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Academic Aspects:

  • Preceptors:    Typically you work exclusively with Dr. Hamilton.  If he is signed out to another family med OB, you are free to continue to follow his patients with whoever is covering. 
  • Teaching: Service Ratio:    Dr. Hamilton gives you as much or as little independence as you're comfortable with.  If there's a case you are unsure about, and would like some teaching or extra direction around it, he happily provides it.  If, on the other hand, you're happy to manage things on your own, giving him updates along the way, he lets you run with it.
  • Other learners: Typically you are the only resident on service.

Location:

  • Practice Population:   Dr. Hamilton's low risk OB population consists of women who either don't have a family MD or their family MD doesn't practice OB.   He also covers the Family Medicine OB clinic at Victoria hospital - these patients are also a varied group without family physicians.  There is a strong immigrant population, as well as some women with socioeconomic challenges.     The palliative population that you will be doing housecalls on live within the London area.  They are a mixed bag - some highly educated, higher SES patients, and some of lower SES.  Of note: Dr. Hamilton always sees new consults before sending you to someone's home to ensure it is a safe environment for residents.
  • Community: London area
  • Accommodations: N/A

A Week in the Life:

Varies depending on personal objectives.  Dr. Hamilton has you create a list of goals/objectives at the beginning of the rotation, and tries to maximize your learning based on your specific areas of interest.  If you're more interested in OB, the palliative work will likely be lighter, and vice versa.

You may be involved in:

  • Low-risk OB clinics typically 1-1.5 hours long on most mornings. Start time usually 7:30 am
  • Coverage of the Family Medicine Women's Health Clinic occasionally either on Tuesday afternoon or Friday morning (only every few weeks)
  • 3-6 palliative care housecalls daily, depending on what else is going on that day
  • Dr. Hamilton covers the palliative care inpatient ward 12 weeks/year - if you are working with him while he is covering the ward, you may or may not round with the rest of the team, depending on a) your level of interest and b) how busy it is and whether they can use an extra resident
        • It may sound like a lot, but you will typically be finished your workday at 2-3pm ****
  • CALL: Call is extremely flexible.  Since you are the only resident on, you can choose which days you want to be on call.  Dr. Hamilton is on call most days for his own patients, and sometimes also for the women's health clinic.  Expectations are generally that you take 2 call shifts/week on weeknights, and 2 weekends of call over the course of your rotation.  Call is hit or miss. You may get called in 0-1 times on a weeknight, and probably a few times over the course of the weekend.  Call is home call and you are eligible for call stipends as per usual. PAIRO rules apply, and if you're in hospital past midnight, you are free to take the next day off.


Miscellaneous

  • OB volume is really good - expect to get >10 deliveries in a block
  • LOTS of hands-on and great opportunity to work on your technical and clinical skills
  • Lots of great opportunities to work on patient communication, breaking bad news, discussing end of life/goals of care
  • Doing housecalls is something that most residents get limited exposure to; this is a great opportunity to see what it is all about and to learn more about the strength and importance patient-physician relationship in this context.
  • Dr. Hamilton is great to work with - an enthusiastic teacher, lets you guide the way in terms of what balance you want between close supervision and independence, very easily reached and very willing to help if ever you have a question or concern, never belittles residents or utilizes shame-based learning.
  • Great for anyone looking to get good OB or palliative care experience.

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