Associate Physician, Cardiac Surgery

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Within the context of a client and family centred model of care and in accordance with the Mission Vision Values and strategic directions of Providence Health Care (PHC) the Associate Physician (AP) Cardiac Surgery serves as a physician extender to provide care to inpatients in the Cardiac Surgery Program. On a day-to-day basis the AP will perform services within the scope of an APs clinical duties and responsibilities while under the supervision of the Cardiac Surgery MRP but is accountable to the Lead Physician or documented delegate for the overall provision of quality of care and professional development. The AP supports the provision of continuous cardiac surgical care in a team-based environment working collaboratively with the MRP Residents nurse practitioners and nursing and allied care providers to care for cardiac surgical patients as assigned throughout the AP will have demonstrated ability to communicate effectively and excellent interpersonal skills with the ability to work within a team and to build relationships with other health professionals and disciplines. The AP also will have demonstrated ability to document in accordance with the College of Physicians and Surgeons of British Columbia (CPSBC) and organizational standards policies and guidelines.

Organization
St Pauls Hospital is a full-service adult tertiary acute care teaching and research hospital located in downtown Vancouver. It is home to many world-class medical and surgical programs including heart and lung services HIV/AIDS mental health emergency critical care kidney care and elder care.

Education:

• Medical degree from a school listed in the World Directory of Medical Schools. Minimum of one (1) year of accredited postgraduate training as a medical or surgical specialist verified by the CPSBC. Successful completion of Part 1 of the Medical Council of Canada Qualifying Examination (MCCQE) or Steps 1 through 3 of the United States Medical Licensing Examinations (USMLEs). Must meet the CPSBCs English language proficiency requirements.
• Must be eligible for registration with the CPSBC in the AP class under sponsorship by PHC.
• Must hold Canadian Citizenship be a permanent resident or be legally able to live and work in British Columbia. Qualified candidates will hold or achieve Advanced Cardiac Life Support (ACLS) certification prior to commencing orientation and will maintain such certification throughout their employment.

Skills and Abilities:

• Knowledge and skills to diagnose and manage common medical and surgical problems in the perioperative cardiac surgical patient e.g. chest pain dyspnea volume overload hypertension arrythmias heart failure cardiac tamponade electrolyte abnormalities pain control delirium and common comorbidities such as diabetes and acute and chronic kidney insufficiency.
• Confidence and experience in recognizing and initiating response to emergency situations such as shock acute coronary syndrome stroke etc. Ability to recognize medical instability and address initial priorities of resuscitation. Able to judge situations where discussion and reporting to senior and most responsible physicians is appropriate.
• Excellent English communication including with patients families and other health care professionals.
• Computer and written communication skills including order entry clinical documentation and ability to review relevant diagnostic information and health history.
• Ability and comfort in working in a team-based environment.
• Ability to carry out professional duties in the face of multiple competing demands.
• Physical ability to carry out the duties of the position.

ASSESSMENT AND PROBATIONARY PERIOD
During a 12-week probationary period the AP will undergo assessment and evaluation of their competence to perform the duties in the intended specialty areas under a supervising physician. The evaluation will include assessment of:

• Basic clinical skills
• Communication skills
• The ability and willingness to function as a member of a clinical team
• Specialized knowledge and skills applicable to the intended clinical placement
• Clinical decision-making and the appropriate use of clinical and diagnostic resources
• Clinical documentation
• Procedures required to function effectively within the team environment

Ongoing employment is contingent upon satisfactory completion of the probationary period and subject to a six-month and annual reviews.

Your Day to Day:

• Receives patient assignments primarily on the postoperative cardiac surgical ward according to decision of the multidisciplinary team.
• Participates in AM team rounds at 0730 with nursing CNL and resident and fellow team.
• Daily comprehensive patient assessment of continuing plan of care including relevant history and physical examination writing medical orders ordering diagnostic blood work and testing consultation with other services and responding to changing patient conditions in consultation with Cardiac Surgery MRP. Liaises with transferring CSICU MRP as necessary.
• Daily documentation of progress notes discharge summaries and medication reconciliation as per CPSBC and organizational standards policies and guidelines.
• Follows through on investigations in consultation with the MRP.
• Communicates with and responds in a timely manner to calls from the nursing staff and other care team members.
• Communicates with patients family members other consulting services and trainees concerning patient care plans as appropriate.
• Performs procedures within the scope of demonstrated competence which may include: performing phlebotomy for diagnostic purposes including arterial blood gases assessment of surgical wounds removal of chest tubes application of temporary pacemaker to existing transcutaneous temporary pacing wires removal of temporary pacing any and all of the above the AP will not proceed until full orientation and competence has been established with sign-off by the Division/Department Head and the Cardiac Surgical MRPs.
• Performs the following procedures where necessary to facilitate urgent patient care: insertion of peripheral intravenous lines initiation of intravenous medication insertion of Foley catheters insertion of naso-gastric tubes application or changing wound VAC and removal of surgical drains/clips/sutures.
• Participates in professional development activities (a minimum of 50 hours per year 25 hours of which must be accredited training similar to that recognized by the Royal College of Physician and Surgeons Maintenance of Certification Program for healthcare professionals.
• Attends clinical rounds morbidity and mortality rounds and other educational/research sessions.
• Participates in quality improvement projects relating to their patient or program.
• Complies with AP programs CPD reporting requirements.