Clinical Services

Our clinical service delivery areas are multidisciplinary and span the entire province of British Columbia.

We will collaborate with you in the care of your patients. We can help connect patients to General Internal Medicine (GIM) physicians and medical services, provide information on GIM-related clinical trials, and answer any questions you may have.

Patient appointments are scheduled Monday through Friday from 8:00 AM to 5:00 PM PST at each site. Consultations with GIM physicians are also available during these hours.

We offer several ways to refer patients. Priority is given to patients with urgent medical or surgical needs. Non-urgent medical issues are scheduled several days to several weeks in advance.

Vancouver General Hospital

Located at Vancouver General Hospital, the Internal Medicine Rapid Access Clinic provides consultation with an internal medicine physician to diagnose a variety of complex medical conditions. After diagnosis, patients can be referred to other specialist services. Appointments must be arranged through a physician.
Referral Form (PDF)
Phone: 604-875-5181
Fax: 604-875-5906

Division members, who are hpertension specialists with American Board Certification, operate clinics for resistant hypertension at clinics at both St. Paul's Hospital and Vancouver General Hospital to optimize blood pressure measurement and management for patients whose blood pressure has been challenging to treat. Poorly controlled hypertension is associated with substantial morbidity (renal, cardiac, stroke), acute care use with ED visits and hospital admission for hypertensive emergency and urgency, and premature mortality. Hypertension specialists in the Division employ motivational interviewing techniques to improve adherence to medications and focus on lifestyle interventions in addition to pharmacologic treatments.
Referral Form (PDF)
Division Members: Nadia Khan, Biri Mangat, Laura Kuyper, Jane McKay, Debbie Rosenbaum, and Karen Tran, Jesse Bittman

With their advanced training in Perioperative Medicine, Division members are working with Anaesthesia to implement a standardized approach to better identify and manage patients with myocardial injury after non-cardiac surgery (MINS). MINS occurs in 8% of patients (only 16% symptomatic) and is associated with a ~10% mortality rate at 30 days and 20% composite endpoint (mortality, CHF~9%, stroke). Members are also working with Cardiology and Anaesthesia regarding the best monitoring strategy and follow-up—in-hospital and as outpatients—to improve patient outcomes.
Referral Form (PDF)
Division Members: Iain Mackie, Erin Morley, Zach Schwartz, Erin Sloan, Terence Yung, Steve Ham

St. Paul’s Hospital

The purpose of the Post-COVID-19 Recovery Clinic is to provide access to care, services, and education for people who have had COVID-19. The clinic provides care through a novel mix of on-site and telehealth-enabled clinics that allow for multidisciplinary engagement with patients, their GP’s, an allied health team, and a network of subspecialists.
Referral Form (PDF)
covidrecoveryclinic[at]providencehealth.bc.ca
Phone: 604-806-8037
Fax (referral forms): 604-806-9057

Located at St. Paul's Hospital in downtown Vancouver, non-emergency patients are discharged and referred to the General Internal Medicine Clinic until the end of treatment. The clinic also takes in referrals from doctor's offices or walk-in clinics.
Referral Form (PDF)
Phone: 604-806-8735
Fax: 604-806-9057

GIM faculty members have expertise in managing the medical complications of patients at the Eating Disorders Program, a tertiary province-wide program housed in Mental Health at Providence Health Care. These patients are very complicated medically and challenging to manage.
Division Members: Ric Arseneau, Jane McKay, and Debbie Rosenbaum 

Division members, who are hpertension specialists with American Board Certification, operate clinics for resistant hypertension at clinics at both St. Paul's Hospital and Vancouver General Hospital to optimize blood pressure measurement and management for patients whose blood pressure has been challenging to treat. Poorly controlled hypertension is associated with substantial morbidity (renal, cardiac, stroke), acute care use with ED visits and hospital admission for hypertensive emergency and urgency, and premature mortality. Hypertension specialists in the Division employ motivational interviewing techniques to improve adherence to medications and focus on lifestyle interventions in addition to pharmacologic treatments.
Referral Form (PDF)
Division Members: Nadia Khan, Biri Mangat, Laura Kuyper, Jane McKay, Debbie Rosenbaum, and Karen Tran, Jesse Bittman

Dr. Gil Kimel, Physician Program Director of Palliative Care at PHC, attends on the Palliative Care ward at St. Paul's Hospital, where he has been successful in building a healthy relationship with the CTU.

With their advanced training in Perioperative Medicine, Division members are working with Anaesthesia to implement a standardized approach to better identify and manage patients with myocardial injury after non-cardiac surgery (MINS). MINS occurs in 8% of patients (only 16% symptomatic) and is associated with a ~10% mortality rate at 30 days and 20% composite endpoint (mortality, CHF~9%, stroke). Members are also working with Cardiology and Anaesthesia regarding the best monitoring strategy and follow-up—in-hospital and as outpatients—to improve patient outcomes.
Division Members: Iain Mackie, Erin Morley, Zach Schwartz, Erin Sloan, Terence Yung, Steve Ham

Two Division members with advanced training in thrombosis developed the Thrombosis Clinic at St. Paul’s Hospital. The vision is to provide exceptional and readily accessible patient care that improves the quality of life for people with thromboembolic disease. The clinic provides urgent assessment and follow-up to patients discharged from the emergency department, urgent primary care centre and inpatient wards. The clinic also accepts referrals from family physicians and nurse practitioners in the community. Common reasons for referral include long term management of deep vein thrombosis (DVT)/pulmonary embolism (PE), treatment of venous thromboembolism in unusual sites, bridging anticoagulation for procedure and management of post-thrombotic syndrome.
Referral Form (PDF)
Division Members: Anna Rahmani and Tony Wan

The Vascular Medicine Clinic provides rapid and comprehensive Internal Medicine care for patients with or at risk for vascular disease. We focus on evaluation and management of sub-optimally controlled vascular risk factors, incidental atherosclerosis found on imaging, demand ischemia/ type 2 MI in multi-morbid patients, and myocardial injury after non-cardiac surgery (MINS).
Referral Form (PDF)
Division Members: Peter Chen, Steve Ham, Biri Mangat, Debbie Rosenbaum, Terence Yung 

BC Women’s Hospital

Division members participate in this multidisciplinary clinic that provides care for patients with Chronic Lyme-Like Syndrome, Fibromyalgia, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Multiple Chemical Sensitivities. Treatment choice takes patient preferences into account, and treatment plans strive to incorporate components of self-care. Vital to the process is development of a partnership with the patient, and facilitation of patient involvement in assessment and treatment decisions.
Division Members: Ric Arseneau, Jane McKay

Faculty work at BC Children and Women's Hospital at this clinic as well as in the CTU at St. Paul's Hospital and in an OB Internal Medicine Clinic at the Internal Medicine Clinic at St. Paul's Hospital. Members also provide outreach clinics at Surrey Memorial Hospital (SMH) weekly.
Division Members: Tessa Chaworth-Musters, Sue Purkiss, Wee-Shian Chan (BCWH, SMH), and Jayson Potts (BCWH and SPH)

Community Health

Dr. Trudy Nasmith is providing a weekly clinic for this patient population who frequently have undiagnosed and unmanaged medical conditions.

A number of Division members regularly do outreach to underserved communities in northern BC (Hazelton, Bella Coola, Smithers, Terrace) and in Yellowknife, NWT. Dr. Marie Pierre Dallaire has worked closely with Dr. John Pawlovich (Family Medicine) and Dr. Terri Aldred to build relationships with First Nations communities. She and others are using telehealth to communicate and follow up with the patients and the staff in these places. Dr. Denise Jaworsky,  recent GIM graduate, was recently hired in Terrace (Mills Memorial Hospital) where she will continue to collaborate with the group on providing outreach and longitudinal care to these patients.
Division Members: Marie Pierre Dallaire, Trudy Nasmith, Dave Sohi, Stephane Voyer, James Tessaro

Division members from Vancouver General Hospital participated in the Ravensong Community Health Centre pilot and continue to spend a half day per week seeing patients and doing case conferences with complex patients and the primary care team (sessional payment). Dr. Debbie Rosenbaum has regular clinics at the Portland Hotel and the Pennsylvania Hotel with family physician Dr. Christie Sutherland—which has been successful in terms of providing access to specialist care to patients who are hard to reach. Division members also provide Internal Medicine outreach ½ day every 2 weeks to Three Bridges Community Health Centre.
Division Members: Cary Cuncic, Harp Nagi, Marie Pierre Dallaire, Trudy Nasmith, Debbie Rosenbaum, Penny Tam, and Peter Weerasinghe