. José François Dr. Julie Lévesque Centre Medical Seine - Ste. Anne Dr. Chantal Fréchette Dr. Patrick Frédette Dr. Paul Demoissac Dr. Maurice Roy Clinique Notre Dame - Notre-Dame-de-Lourdes Dr. Frances Berard Dr. Holly Hamilton Dr. Denis Fortier

Northern and Remote Stream The Northern/Remote stream received its first residents in 2008 and anticipates accepting approximately 15 residents per year. This stream has a strong emphasis on preparing doctors for practice in remote and northern settings. Much of the training is done in the context of northern Manitoba communities and the Northern Medical Unit (NMU). In fact, eight months of the second year is largely based in northern communities and related activities. Residents have the opportunity to work in a variety of practice areas, ranging from large northern towns serving as a referral base, to small First Nation and Inuit communities accessible only by air. This stream is associated with a return-of-service agreement in the North consisting of two years of practice in a remote location within Manitoba and, upon completion of the returnof-service, the opportunity to pursue further postgraduate training at the University of Manitoba. The stream has been designed to meet the accreditation requirements of The College of Family Physicians of Canada, and will undertake an internal review in September 2012 in preparation for its first external accreditation review.

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The Northern/Remote Family Medicine Residency program is an initiative of the University of Manitoba, Health Canada, Manitoba Health, Regional Health Authorities, the Assembly of Manitoba Chiefs, and The College of Family Physicians of Canada. It is estimated that less than 40 per cent of physician health human resource needs are being met in remote and northern regions of Manitoba, and many other areas of Canada. The Northern and Remote Family Medicine Residency program at the University of Manitoba is an innovative initiative designed to address the ongoing issue of physician shortages in northern and remote regions and contribute to efforts to recruit and retain physicians in rural and northern communities.


Northern Connection Medical Centre Key to the long-term success and sustainability of the Northern/Remote stream was the development of a dedicated teaching unit in Winnipeg for residents during their first-year Family Medicine experience. The Northern Connection Medical Centre (NCMC), located at 425 Elgin Avenue in the core of Winnipeg, opened its doors in December 2010 and accepted its first cohort of residents in July 2011. NCMC is unique in the city in that it has a mandate to serve displaced northern individuals from aboriginal and other northern Manitoba communities who require primary or secondary care while in Winnipeg. This service has demonstrated improvements in the communication between patients’ home communities and the tertiary care system in the city. It has also improved patient access to care. Most of the clinic’s physicians have been hired in a half-time capacity, with the other half of their position involving a co-appointment with NMU. Residents in the program go to NMU communities in the second year of their training. This provides an opportunity to extend the concept of “continuity of care” to involve continuity across geography as well as care provider for this group of patients who have traditionally experienced fragmented primary care. It also adds an element of continuity to the residents’ experience as their preceptors have a chance to work with them again in their second year while in the North. To satisfy the educational needs of residents, the clinic has also targeted a number of other patient groups. There is a small core continuing care practice, and the clinic will accept a number of unassigned newborns and pediatric in-patients from Health Sciences Centre. The clinic also accepts: • prenatal patients without a physician • women relocating from Nunavut to Winnipeg for their prenatal/intrapartum care • students from the Bannatyne campus who do not have a family physician

Staff

• spouses and children of Canadian Forces members temporarily stationed in Winnipeg

The teaching and clinical duties of NCMC are supported by:

• referrals from Bridgecare Clinic, also located at 425 Elgin, for new refugee families in need of primary care

Dr. Joanna Lynch, unit and education director

• referrals from Nine Circles HIV Clinic

Dr. Mandy Buss

NCMC continues to participate in the regional working group for electronic medical records implementation. It has been designated as a site for the Bridging General and Specialist Care project (see page 23) and is an UPCON site (see page 23). Several physicians participate in intrapartum care as part of the Artemis call group.

Dr. Perry Gall

As a new program, ongoing evaluation is underway to look at elements such as retention in the North.

Dr. Teresa Cavett, asst. director, education

Kim Perrett, pharmacist Heidi Pharand, registered nurse Cecil Robert, registered nurse Joanne Klassen, Share Care counselor

Dr. Kenneth Hahlweg

Gwen Kydd, community liaison worker

Dr. Martin Nguetsop

Daniel Catte, dietitian

Dr. Ian Whetter

Norma Crawford, office manager

With content from Dr. Joanna Lynch

family medicine annual report | 2011–2012

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Research Unit Publications and Scholarly Activities

The Department of Family Medicine Research Unit provides an exciting opportunity to perform multidisciplinary and community-based partnered research with very practical outcomes on the health of Canadians. Dr. Alan Katz, Research Director, and his research staff promote and support much of the research and scholarly activities among department members as well as development of residents’ research skills required to understand and use research concepts in both evidence-based practice and as community-based and/or academic researchers. Drs Katz, Brent Kvern, and Jeff Sisler, and Gayle Halas currently provide workshops to all Family Medicine residents to support the development of a capstone scholarly or research paper, which is presented on Research Day (October 2011 and June 2012). Dr. Katz’s research grants also support student research assistantships, medical student summer projects or BSc Medicine projects, and postdoctoral fellowships.

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The Department of Family Medicine Research office is located in the Pathology Building of the University of Manitoba’s Bannatyne campus. This has been largely supported by one of Dr. Katz’s Canadian Institutes of Health Research grants and provides the work space to carry out the research (such as data extraction, data analysis) as well as meeting space for team meetings and/or resident consultations regarding their project work. Within the past year, one postdoctoral fellow completed his term and another postdoctoral fellow began a two-year term. One full-time research assistant, who had just completed her undergraduate degree, was accepted into Medical School. She was replaced with a part-time research assistant and a part-time office assistant. Dr. Katz’s research grants fully fund his research projects including all the research infrastructure and staff. This currently includes two research associates, two postdoctoral fellows, a data manager, and a part-time research assistant.

Research Associates

Postdoctoral Fellows

Canadian Primary Care Sentinel Surveillance Network Associates

Gayle Halas, RDH, MA, PhD(c.) Joanne Chateau, Dip. AT, BA

Kathleen Clouston, PhD Masud Khawaja, MD, MLRHR, PhD

Beth Lloyd, BEd, MA William Peeler, BA Collette Thiessen (Philippe), office assistant

university of manitoba faculty of medicine

Dr. Alan Katz, Research Director


Publications Bapuji, S.B., Lobchuk, M.M., McClement, S.E., Sisler, J.J., Katz, A., & Martens, P.J. (forthcoming). Fecal occult blood testing instructions and impact on patient adherence. Cancer Epidemiology.

Hearson, T., McClement, S.E., McMillan, D.E., & Harlos, M. (2011). Sleeping with one eye open: The sleep experience of family members providing palliative care at home. Journal of Palliative Care, 27(2), 69–78.

Chochinov, H.M., Cann, B., Cullihall, K., Kristjanson, L., Harlos, M., McClement, S.E.,… & Hassard, T. (2012). Dignity therapy: A feasibility study of elders in long-term care. Palliative & Supportive Care, 10 (1), 3–15.

Katz, A., Garland, A., Leslie, B., & Moffat, M. (2011). Clinical Research at MCHP Over the Next 20 Years. Healthcare Policy, 6 (Special Issue), 88–90.

Chochinov, H.M., Kristjanson, L., Breitbart, W., McClement, S., Hack, T.F., Hassard, T., & Harlos, M. (2011). Effect of dignity therapy on distress and end-of-life experience in terminally ill patients: a randomised controlled trial. The Lancet Oncology, 12 (8), 753–762. Clouston, K., Katz, A., Martens, P.J., Sisler, J.J., Turner, D., Lobchuk, M.,...& CIHR/CCMB Team in Primary Care Oncology (PCONET). Cudmore, J., Seftel, M., Sisler, J.J., & Zarychanski, R. (2012). Trimethoprim/ sulfamethoxazole induced pancytopenia and mucositis in a patient on long term methotrexate. Canadian Family Physician. Dillon, M., & Ho Ferris Nyriabu, S. (2011). Inner City Rotations. In Kelly, L. (Ed.), Community-based Medical Education – a teacher’s handbook. (pp. 113–122). Milton Keynes: Radcliffe Publishing.

Katz, A., Barré, L., Fogg, T., & Lewis, S. (2011). Beyond Administrative Data: A Vision for Health Information Systems for Canada. Healthcare Policy, 6 (Special Issue), 107–110.

Lentle, B., Cheung, A.M., Hanley, D.A., Leslie, W.D., Lyons, D., Kvern, B.,... & Scientific Advisory Council of Osteoporosis Canada. (2011). Osteoporosis Canada 2010 guidelines for the assessment of fracture risk. Canadian Association of Radiologists Journal, 62(4), 243–250. Lobchuk, M.M., McClement, S.E., Bapuji, S., Sisler, J.J., Katz, A., Marten, P.,...& Clouston, K. (2012). What is the role of family in promoting recommended faecal occult blood test screening? Exploring physician, averagerisk individual, and family perceptions. Cancer Epidemiology, 36(3), 190–199.

Katz, A., Halas, G., Dillon, M., & Sloshower, J. (2012, February). Describing the Content of Primary Care: Limitations of Canadian Billing Data. BMC Family Practice, 13:7.

Menear, M., Grindrod, K., Clouston, K., Norton, P., & Legare, F. (2012). Advancing the practice and science of knowledge translation in primary care. Canadian Family Physician, 58, 623–627.

Katz, A., Bogdanovic, B., Ekuma, O., Soodeen, R., & Enns, J. (2012). Pediatric Primary Care Services in Manitoba: Is the health of the next generation of children at risk? Health Policy, 105(1), 84–91.

Nathan, P.C., Hayes-Lattin, B., Sisler, J.J, & Hudson, M.M. (2011). Critical issues in transition in the care of survivors of childhood and AYA cancers. Cancer, 117(10 suppl), 2335–2341.

Katz, A., Lambert-Lanning, A., Miller, A., Kaminsky, B., & Enns, J. (2012). The national Canadian Family Physician Cancer and Chronic Disease Prevention Survey. Canadian Family Physician, 58, e62–69.

Pilkey, J., Harlos, M., & Hohl, C. (2011). Designing a Canadian Pediatric Palliative Care Residency Program. Journal of Palliative Care 27 (2), 175–180.

Grunfeld, E., Julian, J.A., Pond, G., Maunsell, E., Coyle, D., Folkes…& Sisler, J.J. (2011, December). Evaluating survivorship care plans: Results of a randomized, clinical trial of patients with breast cancer. Journal of Clinical Oncology, 4755–4762.

Konrad, G. (2012). Medication restrictions before fecal occult blood testing, are they necessary? Practical advice based on a systematic review of the literature. Canadian Family Physician, 58 (9), 939–948.

Harlos, M., Stenekes, S., Lambert, D., Hohl, C., & Chochinov, H. (under review). Intranasal Fentanyl in the Palliative Care of Newborns and Infants. Submitted to the Journal of Pain and Symptom Management.

Konrad, G. (as part of The Canadian Task Force on Preventive Health Care) (2011). Recommendations on breast cancer screening. Canadian Medical Association Journal, 183 (17), 1991–2001.

Pilkey, J. (2011). Steroid-Induced Side-Effects Affecting Diet and Nutrition in Palliative Care: Oral Candidiasis and Other Conditions. In Preedy V. (Ed.). Diet and Nutrition in Palliative Care (403–415). CRC Press. Pritchard, S., Cuvelier, G., Harlos, M., & Barr, R. (2011). Palliative care in adolescents and young adults with cancer. Cancer, 15, 117(10 Suppl), 2323–2328. doi: 10.1002/cncr.26044 Roger, K.S., & Halas, G. (2012). Building interdisciplinary qualitative research networks: Reflections on qualitative research group (QRG) at the University of Manitoba. The Qualitative Report, 17(1), 120–130. Shapiro, M., Kvern, B., Watson, P., Guenther, L., McElhaney, J., & McGeer, A. (2011). Update on herpes zoster vaccination: a family practitioner’s guide. Canadian Family Physician, 57(10), 1127–1131. Sisler, J.J., Seo, B., Katz, A., Shu, E., Chateau, D., Czaykowski, P.,... & CIHR/CCMB Team in Primary Care Oncology Research. (2011). Concordance with ASCO Guidelines for Surveillance After Colorectal Cancer Treatment: A Population-Based Analysis. Journal of Oncology Practice.

Pilkey, J., Demers, C., Venketesan, N., & Chochinov, H. (2012). Does Gynecological Malignancy Predict Likelihood of a Tertiary Palliative Care Unit Hospital Admission? A Comparison of Local, Provincial and National Death Rates. Palliative and Supportive Care, 22, 1–6.

Family Medicine faculty were also involved in the development of the McMaster CME Module on early pregnancy loss, the CFPC Family Medicine clerkship objectives, and a Mainpro-C accredited course on caring for cancer survivors, which was presented provincially and nationally.

Pilkey, J., Streeter, L., Beel, A., Hiebert, T., & Li, X. (2012 ). Corticosteroid Induced Diabetes in Palliative Care. Journal of Palliative Medicine, 15(6), 681–689.

family medicine annual report | 2011–2012

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Current and Ongoing Research Studies 2007–2012: Canadian Institutes of Health Research / CancerCare Manitoba Team in Primary Care Oncology The Primary Care Oncology-New Emerging Team (PCO-NET) comprises Katz, A., Martens, P., Turner, D., Sisler, J.J., Lobchuk, M., McClement, S., Wirtzfeld, D., Clouston, K., & Khawaja, M. Funding: Canadian Institutes of Health Research $1.5 million Ongoing study evaluating how to promote colorectal cancer screening and follow-up, the role of family and community partnerships, and enhancing transfer of care from specialist to family physician 2007–2012: Katz, A., Gregory, D., deLeon-Demaré, K., & MacDonald, J. Funding: Social Sciences and Humanity Research Council Understanding the Work of Nurse Practitioners: Exploring Discourse, Transactions, and Actions with Patients through Video-tape Analysis 2009–2011: Sisler, J.J. (project co-lead

and first author of grant application) Funding: Canadian Partnership Against Cancer - $99,986 Moving Forward after Rectal Cancer: A Demonstration Project in Survivorship Care Planning

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2011–Present:

Cavett, T., Jamieson, MJ., & Halas, G. Funding: application submitted to The College of Family Physicians of Canada Janus Research Grants Pilot project underway: Examining the use and impact of Field Notes as an educational tool in Family Medicine Residency

2011–Present:

Dyck, C., Nepomuceno, R., & Law, F. The Impact of the Family Medicine and Emergency Elective in University of Manitoba on Career Choices and Attitudes of Medical Student Participants from Shantou University Medical College

2011–Present:

Cavett, T., Apoeso, O., & Halas, G. Evaluating the Experiences and Practice Choices of Participants from the Family Medicine Summer Work Experience and Training (SWEAT) Program

2011–2012: Clouston, K. & Katz, A. Funding: Canadian Institutes of Health Research, Meetings, Planning and Dissemination Grant $25,000 (co-principal investigator) Partnerships to support colorectal cancer screening in Manitoba

2010–2013: Driedger, M., Brouwers, M. (principal investigators), & Sisler, J.J. (co-investigator) Funding: Canadian Cancer Society Research Institute - $711,198 Advancing quality in cancer control and cancer system performance in the face of uncertainty

2011–2012: Duhamel, T., Katz, A., Edwards, J., et al. Funding: Heart and Stroke Foundation of Manitoba $80,000 (co-applicant) Developing the resources, referral processes and community linkages that are needed to enhance the delivery of physical activity counseling and supports for sustained behaviour change within primary care and the community

2011: Cavett, T. An Exploratory Study of Department of Family Medicine Members’ Perceptions of International Medical Graduate Residents’ Integration into Medical Residency (approved by the Faculty of Education Coursework Research Review Committee) Study to inform Dr. Cavett’s research toward Masters of Education thesis

2011–2012: Brouwers, M. (principal investigator), Hoch, J. (co-primary investigator), & Sisler, J.J. (co-investigator) Funding: Canadian Cancer Society / Centre for Applied Research in Cancer Control - $50,000 Advancing Quality in Cancer Control and Cancer System Performance in the Face of Uncertainty

university of manitoba faculty of medicine

2011–2013:

Sisler, J.J. (local primary investigator) Funding: internal CancerCare Manitoba International Cancer Benchmarking Project, Module 3: Cancer Diagnosis in Primary Care: An International Survey of GPs

2011–2013: Jones, J. (principal investigator), & Sisler, J.J. (co-investigator) Funding: Canadian Breast Cancer Foundation - $144,764 Pilot study of a brief telephone-based intervention (adhERe) to improve adherence to adjuvant hormone therapy in women with early stage breast cancer 2011–2014: Deber, R., Barnsley, J., Glazier, R., Katz, A., Laporte, A., Roos, L., Stukel, T., & Wodchis, D. Funding: Canadian Institutes of Health Research $370,000 (co-investigator) Paying for primary care: Relationship between incentives and patient/provider characteristics 2011–2016: Martens, P., Brownell, M., Chartier, M., Katz, A., Fransoo, R., Lix, L., Metge, C., Roos, L., & Santos, G. (principal investigators) Funding: Canadian Institutes of Health Research $2,000,000 (co-principal investigator) PATHS Equity for Children: A program of research into what works to reduce the gap for Manitoba’s children 2012–2013: Johnson, J.A., Eurich, D., Katz, A., & Majumder, S. Funding: Canadian Institutes of Health Research (co-investigator) Diabetes, influenza, and cardiopulmonary outcomes: The rationale for targeting influenza vaccinations for patients with diabetes 2012:

Katz, A. (supervisor) & Coleman, N. (Med Student II) Canadian Primary Care Sentinel Surveillance Network Data Validation Study: Information Quality and Validity in an Era of EMR Use Med II Summer Project

2012: Falk, J., Toews, K., & Plett, J. Effect of Web-based Asthma Management on Asthma Patient Care and Satisfaction BScMed project 2012:

Cavett, T., Goosen, R., Jones, T., & Halas, G. Building the Foundations of Collaborative Practice: A Family Medicine-Psychiatry Shared Care training model at the University of Manitoba

2012: Katz, A. & Halas, G. Funding: applying for funding to expand project and investigate clinical outcomes The Risk Factor Identification Tool (RFIT); program development and pilot testing completed 2012: Katz, A. & Singer, A. Exploring the Process of Implementing an Electronic Medical Record in a Family Medicine Teaching Clinic 2012: Lynch, J. (co-investigator) Measuring the Effectiveness of Distributed Inter-Medical and Intra-Professional Education using Telehealth Submitted to ethics 2012: The Canadian Primary Care Sentinel Surveillance Network (CPCSSN) Manitoba is one of the regional networks (MaPCReN) under the direction of Dr. Alan Katz.


Presentations and Workshop Clouston, K. & Katz, A. (2011). Enhancing Clinical Practice through Family PhysicianPrimary Care Research Partnerships. Presented at Family Medicine Forum, Montreal, Quebec.

Clouston, K. Funding: Canadian Institutes of Health Research, Meetings, Planning, and Dissemination Grant Workshop: Partnerships to Support Colorectal Cancer Screening in Manitoba

Clouston, K., Menear, M., Grinrod, K., Norton, P., & Legare, F. (2011). Developing Knowledge Translation Strategies in Primary Care: Reflections from the Canadian Institutes of Health Research Summer Institute on Primary Healthcare Research. Presented at Family Medicine Forum, Montreal, Quebec.

Halas, G., Katz, A., McSwiggan, J., Gregory, D., DeLeon-DemarĂŠ, K., & Macdonald, J. (2011, November). Davis Observation Code: Describing patient encounters in a new era. Oral presentation at the College of Family Physicians of Canada. Presented at Family Medicine Forum, Montreal, Quebec.

Halas, G. & Katz, A. (2012, January). Supporting Prevention and Health Behaviour Change in Primary Care: RFIT and the Wellness Navigator. Presented at University of Manitoba Department of Psychology Colloquium. Parker, J. (co-primary investigator). An evaluation of a multidisciplinary group based diabetes education program in a family medicine residency teaching clinic. Presented at Family Medicine Forum, Montreal, Quebec and St. Boniface Hospital Nursing Week.

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enhanced skills The Department of Family Medicine provides enhanced skills training in anesthesia, care of the elderly, emergency medicine, oncology, palliative medicine, and sports and exercise medicine. These enhanced skills require an additional 6–12 months of study and are options available to graduating residents as well as doctors already in practice.

program

# of students 2011–2012

Anesthesia

2

Care of the Elderly

1

Emergency Medicine

5

Palliative Medicine

2

Sports and Exercise Medicine

1

Oncology

0

Total

11

An accreditation review was held in May 2012.

Palliative medicine Palliative Care is a distinct program at the Winnipeg Regional Health Authority; however, at the University of Manitoba it is a section within the Department of Family Medicine. The Palliative Medicine residency program was one of the first to receive joint accreditation by The College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada. There are two funded one-year residency positions per year, which have consistently been filled. In addition, we provide one-month clinical rotations for 65–70 residents per year from various medical specialties (Family Medicine, Internal Medicine, Anesthesia, Medical Oncology, Radiation Oncology, Surgery, and Psychiatry). To accommodate the increasing number of learners, in addition to the clinical rotation sites at St. Boniface General Hospital and Riverview Health Centre, we have added clinical rotations doing consultations at the Health Sciences Centre and community hospitals, as well as home visits.

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The learning objectives for a clinical rotation include familiarity with the approach to common symptoms seen in palliative patients; familiarity with prescribing opioids, sedatives, and antinauseants; developing communication skills regarding end-of-life issues; and developing an understanding of common ethical challenges in palliative care.

Formal positions within the section include: Dr. Michael Harlos, Section Head Dr. Christian LaRiviere, Palliative Care Residency Program Director (replacing Dr. Jana Pilkey) Dr. Marcelo Garcia, Coordinator of Undergraduate Education Dr. Fiona Crow, Coordinator of Clinical Rotations Erin Shepherd, Clinical Nurse Specialist in Pediatric Palliative Care Submitted by Dr. Michael Harlos Medical Director, Adult and Pediatric Palliative Care, Winnipeg Regional Health Authority Professor and Section Head, Palliative Medicine, Dept. of Family Medicine, University of Manitoba


Anesthesia

Emergency Medicine

The family practice anesthesia program is a successful collaboration between the departments of Anesthesia and Family Medicine. This one-year program encompasses training in tertiary care settings, community hospitals, and rural settings. Entry into this program is coordinated through the Office of Rural and Northern Health and is associated with a return-of-service agreement. Dr. Anthony Wiens, Program Director

This one-year program prepares residents for a career in Family Medicine with an Emergency Medicine focus. Dr. Al Buchel, Program Director

Care of the Elderly The Care of the Elderly residency was reinitiated in 2008. The Postgraduate Medicine office has approved secure funding for one position yearly. The departments of Family Medicine and Geriatrics collaborate to offer a 6–12 month experience in various settings caring for elderly patients. These settings include hospitals, personal care homes, home/community, and geriatric day hospitals. Members of the Section of Geriatric Medicine have particular expertise in areas of evidence-based medicine, administrative medicine, and pharmacology. They also work with a broad network of community agencies and resources. Geriatric medicine has a good understanding of the role of family physicians and encourages residents to become comfortable combining their roles. Program Director - vacant

Primary Care Sports and Exercise Medicine The Primary Care Sports and Exercise Medicine program was launched in September 2008. The first resident completed training and in 2009 and one resident has graduated in each subsequent year. In this program, residents have unique opportunities to work with the Manitoba Moose, Winnipeg Goldeyes, Royal Winnipeg Ballet, and other elite-level athletes. Having a residency program running through the Pan Am Sports Medicine Clinic, Primary Care Innovations Clinic, and the Minor Injury Clinic has been an excellent educational opportunity for the residents and preceptors. Dr. Swee Teo, Program Director

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family medicine annual report | 2011–2012


SHANTOU University Medical College Academic Exchange Since 2006, the Department of Family Medicine (DFM) has participated in a joint academic exchange project with Shantou University Medical College (SUMC) in Shantou, China. This project was developed as part of a larger exchange between SUMC and the Faculty of Medicine, established in 2001 through an endowment by the Li Ka Shing Foundation. The 2011–2012 project year demonstrates greater breadth of project activities, while continuing with activities that have proven successful in previous years. Activities this academic year included celebration of the tenth anniversary of the U of M/SUMC exchange, exchange visits, and an opportunity to participate in the Canada-China Family Medicine Forum at the Canadian Embassy in Beijing. 34

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Tenth Anniversary

Canada-China Family Medicine Forum

In September 2011, the Faculty of Medicine hosted a one-day celebratory symposium for the tenth anniversary of the U of M/SUMC exchange. Entitled Ten Years of Building Bridges in Medical Education and Research, the symposium was attended by leadership from the Li Ka Shing Foundation, the University of Manitoba, and SUMC, as well as past and present faculty and student exchange participants. During the official ceremony, Ms. Solina Chau, Director of the Li Ka Shing Foundation, graciously announced an additional endowment of $1 million to the U of M/SUMC exchange.

In March 2012, five members of the DFM and SUMC were invited to participate in the Canada-China Family Medicine Forum at the Canadian Embassy in Beijing. The purpose of this meeting was to facilitate collaborations in family medicine training and care delivery in both countries, and was attended by representatives of nine Canadian family medicine programs, Chinese universities, and government departments. While still in early development, several potential new collaborations at national and local levels were identified. The Department of Family Medicine has offered to be active participants in these initiatives.

Exchange Visits

In January 2012, DFM/SUMC Exchange Project Manager Dr. Clayton Dyck assumed additional responsibilities as coordinator of the broader U of M/SUMC Academic Exchange.

Two fifth-year and two fourth-year medical students from SUMC came to Winnipeg for a six-week exchange. Students were given clinical exposure and formal teaching sessions at department teaching units, the St. Boniface and Concordia Hospital emergency departments, in Steinbach, and at the University of Manitoba Bannatyne campus. In April–June 2012, six Chinese students from SUMC’s English only training stream attended an eight-week exchange visit in Primary Care. This visit featured learning exposures in urban and family medicine teaching units, emergency departments, and aboriginal communities. A four-week reciprocal exchange visit at SUMC was held in March 2012 by four department faculty members (Drs. Tunji Fatoye, David O’Hagan, Brent Kvern, and Clayton Dyck) and one Family Medicine resident. The visit’s principal activities included:

Feedback from project stakeholders, including senior leadership, exchange participants, students, faculty and staff, remains positive and encouraging. In particular, the formal faculty development sessions, student exchange visits, and student lectures have been well received. A qualitative study is being conducted on the impact of previous SUMC student exchange visits on students’ attitudes to patient care and career choices, with outcomes to be presented in 2012–2013. At a relatively low cost to the department, the project continues to contribute to medical education at an international level, increase intercultural awareness and skills within the department, and promote the department and the discipline of Family Medicine locally, nationally, and internationally. Content provided by Dr. Clayton Dyck

• The development and implementation of faculty development sessions with SUMC clinical faculty in case-based teaching skills and North American teaching and learning styles • A continuation of small group sessions to be conducted with fourth- and fifth-year medical students • Presentations at student information sessions on the theme of patient-centred care and rural/remote medicine in Canada • Exploration of future exchange activities, particularly in the area of faculty development, and increased student exchanges

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family medicine annual report | 2011–2012


University of Manitoba Department of Family Medicine Office of Professor & Head, St. Boniface General Hospital E6003–409 TachÊ Avenue Winnipeg, Manitoba R2H 2A6

umanitoba.ca/medicine

Faculty of Medicine Family Medicine


Family Medicine Annual Report 2011-2012  

Family Medicine Annual Report

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