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12 Southern Medical 15 An artifi cial 29 John Webb: Heart Program opens epidemic of valve replacement its doors ADHD pioneer UBC MEDICINE VOL 8 | NO 1 SPRING 2012 THE MAGAZINE OF THE UBC FACULTY OF MEDICINE Personality Transference Recovery PORT MOODY Serotonin BURNABY Gender COQUITLAM roles PITT MEADOWS Catharsis Culture shock PORT Care COQUITLAM Coping mechanisms NEW Identity WESTMINSTER Fraser River MAPLE RIDGE Fraser River Self-image EXTENDING MENTAL HEALTH TO THE SUBURBS Projection NEW RESIDENCY LURES ASPIRING AND SEASONED PSYCHIATRISTS TO FRASERAbuse HEALTH Sublimation LANGLEY Alienation Medication Psychoanalysis SURREY Crisis Cognitive DELTA Counselling behavioural Deinstitutionalization therapy Inclusion 12 14 10 FACULTY OF MEDICINE 06 UBC MEDICINE VOL. 8 | NO. 1 SPRING 2012 A publication of the University of British Columbia’s Faculty of Medicine, providing news and information for and about Message from the Vice Provost Health and Dean 03 faculty members, students, staff, alumni and friends. Focus on: The Fraser Health region Letters and suggestions are welcome. Contact Brian Kladko Extending psychiatric training – and care – to Fraser Health 04 at [email protected] A “Surrey boy” comes home 06 Editor/Writer Brian Kladko Royal Columbian: A history of clinical education 06 Contributing writers A new model for medical education – by way of Chilliwack 07 Libby Brown Anne McCulloch The Faculty of Medicine’s Fraser footprint 08 Ian McLeod Additional Research Research thriving in Fraser region 10 Melissa Carr Distribution coordinator Elizabeth Kukely A new window on patients’ personal struggles 11 Design The first wave: Southern Medical Program opens 12 Signals Design Group Inc. www.signals.ca Making hospitals healthier places 14 Online at http://med.ubc.ca/news/ Investigations and breakthroughs 16 ubc-medicine-magazine A dedication to solving hematology’s puzzles 18 The Dodeks’ multi-generational relationship with the Faculty of Medicine 19 New faculty members 20 Making a mark: Achievements and awards 22 Philanthropy news 24 Medical alumni news 25 DEAN’S GREETING UBC MEDICINE 3 MESSAGE FROM THE VICE PROVOST HEALTH AND DEAN Recognizing those who add value and meaning to our lives – Those contributions have been recognized by designating whether partners, family, friends or colleagues – is probably Royal Columbian Hospital and Surrey Memorial Hospital as one of the most neglected items on my “to-do” list. Clinical Academic Campuses, and designating the hospitals in Chilliwack and Abbotsford as Affi liated Regional Centres. I’m probably not alone in this regard. But as Dean of the Among our four geographically-based MD programs, we call UBC Faculty of Medicine, my list of recipients deserving the largest the “Vancouver Fraser Medical Program,” refl ecting recognition (and not always receiving it) is particularly long. how much time those students spend in Fraser Health sites. And as the Dean of this particular medical school, with its We have worked with Fraser Health to create full-fl edged elaborate web of partnerships across the province, my list might residency programs in Family Practice and Psychiatry, and be longer than those of my counterparts across Canada or the look forward to other regionally-based postgraduate training U.S. The distribution of medical education across B.C. has programs to be aligned with the needs of the population. required an enormous amount of collaboration and hard work by an ever-widening circle of people at academic institutions But that is surely not enough, and this issue of UBC Medicine and health authorities – a circle so wide, it’s hard to keep track of magazine is a modest attempt to honour and celebrate the vital them all. Our collective success is dependent on our partnerships. role that Fraser Health and other health care providers in that region are playing in academic medicine. We want the people Among those deserving recipients are the people of the Fraser of those communities to know it too, because it has paid Health region. Much has been made of our ambitious expansion dividends – expanded facilities, an infl ux of health care talent, to places far from UBC’s “home” in Vancouver – to northern B.C., and greater attention to the latest, evidenced-based medicine. Vancouver Island and now the Interior. But health care providers, support staff and patients in nearby towns like Surrey, Chilliwack, I have long been well aware of that mutually benefi cial relationship. Cloverdale and Abbotsford have been quietly, consistently and We want to make sure all of our stakeholders know it, too. conscientiously contributing to our educational and research enterprise. They set the stage for our wider expansion over Gavin C.E. Stuart, MD, FRCSC the past few years, and are helping make sure that it Vice Provost Health, UBC maintains momentum in the years ahead. Dean, Faculty of Medicine BURNABY COQUITLAM PITT MEADOWS Identity Sublimation PORT COQUITLAM Self-help NEW WESTMINSTER Fraser River Fraser River Self-image Cognitive behavioural therapy Transference Recovery SURREY Culture Defense mechanism shock DELTA LANGLEY Isolation Coping mechanisms Sanity Personality EXTENDING PSYCHIATRIC TRAINING — AND CARE — TO FRASER HEALTH It’s a Wednesday afternoon at the in-patient psychiatry unit of “He’s exhibiting some pretty serious symptoms of psychosis, but Royal Columbian Hospital, and UBC Clinical Assistant Professor we can’t quite say that this is schizophrenia at this point,” he says. Anson Koo is getting an update from resident Charlena Chan The diagnosis may be frustratingly elusive, and the path to on the ward’s current roster of patients. recovery uncertain, but C.N. offers a valuable learning experience Dr. Chan discusses a middle-aged female patient with depression. for Dr. Chan. She is in her second-year of a fi ve-year psychiatry “She always loops back to abuse from her mom as a kid, and how residency program, and must come to grips with the occasional it’s affecting her,” she says. “When she talks about her mom, she ambiguity in her chosen fi eld. becomes super-anxious and then self-isolating. She looks about Such learning experiences have become increasingly commonplace the same, but I think I understand now where her depression in Fraser Health, which created its psychiatry residency program is coming from.” three years ago to keep pace with the growing prevalence of mental Dr. Chan thinks she should be referred for outpatient cognitive- illness in Fraser Health – including depression, substance abuse, behavioural therapy. Dr. Koo, Division Leader of Fraser Health’s bipolar disorder, geriatric mental illness, and schizophrenia. Adult Mental Health Programs, agrees, and suggests assessing “We are undergoing a demographic explosion, and had the her after the weekend. second-lowest psychiatrist-to-population ratio in the province,” The next patient – let’s call him C.N. – is a young adult with says Dr. Koo, who also oversees academic psychiatry programs a history of sporadic drug use who exhibits a muted but in Fraser Health. “With a large cohort of psychiatrists preparing unmistakable paranoia. to retire, and ever-increasing needs for mental health care in Fraser Health, we needed a comprehensive, sustainable “He can hold it together for an hour interview,” Dr. Chan says. approach to physician recruitment. Training and educating future “But if you see him often enough and ask the right questions, psychiatrists within Fraser Health is a cornerstone of this strategy.” it comes out.” Fraser Health is not a newcomer to psychiatry residency training. Dr. Koo explains that there will always be murky cases Until 2009, the health authority trained residents for their fi rst like C.N.’s – where the patient’s symptoms don’t fi t neatly two years – after that, post-graduate trainees had to fi nd training into a diagnosis, whose scant medical record offers no clues, positions elsewhere. This meant losing potential psychiatrist recruits. whose accounts of his own behavior and illness aren’t reliable. Catharsis FOCUS ON: FRASER Counselling UBC MEDICINE 5 Projection MISSION Loneliness MAPLE RIDGE Care HOPE Individuation Psycho Medication analysis Fraser River CHILLIWACK L – R: Charlena Chan, a second-year Psychiatry resident, discusses patients ABBOTSFORD with Clinical Assistant Professor Anson Koo at Royal Columbian Hospital. Clinical Instructor Paul Sobey, Division Leader of Fraser Health’s Substance Alienation Use Program, discusses addiction treatment during resident rounds. Serotonin Psychiatry residents prepare for the Royal College of Physicians and Surgeons’ psychiatry certifi cation examination. PHOTO CREDIT: BRIAN KLADKO Now the UBC-Fraser Greater Vancouver Psychiatry Residency Health’s Mental Health-Substance Use Program Medical Director. Program, coordinated by Ambrose Cheng, the Assistant Post- “They now have an opportunity to be engaged in the educational graduate Program Director, has six new psychiatric residents enterprise and have contact with students and residents.” a year, each able to complete their training – and to care for As a result, the months-long waits for outpatient mental health patients – in the health authority’s wide array of hospitals, services are becoming increasingly rare, and patients can be residential mental health facilities, and outpatient clinics. offered specialized services. As word spread about the opportunities for aspiring psychiatrists, Another area targeted by Fraser Health is substance misuse – the demand for residency positions has risen. In 2012, applications a problem that is widespread in Fraser Health’s service area, more than doubled, and all six positions were fi lled in the fi rst despite being commonly associated with more urban areas round of the CaRMS residency match in March. like Vancouver’s Downtown Eastside. In response, Dr. Isomura, The growing number of psychiatry residents is attracting other, working with Paul Sobey, Division Leader of Fraser Health’s experienced psychiatrists drawn by the health authority’s growing Substance Use Programs, has created an elective in addiction academic profi le. Fraser Health has hired 45 new psychiatrists in medicine this year – the residency’s fi rst.

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