Orientation Manual
UBC Cardiology Residency Program 2013-2014
Specialty Training Requirements
1. Royal College Certification in Internal Medicine.
2. Three years of approved residency in an approved Adult Cardiology residency
program.
The following core experiences are required. Some learning experiences can
occur simultaneously and/or longitudinally (e.g., electrocardiogram (ECG)
interpretation, ambulatory clinics).
a. 15 blocks of clinical residency:
i. 4 blocks acute cardiac care (CCU)
ii. 6 blocks clinical cardiology (HF, Rehab, Consults, CSICU)
iii. 3 blocks ambulatory cardiology (may be done longitudinally)
iv. 2 blocks pediatric cardiology (which may include adult and
congenital heart disease)
b. 15 blocks of laboratory based residency:
. 3 blocks cardiac catheterization
i. 6 blocks echocardiography
ii. 3 blocks electrophysiology/pacemaker
iii. 2 blocks ECG/ambulatory ECG monitoring/exercise stress testing
iv. 2 blocks nuclear cardiology
v. 1 Blocks of Advanced Cardiac Imaging
c. 4 blocks elective
d. Minimum 2 blocks research (clinical and/or basic)
Rotation Contacts
Rotation
Rotation Head
Cath VGH
Cath SPH
CCU SPH
CCU VGH
CHF, SPH (including cardiac transplant)
Clinical Rotation
Consults VGH
CSICU, VGH
Echo VGH including Diamond Centre
outpatient clinic
Echo SPH
Elective
EP, SPH
Dr. Jackie Saw
Dr. Eve Aymong
Dr. Krish Ramanathan
Dr. Graham Wong
Dr. Andy Ignaszewski
Various at three sites
Dr. Hartmut Henning
Dr. Rael Klein
Dr. John Jue
Dr. Marla Kiess
Various
Dr. Charles Kerr
Nuclear, SPH
Pediatrics, BCCH
Rehab, SPH
Research
Adult Congenital
Dr. Marla Kiess
Dr. Walter Duncan
Dr. Sammy Chan
Dr. John Jue, Dr. Sean Virani, Dr. Graham
Wong
Dr. Marla Kiess
Cardiology Resident On-Call Guidelines
First year residents are on call 1 in 7. They are in-House during the first 6 months. All
subsequent call is home call. Second year residents take call 1 in 8. Third years take call
1 in 9. If you are in house call you are expected to go home post-call after handover. If
you are home call you need to exercise your discretion about going home post-call based
on your level of fatigue.
The CCU directors will make every attempt to schedule a first year resident with a first
year fellow so that first year residents have in-house supervision for the first 6 months of
the year.
Once the call schedule is finalized it is the responsibility of the residents to make call
trades amongst themselves and notify Dr. Wong’s and Dr. Ramanathan’s assistants about
that trade. The chief residents must also be notified to update the master schedule.
Hand-Over
(1) The cardiology resident on-call should be physically available for hand-over in the
CCU at 17:00 unless alternate arrangements have been made (e.g. fellow to fellow
hand-over when a cardiology resident is on a CCU rotation).
(2) All critically ill patients in the CCU should be reviewed as required to assume care
by the on-call resident at the time of handover.
(3) It is not required that cardiology residents will be responsible for providing handover to on-call attending staff.
Communication
The on-call cardiologist should be informed in the case of:
(1) A significant unexpected change in a patient’s clinical status (including changes
requiring involvement of a subspecialist/cardiac surgeon)
(2) The following procedures: intubations, transvenous pacemaker insertion,
electrical cardioversion, PA catheter insertion and pericardiocentesis
(3) Outside calls requesting advice or patient transfer, as well as urgent ECG
interpretations when residents are unsure and require assistance. All BC Bedline
calls should be directed to the attending cardiologist.
(4) Discharging patients from the emergency room
(5) All echocardiograms in which the results will dictate patient management
Review with Residents
Residents on weeknight call are expected to physically review all patients until 2200 hrs.
All patients are then to be discussed with the cardiology resident after 2200 hrs. The
cardiology residents are expected to physically review all patients who can be potentially
discharged, all acutely ill patients, and must be available to supervise invasive procedures
performed by more junior residents.
At Saint Paul’s Hospital, the fellows are expected to perform “night rounds” on the CCU
between 20:00-22:00 with the cardiology resident and nurses.
In all cases of uncertainty, cardiology residents should err on the side of caution and
review management with the on-call attending staff. If after repeated attempts you
cannot reach the on-call cardiologist, you should try to reach a sub-specialty cardiology
attending on-call (eg. Echo, Intervention, etc.) and explain your situation.
Evaluation Methods
All cardiology residents will receive written evaluations at the end of each rotation
through WebEval at www.one45.com. Verbal evaluation should also occur at the
midpoint and completion of a rotation. Evaluations of the attending’s must also be filled
out by the resident before a rotation deemed completed.
It is the responsibility of residents to get a completed evaluation from each rotation, and
also to keep their reverse evaluations up to date. If evaluations are not kept up to date, the
residents will not be reimbursed for expenditures or conferences.
Methods of evaluation:
1. Rotation evaluations
2. Bi-Annual review with the program director
3. Annual Clinical OSCE
4. Graphics OSCEs
5. CCU 360 Degree evaluation – evaluation by Attending and Allied Health Staff
http://postgrad.med.ubc.ca/files/2012/09/Resident-Evaluation-Policy-September-2012.pdf
Intimidation and Harassment
Intimidation and Harassment are not tolerated at UBC. In situations where residents feel
that they are not being treated fairly, or where personality conflicts may arise, residents
are encouraged to speak to the program director. If the problems remain unresolved,
residents are encouraged to discuss this with the Head of Cardiology.
In addition, a formal mechanism is in place. Dr. V. Huckell (VGH) and Dr. C. Taylor
(SPH), both cardiologists, have been appointed as internal resident advocates, and Dr. I.
Mackie (general internist, prior UBC Internal Medicine Program Director) have been
appointed as external resident advocates. The UBC Dean of Equity Dr. G. Parhar is a
final resource for cases of discrimination. This information is included in the Orientation
Manual, which all residents receive at the beginning of their training. For more
information see:
http://postgrad.med.ubc.ca/files/2012/02/Policy___Process_to_Address_Unprofessional_Bea
hvior__Including_Harassment__Intimidation92.pdf
http://postgrad.med.ubc.ca/files/2012/02/Process_to_address_concerns__complaints_of_har
assment__intimidation__unprofessional_behavior93.pdf
http://www.cfpc.ca/uploadedFiles/Education/Intimidation_and_Harassment_en.pdf
http://postgrad.med.ubc.ca/files/2012/09/RESIDENT-APPEAL-POLICYsept2012.pdf
CMPA insurance
CMPA insurance is now considered mandatory and must be obtained.
Parking Information
The program administrator will provide a parking pass that allows parking at the VGH
courtyard for after-hours and weekends on call. A SPH staff placard can be obtained
from the parking office in the Willow Chest Center and allow for discounted rates for
parking at SPH.
Royal College Examination in Internal Medicine
First year cardiology fellows are allowed one week (5 business days) off duty for the royal
college examination. If taking this time off of a 4-week rotation, a resident cannot also take
vacation or conference time during this rotation. All attempts are made to ensure that clinical
and academic duties are lightened for the several months prior to the royal college exam for
adequate study time.
Things to Take Care of New Residents to Vancouver
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Getting a program manual
Requisition of prescription privileges (voluntary)
Hospital ID at both sites
VGH: photo ID available from Photo ID Department, Heather Pavilion, Ground floor
SPH: photo ID available from Photo ID Department, 4th floor Burrard
Pager requisition
Computer access and training
Keys to residents’ room
Information regarding on-call room
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Dictation information, dictation number etc.
Vacation and Conference Policy
Each year (July - July) residents are entitled to a vacation period of 4 weeks, including
the weekends prior to, and following. In addition, residents are entitled to five
consecutive days during either the Christmas or New Year’s period and other statutory
days during the calendar year as determined by the hospital.
A resident cannot accumulate vacation or statutory holiday time from year to year unless
for exceptional reasons subject to the approval of the PECC committee and the Division
Head. Current policy is that residents cannot be away more than four weeks during the
first six months of their training. Holiday is not allowed while scheduled on a CCU
rotation. Vacation requests should be submitted in writing to the program secretary and
rotation head at least 2 months in advance. All vacation requests are subject to the
approval of the Program Director.
Conference time will be prioritized for those residents whose research has been accepted
for oral or poster presentation. The Division will strive to provide funding for this. A
request to attend any conference must be submitted in writing to the program director no
later than 3 months prior to the conference. Residents can attends the CCC each year and
attend an international conference twice in 3 years. Conferences are reimbursed by the
program so residents can attend the Canadian Cardiovascular Congress twice (funded up
to $1500) and international conferences twice (up to $2000).
1) A request in writing must be given to the Program Administrator and rotation head three
months prior to the start of rotation. In the event of too many requests per rotation, the
final decision will rest with the Program Director. The Program Director has the
discretion of not approving conference leave that is not appropriately requested as
indicated above.
2) One day of travel time prior to event and one day after event is allowable to a total of 5
working days.
3) The conference must be relevant to Cardiology Training.
4) While approval for conference leave may be granted, the resident requesting leave is
ultimately responsible for ensuring appropriate call coverage and trade teaching duties
during the conference period.
5) Residents on a one month rotation will be allowed one week vacation or 5 days
conference leave only, but will not be allowed to take both during the month.
Academic Schedule
Monday
Tuesday
Wednesday
Thursday
Friday
7AM – Cardiology Fellow Teaching
7AM – Cardiology Fellow Teaching
12PM - CCU Resident teaching by a fellow – SPH ICU Conference Room
12PM – Echo/PACH Rounds - SPH 5C/D Conference Room
7-9AM – Combined Rounds and Cardiology Grand Rounds – VGH/SPH
1:30-4:30PM – Cardiology Academic Half-Day
7-8AM – CCU resident teaching by a fellow – VGH Taylor-Fidler Room
7:15-8AM – SPH M&M Rounds
A GUIDE TO BC CHILDREN’S HOSPITAL
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On the first day of rotation, the residents will get a guided tour of the hospital. All
dictation goes through the hospital central system, or through the related
attending’s personal secretary. Computer work can be done on any of the several
computer workstations that are available for resident use.
There is no night-call required at BC Children’s Hospital. During this rotation,
residents will perform 2nd call on weekends at SPH or VGH as described earlier.
On-site parking is available at public rates.
Name
Duncan, Walter
Phone
604-875-2855
Pager
Email
wduncan@cw.bc.ca
TBazin@cw.bc.ca
(Theresa)
A GUIDE TO UBC HOSPITAL
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The rotation will be supervised by Dr. Saul Isserow. The main goals for the
rotation will be to gain proficiency in all aspects of outpatient cardiology
including exercise treadmill testing, supervision of the stress component of
nuclear scanning, ECG and holter monitor interpretation and outpatient
cardiology.
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Residents should contact Dr. Isserow prior to starting the rotation to see where
they should report to on the first day of the rotation.
Name
Isserow, Saul
Phone
604-822-1747
Pager
604-877-2827
Email
isserow@interchange.ubc.ca or
sonia.reddy@vch.ca (Sonia)
Community Cardiology Rotations
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A formal community cardiology rotation is available through Dr. Jonathan Tang
at Mount Saint Joseph Hospital. In addition, many residents do schedule elective
community cardiology rotations at the breadth of hospitals across Vancouver
Coastal Health and Fraser Health.