Your residency is one of the most intense and rewarding chapters in your career. This section provides insider insight into surviving and thriving. All resources were recommended by graduates of the UBC Family Practice Residency Program.

You will find useful nuggets of information, as well as recommendations for websites, online tools, memberships and other resources help you through residency and transition to practice. Be sure to read Dr. Shahana Alibhai’s personal Top Tips for Survival!

A big thank you to Dr. Alibhai and her colleagues for compiling these essential resources.

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  • Top tips for survival

    Dr. Shahana Alibhai provides tips that range from pointers on planning your electives to advice on when to review your learning objectives.

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    • Plan way ahead – at least four months – when doing an out-of-province elective. The process to obtain a license in your chosen province can take some time. Keep photocopies of the following documents handy for electives and community hospitals, as they may request them: immunization record, licentiate of the Medical Council of Canada (LMCC) I/II exam results, CMPA registration, curriculum vitae and medical degree.
    • Finding a colleague/friend/mentor who can be your “phone a friend” is important. We all need reassurance at some point in our professional lives.
    • It’s okay to not know everything about anything. Do ask lots of questions to your peers, nurses, staff, lab technicians. Going online to a family physician forum of discussions, the Facebook First Five Years page, is a good place to start.
    • If you find yourself struggling at any point during residency or going through a crisis, don’t hesitate to call the Physician Health Program of British Columbia (open 24-hours-a-day, seven-days-a-week).
    • Before every new rotation, sit down and look at the CCFP 99 to remind yourself of learning objectives pertinent to the rotation.
    • Start thinking “practice management” during residency. For resources on this subject, the CMA website is a good place to start, and the Society of General Practitioners of BC (SGP) has a good website on MSP billing.
  • Which organizations should I join?

    As well as the BC College of Family Physicians, there are a number of organizations that will be helpful to you as you go through your residency and transition to practice.

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    The descriptors below focus on some of the services recommended for residents by residents. For more information on the mandate and full range of services for each organization, click on the web links. In some cases, residents have either free or preferred rates for membership.

  • Awards and Honours

    Take note of some of the awards and honours open to you during your residency. If you are successful, awards can provide you with financial support as well as recognition of your commitment to family medicine.

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    BC College of Family Physicians (BCCFP)

    • The BCCFP provides financial awards to a fourth-year UBC medical student entering UBC Family Practice and to residents in the UBC Family Practice Residency Program:
      • $5,000 BCCFP Resident Leadership Award – awarded to a UBC Family Practice R2 graduating from the UBC Family Practice postgraduate program
      • $1,000 Dr. Manoo and Jean Gurjar Award, BCCFP Family Medicine Resident Scholarship – awarded to a male and a female resident in the UBC Family Practice Residency Program
      • $1,000 BCCFP Medical Student Scholarship – awarded to two fourth-year Medical Students entering the UBC Family Medicine postgraduate program

    For more information and how to apply, please click here.

    CFPC Family Medicine Resident Awards

    UBC Family Practice Residency Program

    • Visit the UBC intranet for an updated list of all honors/awards.

    CMA Young Leaders Awards

    • The CMA offers medical student, resident and early career leadership awards. These exemplary leaders are recognized for their commitment to one of four domains including: political, clinical, research or educational .
    • Check out this link for more details and application information.

    Compiled July, 2015

  • Transition to practice: Tips and helpful resources

    As you transition from resident to practicing family physician, this page will help you find a host of useful resources ranging from billing information to education resources.

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    Tip: When doing a locum make sure you ask if the practice is an “Attachment participating practice” if so, have the billing manager submit an Attachment Locum code for you so that you are able to bill these fees .

    UBC Postgrad Medical  Education: Transition to Practice

    Transitioning from being a resident to an independent clinician is an exciting time, but there are a number of practical considerations to take into account before you can successfully get out and practice.  This site is a resource that you can access at any time during your residency training.

    Canadian Medical Protective Association (CMPA)

    One of the most difficult things about transitioning into practice is dealing with situations that might be beyond your comfort level. Never hesitate to call the Canadian Medical Protective Association (CMPA) if you have a question or concern about a clinical encounter. When you call, you will speak to a physician about your situation not a lawyer.

    General Practitioners Services Committee

    This is a partnership between Doctors of BC and the Ministry of Health that offers:

    Practice Support Programs (PSPs):

    • Offers fantastic physician directed learning modules on a variety of topics (MSK, mental health, group medical visits etc.)
    • Be sure to ask your preceptor if he/she participates in PSP modules.
    • Did you know? Physicians are actually compensated for their time to participate in these learning modules and implement specific changes if needed.
    • To find out a course schedule in your community, check the web link above.

    GP for Me

    Be aware of the GP for Me or “Attachment” initiative, which helps to increase access to primary care with the goal of providing every patient in BC with a family doctor including:

    • Creation of the Attachment Fee Codes
    • Billing for unattached/high needs patients/frail/complex care
    • Billings for telephone visits, case conferences

    Divisions of Family Practice

    Created from a partnership through the Doctors of BC, the Ministry of Health and local Health Authorities, these provide a local voice for family physicians in each community.

    • They are focused on: the GP for Me initiative; providing local CME; engaging and supporting local physicians; and creating cohesive solutions to community based challenges.
    • As a resident you are automatically a part of your local Division. Be sure to contact the Division administrator to ensure you are on their email list.
    • All physicians and residents have access to UpToDate® FOR FREE through the Division portal.
    • Don’t shy away from opportunities to attend Division events like GP for Me related initiatives. This is a great way to engage with your local community and advocate for family medicine.

    Pathways BC

    This is a Divisions of Family Practice based program, a web based resource to streamline and optimize referrals, as well as a rich collection of physician and patient resources. Contact your local Division to obtain your free access code. You will find:

    • Specialist information: How many times have you been asked, “How long will it take me to see that specialist?” or “Can’t you get me in quicker?” Pathways has up-to-date information about specialists that is organized by region, special interest and, most importantly, wait times!
    • Physician and patient resources that are continually updated by a team of experts. Resources include handouts and videos that can be directly emailed to patients if needed.

    Society of General Practitioners of BC (SGP)

    This is the political voice of BC family physicians, advocating for family physicians at the Doctors of BC, GPSC, and focused on fair economic remuneration for family physicians. Successes have included: billing fees for phone consultations, conferences and specialist consultations; chronic care bonuses; and attachment initiative fees. Join while you are a resident to take advantage of these services:

    • Billing resources – you will quickly learn that one of the most challenging things learn is billing, especially as new fee codes get developed. The SGP online billing resource makes your life easy by organizing all codes into pertinent sections (i.e. office procedures, out-of-office codes etc.) and keeping information up-to-date and current.

    Compiled July, 2015

  • Education: Conferences

    Attending conferences is the best way to increase your medical knowledge, discuss new trends in primary care and meet new people sharing the same enthusiasm for family medicine.

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    Take advantage of your education leave negotiated with your Collective Agreement! Here are the top six medical conferences recommended by our panel of residents.

    St. Paul’s Hospital CME Annual Conference for Primary Care Physicians

    • Conference extends over a four-day period in Vancouver, taking place during the month of November

    Family Medicine Forum (FMF)

    • This popular national convocation organized by the College of Family Physicians of Canada (CFPC) takes place yearly in November.

    BC College of Family Physicians Spring and Fall Conferences

    • The BCCFP organizes two weekend conferences yearly, typically taking place in Vancouver, and videos from the conference presentations are posted within the members’ section of the BCCFP site.

    UBC CPD Practice Survival Skills

    • Awesome annual course taking place in June in Vancouver, specially designed for residents and physicians new to BC.

    Topics covered are less about medical knowledge, but more about practice management issues.

    Rural and Remote Medicine Conference

    • Fun annual conference organized by the Society of Rural Physicians of Canada (SRPC)
    • More than 150 seminars, small group sessions, and hands-on workshops offered, with a focus on rural family medicine approach
    • Location of the conference changes each year

    UBC Postgrad Review in Family Medicine

    • Comprehensive three-day review course taking place each February in Vancouver

    Compiled July, 2015

  • Education: Earning your CFPC credits during residency

    In order to maintain your CFPC standing, you need to accumulate enough continuing education credits, so it's good to know that you can start earning credits during residency.

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    The reporting system for this is called MAINPRO®, which is administered by the College of Family Physicians of Canada (CFPC). It will be changing in 2016 to include easier reporting tools and more practice activities eligible for credits.

    Why does this matter to you?

    Do you plan on going to morning rounds? Or perhaps to the BCCFP conference or FMF? All of these activities will earn you credits. Why not start collecting them during residency!

    What do you need to know?

    You can transfer a number of credits from your residency. Therefore, keep track of any continuing education you do (e.g. conferences) and be sure to report them on the CFPC website

    The Bottom Line

    Most residents don’t even know about Mainpro. By reading this section you are one step ahead! Get more informed by visiting the CFPC site to learn how Mainpro works for you and how to report your activities. Remember to keep track of all your continuing education (i.e. conference certificates).

    Compiled July, 2015

  • Education: Exam hints and tips

    When it comes to exams, hints from your peers with firsthand experience can help you prepare for the various exams required along the journey to CFPC.

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    The CFPC Examination

    You have a lot on your mind right now as you enter the first few weeks of your residency program… thinking about exam preparation is probably not at the top of your list! This section is broken down into what you need to know for the exam during your R1 and R2 year.

    Harmonized versus de-harmonized

    The CFPC examination was formerly harmonized with the MCCQEII, which meant that residents would write a three-day exam. Two days were spent writing the CFPC portion and one day would be dedicated to the OSCE. Now, the exam has become de-harmonized. This means that R2s will write the OSCE component in the fall and the CFPC portion in the spring of their graduating year.

    SAMPs? SOOs? What does this all mean?

    SAMP: Short Answer Management Problems

    • A six-hours computer-based written component
    • A case will be presented and three to four follow up questions will follow each scenario

    How to best prepare?

    In your R1 year:

    • Familiarize yourself with: Priority topics and key features in family medicine (also called the “99 topics”) These can be found here.
    • Study Tips:
      • Organize Academic Half-Day presentations around the “99 topics”
      • Start early in studying and collecting a database of all current Canadian guidelines (Note: you might be familiar with provincial guidelines but as this is a national exam you should know Canadian guidelines.)

    In your R2 year:

    • Practice, practice, practice! The CFPC website has practice SAMPs available, as do many of your program offices
      • Study Tip: As with any exam, READ THE QUESTION CAREFULLY. Many answers just require one word or a short phrase… you don’t need to write paragraphs!
    • CFPC Self Learning: as noted above, log onto the CFPC website and access the Self Learning program. Many of these have two to three practice SAMPs at the end of the multiple choice section.

    SOO: Simulated Office Orals

    • Designed to simulate the office environment and a typical patient-physician encounter.
    • The marker here is actually a physician trained to act out a particular scenario.
    • Every SOO has a presenting problem (the chief complaint that the physician will disclose to you at the beginning) and also a secondary problem that you must discover through the interview.
    • You are responsible for providing a diagnosis for both problems and a management plan.
    • More importantly, you must explore the psycho-social constructs and how they influence the health problems.

    How best to prepare?

    In your R1 year:

    • Watch the SOO demonstration videos on the CFPC websites – this is very helpful to get a sense of what is required.
    • Volunteer to be an actor – as your R2 group starts to study volunteer to be an actor so that you can read various case presentations and have an understanding of the marking scheme.

    In your R2 year:

    • The CFPC website has a database of past SOOs – start practicing early on in your R2 year
    • Practice SOOs for “real life” – have a timer in your family practice office to get used to what 15 minutes feels like. Also, practice ‘FIFE’ing all your patients – you will be amazed at what you can find out!
    • Tip: Don’t rush over the psychosocial component. Lots of marks are given for integrating the patient’s personal circumstances and how they influence the presenting complaint. Develop a set way of asking these questions. Some residents use the acronym FIFER.
      • Family
      • Interests/hobbies
      • Friends/social supports/relationship
      • Employment
      • Religion
    • Always think about red flags, including:
      • Driving, if there is a history of seizure disorder, alcohol/drug abuse etc
      • Are minors involved (e.g. in cases of domestic violence)
      • Is there any danger to the patient or public (e.g. need to break confidentiality and/or certify the patient)

    OSCE (MCCQEII)

    • Finally an exam format you are familiar with – the OSCE!
    • Thankfully (or not) we have all had to write numerous OSCEs throughout medical school and have hopefully figured out how to pass them.
    • Now that the exam has become “de-harmonized” – residents will write a two-day (versus the one-day) OSCE.

    How best to prepare?

    In your R1 year?

    Check out the Medical Council of Canada (MCC) website on Exam Preparation.

    Pay particular attention to these two links:

    • Common mistakes made on OSCE stations
    • Preparing for the OSCE station format and examples of OSCE stations

    Check out the “Candidate orientation presentation.”

    Later in your R1 year/Early R2 year?

    Remember you will likely be writing this exam in the fall of your R2 year, so start preparing in the second half of your R1 year:

    • Start a study group.
    • Gather OSCE scenarios or cases. Use books like “The Edmonton Manual,” which is divided up into various specialty sections with multiple OSCE scenarios and marking schemes.
    • Know your weaknesses – whether it be trauma-related stations, physical exam stations or even counseling a patient. Communicate these with your preceptor and use your time in the office to improve these skills .

    Exam Tip

    Get to know the SELF LEARNING program on the CFPC website. At the end of the multiple choice questions there are often two to three SAMP style questions, which are great additional practice.

    Compiled July, 2015

     

  • Wellness: Start early, stay well

    If you have successfully made it through medical school, you already know the meaning of stress, pressure and the incessant need to multi-task! Residency will bring about a new set of opportunities, expectations and challenges.

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    We all know how to talk to our patients about “work-life balance” but how often do we practice what we preach? This section will give you some of the tools that you may need to be successful.

    Early in Residency

    Find yourself a family doctor if you don’t already have one!

    It can be difficult especially if you are completing your residency in a smaller town to find a physician that you are not working with directly. Be sure to talk to your site director and site administrator if you are unable to find a physician for yourself.

    Communicate

    If you have a pre-existing medical condition that requires you to take time off for specialist appointments, be sure to let your site director and site administrator know early on.

    De-stress!

    How do you like to unwind and relax? Is it through exercise? Listening to music? Hanging out with a good friend? If you have never tried yoga or meditation, residency might be a time to explore these fantastic ways to de-stress.

    Compiled July, 2015

  • Wellness: Online tools and apps

    When you have a busy schedule, wellness apps can help you look after yourself as well as your patients.

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    Down-load the MindShift App

    This FREE app is gaining a lot of popularity for its great tools and ease of use. Designed to help adolescents with anxiety, it includes guided meditation, breathing and body scan exercises that can be beneficial for anyone to do.

    Download the MindShift App

    My Yoga online

    Making it out to a yoga class can be difficult (and expensive) so why not practice from home?

    This website allows you to do exactly that with access to hundreds of yoga, Pilates, meditation and other restorative practices. You can typically get one or two months for free as a trial and then membership is as little as $5 to $10 per month!

    Download My Yoga online

    Other great “health and wellness” websites and apps

    get.gg: A great website for free cognitive behavioral therapy resources

    moodgym: Another great website for free cognitive behavioral therapy

    Apps:

    • MINDBODY Connect – an app that helps you connect to everything “wellness” in your community. Whether it be local group fitness, yoga or dance classes or a great nearby spa, this app has you covered
    • SleepBot – ever wonder how much sleep you are actually getting? Sleepbot is a complete sleep tracker including a smart alarm to help wake you up at the best time each day

    Compiled July, 2015

  • Wellness: Resident in Distress

    The UBC Department of Family Practice Post-graduate Program website contains important information for residents in distress.

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  • Wellness: Seeking professional help

    Feeling like it is all too much? Feeling overwhelmed is not unusual so you are certainly not alone. The key is knowing where to turn to.

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    If you do not have a trusted partner, friend or family member that you can confide in, you can always speak to your family doctor.

    It is important that you communicate early on with your preceptor, site director or site administrator if you are struggling. There are many things that can be done to support you. Whether it be moving up your vacation, reducing your work load or even taking a leave of absence.

    Physician Health Program (PHP)

    The PHP is a completely confidential program that offers support and referrals for various personal and professional problems. These include: substance use disorder; workplace conflict; mental health and burn out; relationship stress; and concern for colleague.

    You will speak to an intake worker and then a physician who will help advise you on the best course of treatment. The PHP has a network of phenomenal clinical counselors in various communities. The PHP also offers support for all BC physicians, residents, medical students and their immediate family.

    All information including personal and health information and the fact that you even called the PHP is kept strictly confidential. Contact the PHP through the 24/7 phone line at 1-800-663-6729 or online.

    The UBC Resident Wellness and Resiliency

    If you are asking yourself “where should I turn?” the brochure Resident Resiliency – a Guide for Residents provides a host of resources.

    Know your rights

    The UBC Family Practice Residency Program has policies in place to ensure that residents feel they are safe. These cover issues such as: unsafe travel to and from clinic; exposure to infectious agents, environmental toxins or radiation; risk of verbal, physical, sexual assault; and walking alone after hours between the hospital and your vehicle.

    Compiled July, 2015

  • Clinical Resources: Point-of-care tools

    Residency promotes learning autonomy. As a resident, you will be faced with daily clinical questions, and you will quickly become an independent learner. This list of useful clinical resources can help.

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    UpToDate

    • This is the most widely used point-of-care medical resource.
    • It includes access to Lexi-comp drug monographs, which is a great tool for new prescribers.
    • You should not need to subscribe to UpToDate, as it is usually available through hospital networks, and can also be accessed through your local Division of Family Practice.

    CPSBC

    Become familiar with the College of Physicians and Surgeons of BC online library, which has an exhaustive list of loan materials that can be requested by mail.

    We found that the most useful clinical tools available through CPSBC are:

    • Audio Digest – a subscription to Audio Digest is free for CPSBC members. Audio Digest produces high-quality CME audio programs for physicians. Why not download lectures on your MP3 player or iPod?
    • ClinicalKey (formerly MDConsult) has an impressive core collection of Elsevier e-books and e-journals, accessible for free when you log in through your CPSBC website. They also have a great searchable section for patient education pamphlets.
    • BMJ Best Practice is another excellent point-of-care resource. Download the BMJ Best Practice app (available on iOS and Android devices), which is very similar to Epocrates. Information is arranged with drop-down menus for ease and speed of use. The “treatment details” subsection for each medical condition is particularly handy. The app contains almost 1,000 modules.

    Canadian Medical Association (CMA)

    Logging in through the CMA website gives members access to some resourceful clinical tools. The most useful tools are:

    • POEMs : You can subscribe to receive daily POEMs emails, which review evidence-based articles on relevant clinical questions.
    • RxTx Mobile app: a new tool is the downloadable, which provides CMA members with access to the Canadian Pharmacists Association’s Compendium of Pharmaceuticals and Specialties – which is the best resource for Canadian drug monographs. It has convenient subsections on most common side effects and approximate Canadian monthly costs for each prescription drug.
    • AccessMedicine: provides online access to medical textbooks across all major specialties.
    • ClinicalKey: also available through the CPSBC website
    • DynaMed: is another point-of-care tool that provides evidence-based summaries on diverse medical conditions and symptoms. It includes a wide variety of medical calculators.Downloadable app is available on iOS and android mobile platforms.

     Compiled July, 2015

  • Clinical Resources: Online learning

    With many resources available online, recommendations from your peers can save you time and help you find the information that's invaluable to resident learners.

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    Canadian Medical Practice Association (CMPA )

    The CMPA website has eLearning activities and modules of great interest for learners (e.g. anatomy of lawsuit, informed consent, documentation, etc.).

    • An entire section “Good Practices Guide” is dedicated for medical students and residents. It describes ways to reduce medico-legal risks and explain key concepts and good practices within our health care system.

    McMaster Modules

    • The McMaster modules are free for medical residents.
    • Great resource if used within learning groups of family physicians or residents. Groups meet typically for 90 minutes to discuss the educational module content chosen.
    • An entire library of over 70 topics can be accessed through their website.
    • Modules give an opportunity to discuss with colleagues and implement change in your medical practice.

    Alberta College of Family Physicians (ACFP) – Tools for Practice

    • Sign up for free for this useful biweekly short summary of medical evidence on a specific clinical question.
    • They have a focus on information that can modify family physicians day-to-day practice.
    • Website also contains an archive of previous summaries published.

    “This Changed My Practice”

    • Produced by the UBC Continuing Professional Development (UBC CPD), this monthly article focuses on the impact that various studies or clinical tools have had on their practice. The format is divided up into: “What I did before”, “What changed my practice” and “What I do now”. Topics are diverse and cover a wide range of specialties.

    Compiled July, 2015

  • Clinical Resources: Podcasts

    Podcasts are a great way to plug in, listen and learn while you are commuting or exercising.

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    Best science podcast – BS Medicine

    • If you haven’t listened this podcast yet, you should!
    • Presented by James McCormack (a UBC professor Professor with the Faculty of Pharmaceutical Sciences) and Michael Allan (a family physician working in Alberta), this podcast reviews the medical evidence of common pharmaceuticals and engages listeners by promoting critical thinking.

    Primary Care RAP Podcast

    • Over three hours of “crazy-good” audio CMEeach month if you have an annual subscription.

    Audio Digest

    • Not true Podcasts, but downloadable audio lectures
    • Available for free on the CPSBC library website for College registrants

    Compiled July, 2015

  • Clinical Resources: Apps

    New apps aimed at physicians and other health care professionals are launched almost every day. Here are some of our favourites.

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    Tarascon pocket pharmacopedia app

    • If you dislike Lexi-comp (through Up-to-date) or RxTx mobile (through CMA subscription), here’s another useful portable drug reference app.
    • A subscription for one year costs about $40.
    • It does contain unique Canadian trade names and drugs.

    Sandford antimicrobial app

    • The Sanford Guide to Antimicrobial Therapy is one of the best clinical references for treatment of infectious diseases.
    • There’s a good search function and the app contains huge amount info.
    • A subscription for one year costs about $30.

    Compiled July, 2015

  • Clinical Resources: Websites

    These recommended websites provide good sources of CME or tools that can help you care for and educate your patients.

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    Best science CVD risk calculator

    • Another great tool by the Therapeutics Education Collaboration (TEC) team
    • This patient-friendly website (available offline) illustrates cardiovascular risk factors in a way that makes sense for patients – a great tool to use with patients during clinical encounters.

    Sexuality and U

    • This website is an initiative of the Society of Obstetricians and Gynaecologists of Canada (SOGC) that aims to provide guidance and advice to help individuals develop and maintain a healthy sexuality.
    • Contains credible and up-to-date information and education on sexual health, STIs and birth control.

    Canadian ADHD Resource Alliance (CADDRA)

    CADDRA is a national Canadian alliance of professionals working in the area of ADHD.

    • It produces the Canadian ADHD Practice Guidelines – now in its 3rd edition – and assessment toolkits (available on their website).
    • CADDRA also maintains an eLearning portal, with a searchable database of educational materials on ADHD for the health professional.

    The Rourke Baby Record

    • The Rourke Baby Record is an evidence-based health guide for primary health care practitioners related to children in the first five years of life.
    • Indispensable standard tool for well baby/child care

    Motherisk

    • Essential resource for physicians doing obstetrical care
    • Relevant information available on their website about the risk or safety of prescription and over-the-counter drugs
    • Motherisk helpline number is a good number to keep close by

    Canadian Diabetes Guidelines

    • Health care provider tool, including screening algorithm and treatment recommendations
    • For the learners keeners, great video presentations and PowerPoint slides on the actual guidelines themselves

    MDcme.ca

    • Free online CME in a number of therapeutic areas (psychiatry, infectious diseases, paediatrics)
    • Modules cover relevant topics for family practice residents and family doctors.

    MDBriefCase

    • Free Canadian CME provider that produces numerous interactive and accredited learning programs.

    UBC CPD online learning

    • This has free interactive modules that include information of relevance for family doctors in BC, case scenarios, practical tools.

    Compiled July, 2015

  • Clinical Resources: Books

    Recommended books include a downloadable palliative care resource manual and a pocket primer for internal medicine.

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    Alberta Hospice Palliative Care Resource Manual

    Available as a PDF online

    Pocket internal medicine

    If you didn’t come across this small book during medical school, you should check it out:

    • To the point medical information in a pocket-size format
    • Designed for internal medicine residents, but still very much relevant for family practice residents

     

    Compiled July, 2015