PGY-2 Family Medicine – University of Manitoba
ResidentNorthern Family Medicine University of Manitoba
January 2017
Printable versionAbout Me
I’m Stephen Cashman from the Northern Remote Family Medicine program in Winnipeg, Manitoba. I’m a PGY-2 and will finish my program in 2017. I studied medicine at the University of Manitoba after completing a bachelor of science degree in genetics at the University of Guelph in Ontario.
I think it all started with my love for travel and desire to see the world. Northern Remote is exciting, diverse, and brings me to parts of Canada I might never see otherwise. Family medicine is also great for people like me who can’t make up their minds about what they want to do for the rest of their lives but want to do a bit of everything. It’s also rewarding to work with marginalized populations within Canada to tackle health outcome disparity and discover the richness of indigenous culture.
Clinical Life
What does a typical day of clinical duties involve?
It varies a lot. Family medicine is only a two-year program, and a big chunk of the first year is spent in off-service rotations. In my program, the family medicine block time in PGY-1 is spent in the city of Winnipeg, and the time in PGY-2 is spent in a variety of communities in the North. PGY-1 time is similar to that of any other inner city academic family medicine clinic. PGY-2 time, however, is much more diverse as it includes a mix of clinic time, hospitalist work caring for inpatients, on call time for low risk obstetrics, and emergency time with patients who can fall anywhere within the CTAS acuity spectrum. The schedule below is from a week I spent in Yellowknife, NWT, that was divided between clinic, emergency, and time in a small indigenous community. Other weeks were spent on inpatient medicine or obstetric rotations.
What kinds of clinical rotations are required in your program?
Family medicine always involves a diversity of rotations. For the northern program, the family medicine time is divided between city and northern community time. In the northern remote program, we rotate through medicine CTU (inpatient), adult emergency, pediatric emergency, pediatric inpatient medicine, neonatology, obstetrics, orthopedic surgery, trauma surgery, palliative care, and ICU. We also do rotations in addictions and HIV medicine, work with allied health practitioners, and participate in longitudinal exposures in psychiatry.
What kinds of clinical rotations are required in your program?
Family medicine always involves a diversity of rotations. For the northern program, the family medicine time is divided between city and northern community time. In the northern remote program, we rotate through medicine CTU (inpatient), adult emergency, pediatric emergency, pediatric inpatient medicine, neonatology, obstetrics, orthopedic surgery, trauma surgery, palliative care, and ICU. We also do rotations in addictions and HIV medicine, work with allied health practitioners, and participate in longitudinal exposures in psychiatry.
Can you describe the transition from clerkship into residency?
I thought the transition was smooth. While it is more work than clerkship, residency is much more fun and satisfying. Having to get that Tylenol order signed at 3 am is really a huge pain. The minor things are quicker and easier to deal with, and for the major items, I’m still adequately supported. Going up north for PGY-2 was a big jump, though, as there is less support there than in the city.
What are your future practice plans?
Good question! I hope I will be able to practise in different clinical settings (e.g., clinic, emergency, inpatient) and still have time to be involved in organizational tasks. I’d like to split my time between a city and a northern or remote environment, and maybe do some international stuff, too. I’m still figuring this out. I’ll probably do locums for a while to get a sense of the diverse range of Northern communities before I settle down, and might split my time between the North and a southern urban center.
What are your fellow residents like and how do you interact with each other?
They are a great bunch of people – really collegial, funny, and easy to get along with. I’m a pretty easy-going guy, but I’ve definitely met some people over my medical career who rubbed me the wrong way. None in the northern program, though – a great bunch!
Non-Clinical Life
What are your academic interests (e.g. leadership activities, research)?
I have been very involved with organizational work over the last few years (with RDoC, among others) and really value this aspect of my career. I am not very heavily involved in research yet, but will do a quality assurance/quality improvement project during my residency.
What is your work-life balance like, and how do you achieve this?
I’ve been very involved with organizational work over the last few years (with RDoC, among others) and really value this aspect of my career. As a PGY-2 I’ll be doing a quality assurance/quality improvement project during my residency. The North is an untapped place to do research. So much of the research that guides our decision making is done in urban academic centers with populations very different from those you might see in Northern Canada!
