The BC Cancer Agency’s oncology preceptorship program for family physicians was established to meet the education and training needs of doctors in rural communities. Of the more than 4,700 practicing family physicians in British Colombia, about 20 percent work in rural areas.
The program recognizes the front-line role physicians play in prevention, screening diagnosis, and treatment of cancer, particularly in rural communities. With the demand for cancer services increasing – a result of an aging population and more people living longer with the disease – the demand on family physicians to complement existing cancer care services is growing.
A survey conducted by the BC Cancer Agency (300 respondents) revealed that 69% of family physicians had a special educational interest or would like to develop their practice in oncology. About 32% said they would be willing to take time out of their practices to enroll in a preceptorship program.
“The program is part of the Agency’s overall cancer control strategy,” says Dr. Judith Pike, a clinical associate with the Agency and a curriculum developer of the Preceptorship Program. “Family physicians play an important role in providing education and follow-up care when patients return to their communities.”
The Agency’s goal is to have at least one family practitioner graduate from the program in every B.C. community with a population of 15,000 or more.
The eight-week program, conducted twice a year, accepts up to 16 physicians per year. An introductory week, offered at the Agency’s Vancouver Centre, consists of small group learning sessions, computer and Palm Pilot training, participation in educational rounds, and lots of hands-on experience in clinics.
The remaining modules, offered either in Vancouver at the Agency’s other regional centres in Victoria, Kelowna and Surrey provide additional instruction and training in chemotherapy, radiation therapy, pediatric oncology, and specific tumour sites (breast, lung, prostate, etc), how to keep up-to-date on the most current information and future advances, and how to teach others. Physicians can also tailor the program by spending a week receiving training in a specific area of interest, or acquiring skills particularly relevant to their community’s needs.
“Family physicians get to know and network with oncologists at the regional centres,” says Dr. Pike, “so they know who to call when they have a difficult case. They learn how to get the information and treatment protocols they need from the Agency’s website and how to be an effective facilitator in their community.”
The physicians in the Program receive a stipend and an allowance for travel and accommodation through the University of British Columbia’s Enhanced Skills Program. They also receive Royal College of Canada credits upon completion of the program.
So far, three family physicians from Salmon Arm, Fraser Lake and Smithers have graduated from the program and five others will finish in early 2005.
“Eventually, with more and more trained physicians, we would hope to see earlier diagnosis of cancer, decreased hospitalizations because family physicians are equipped to handle treatment complications, and more physicians participating in research programs at the Agency,” says Dr. Pike.
Dr. Bob Newman, a Family Physician from Dawson Creek, chairs the Preceptorship Program Working Group. “There’s a shortage of oncologists in B.C. and Canada, and family physicians can help fill in some of the gaps. We don’t expect family physicians to take on the role of oncologists, but they can receive training to provide core services in a safe, efficient and effective way. It’s better financially and emotionally for a patient to remain as close to home as possible when receiving care and the preceptorship program will help us do that.”
Dr. Biz Bastian, a family physician in Smithers, B.C., is one of the first graduates. While Smithers already has a chemotherapy clinic with two oncology nurses, the addition of a physician will allow for an expansion of services. “There’s a need to help patients better navigate through the system and to provide more pain and symptom management services,” says Dr. Bastian.
With sessional funding in place, Dr. Bastian works two days at the Smithers clinic, often receiving referrals from family physicians. She is able to conduct longer care sessions that fee for service physicians may find difficult to fit in a busy practice. But, Dr. Bastian stresses that her role is a complementary one. “I think of myself as an additional resource for both the patients and the physicians in the Smithers area,” she says.