Doc-to-Doc Guest Contributor: Dr. Nilanga Aki Bandara, Resident Board Member, 2025/26
As a family medicine resident training in Metro Vancouver, one of the most surprising challenges has been seeing how different primary care models can look. In medical school, “community practice” felt like a fairly uniform concept. In reality, Vancouver offers an incredibly wide spectrum of clinic models, payment structures, patient populations, and team-based care environments. While this diversity is exciting, it can also make the transition out of residency feel a bit overwhelming.
After practicing in different settings throughout my training — including longitudinal family medicine, urgent primary care, and walk-in clinics — I have started to appreciate how unique each model can be. Each setting felt rewarding in different ways, but also required very different trade-offs in workflow, autonomy, and scope. In longitudinal family practice, the emphasis on continuity and relationships stood out, while urgent primary care highlighted efficiency and time-sensitive decision-making. Walk-in clinics offered accessibility and variety, but with less continuity. Through these experiences, it became clear that “choosing a clinic” is really about choosing a practice environment that aligns with one’s values and preferred style of care.
What has helped reframe this challenge is learning about the Recruitment & Retention (R&R) program through the Vancouver Division of Family Practice (See more about the R&R team here: https://vancouverdivision.com/work-in-vancouver/#recruitment-retention).The R&R team supports residents and physicians at different stages of their careers by helping match individual preferences with practice opportunities. Their role includes providing information on available positions across Vancouver and helping clarify key considerations such as clinic location, remuneration models, team-based care options, and attachment opportunities for patients. Rather than expecting physicians to navigate a complex landscape by themselves, the program emphasizes finding a mutually good fit between physicians and clinics.
The key takeaway for me is that the abundance of choice in Vancouver’s primary care landscape is not something to solve alone — it is something to navigate with support and structure. For residents approaching practice decisions, early reflection on priorities, combined with available Division resources, can help turn an overwhelming number of options into a meaningful and intentional career choice.