Expanding Medical Education in British Columbia within a Socially Responsible Framework Oscar Casiro, MD, FRCPC Head, Division of Medical Sciences, UVic Associate Dean, Island Medical Program, UBC

Challenges Shortage of physicians Shortage of physicians Recruitment and retention problems Recruitment and retention problems Maldistribution of physicians Maldistribution of physicians

British Columbia BC provides only a fraction of the new physicians it needs each year. BC provides only a fraction of the new physicians it needs each year. Only 26% of physicians practicing in the province are UBC graduates. Only 26% of physicians practicing in the province are UBC graduates. BC has the lowest medical student spaces per capita in Canada. BC has the lowest medical student spaces per capita in Canada. Shortages of physicians in rural/northern communities Shortages of physicians in rural/northern communities Growing, ageing population Growing, ageing population B. McBride & J. Cairns, 2001

University of Northern British Columbia: Northern Medical Program (NMP) University of British Columbia: Vancouver-Fraser Medical Program (VFMP) University of Victoria: Island Medical Program (IMP) The MD Undergraduate Program Distributed Model of Expansion

Changes in Student Enrolment in the UBC Faculty of Medicine N=1024 N=512

Proposed changes to undergraduate enrolment by year N=504 N=1024

Degrees Of Distribution University of British Columbia Faculty of Medicine Undergrad Program – Degrees of Distribution UBC UVic UNBC VCHA/FHA VGH/SPH/RCH VIHA Vic Gen/RJH NHA PGRH Rural & Remote PHSA BCCWH/ BCCA Affiliated Regional Centres Affiliated Regional Centres – Types 1 & 2 Phases 5&6 Dispersed Sites - Rural & Remote Phases 3, 5, 6 Clinical Academic Campuses Phase 4, 3 rd Year Partner University Campuses 1 st & 2nd Year IHA KGH Community Based Sites

Uses of Technology Planning: Planning: MeetingsMeetings Team roomsTeam rooms Administration: Administration: Curriculum meetingsCurriculum meetings Faculty development Faculty development Tutor meetingsTutor meetings Instruction Instruction LecturesLectures LabsLabs PBL groupsPBL groups Student support Student support Student connection Student counseling Evaluation Evaluation Exams Faculty/course evaluation

Medical Sciences Building: Home of the Island Medical Program Officially opened December 2004 Officially opened December 2004 “Green” building “Green” building Students have 24-hour access (coded security cards) Students have 24-hour access (coded security cards) Designed to accommodate students and staff with disabilities. Designed to accommodate students and staff with disabilities.

Medical Sciences Building: Facilities Two state-of-the-art lecture theatres Two state-of-the-art lecture theatres Seven PBL rooms Seven PBL rooms Two research labs Two research labs Computer lab Computer lab Reading room Reading room Gross anatomy lab Gross anatomy lab State-of-the-art multipurpose lab State-of-the-art multipurpose lab

Medical Sciences Building

Island Medical Program Vancouver Island Health Authority (VIHA) Clinical Academic Campus Royal Jubilee Hospital Royal Jubilee Hospital 656 bed acute care656 bed acute care Clinical skills facility forClinical skills facility for 1 st & 2 nd year IMP students Victoria General Hospital Victoria General Hospital 379 bed acute care379 bed acute care Educational Centres in Central and North Island Educational Centres in Central and North Island

Class of 2008 The Island Medical Program’s most important asset! “I had high expectations when I decided to participate in the Island Medical Program, and those expectations have been exceeded! I love being able to study with a small group of students, and I love the interaction with IMP staff – they know all the students by name!”

Pre-Med Undergraduate Medical Education Postgraduate Medical Education Continuing Professional Development (CME) Continuum of Medical Education

Develop core clerkships in Victoria Develop core clerkships in Victoria Build infrastructure to support medical education outside Victoria Build infrastructure to support medical education outside Victoria Community-based integrated clerkships in Central or North Island Community-based integrated clerkships in Central or North Island Community-based rural electives and selectives Community-based rural electives and selectives

MD Undergraduate Program Years 3 and 4 Phase III- Community Practice (4-8 week practicum in rural and underserved communities) Phase III- Community Practice (4-8 week practicum in rural and underserved communities) Phase IV- (48 weeks) required clinical clerkships Phase IV- (48 weeks) required clinical clerkships Phase V- selectives and electives (first 16 weeks of year 4) Phase V- selectives and electives (first 16 weeks of year 4) Phase VI- Effective Learning Skills for Medical Practice (16 weeks including a 2 week LMCC preparation course and 4 week senior elective) Phase VI- Effective Learning Skills for Medical Practice (16 weeks including a 2 week LMCC preparation course and 4 week senior elective)

Undergraduate Curriculum and Planning Model Years 3 & 4