There have been significant changes to and expansion of distributed medical education (DME) in the last dec­ade.[1,2] In response, the Professional Association of Residents of British Columbia (PAR-BC) struck a commit­tee to explore and report on DME in BC from the resident’s perspective.[3] An initial challenge to the committee was the lack of consistent language, and definitions were proposed.

Residents enjoy living and learning at distributed sites and identify with the socially accountable undertones of training in these commun­ities to address the misdistribution of human health resources and improve access to health care for marginalized populations.

They enjoy the focus on a generalist, hands-on approach to medicine, and greater autonomy. However, residents experience challenges including professional, academic, and personal isolation; balancing service and education; resolving conflict; and planning, organizing, and integrating into new communities and health care teams.

There is a lack of transparency, accountability, and forums for discussion about DME with key stakeholders. The challenges include deciphering the role and requirements of DME in postgraduate programs, as well as who assumes responsibility for a resident’s well-being and work conditions. While PAR-BC will maintain a standing committee to highlight and explore DME internally, we call on UBC, the Ministry of Health, and the health authorities to work collaboratively with PAR-BC to evolve the discussions and delineate accountability.

DME is a reality for all residents who train in BC. Given the expanding nature of DME it is imperative that the stakeholders engage in open, ongoing dialogue to provide clarity to residents, build on known strengths, identify challenges, and strive for solutions. These discussions will protect and improve residents’ learning experiences and well-being, and ultimately train residents in a context that prepares them to address the health care needs of the province.
—M.F. Masterson, MD
—A. Anawati, MD
On behalf of the Distributed Medical Education Committee of PAR-BC

References

1.    Research Universities’ Council of British Columbia. The Medical School Expansion: Interim Report (April 2003). Acces­sed 30 July 2012. www.rucbc.ca/publications/med_rpt.pdf [10].
2.    Bates J. Medical school expansion in BC. BCMJ 2008;50:368-370.
3.    Anawati A. Residency Snapshot: The distributed medical education experience at the University of British Columbia. Paper presented at PAR-BC Board of Directors’ Meeting; 18 January 2011. Vancouver, BC.