Recruiting a doctor to set up a practice in a rural area is an issue the province has been dealing with for a long time, but the University of British Columbia (UBC) and the Southern Medical Program may have a solution.
In Trail, Kootenay Boundary Regional Hospital (KBRH) is the site for the Integrated Community Clerkship (ICC) where students can get a glimpse of small town medicine before they graduate and become practicing physicians.
When Rossland native and UBC medical student, Nichole Gill, was given the opportunity to study in the Kootenays, she jumped at the chance to come home.
Once her first two years of medical school were done, Gill was required to apply for a third-year clerkship at a hospital in the province. Through the ICC program, studying at KBRH was an option and she was picked for one of four spots in the 2014-2015 program.
“You had to apply to the program and then you rank your preference on where you wanted to go,” she said. “Trail was my first choice, and I was was really excited at being able to come back here.”
Having grown up in Rossland, Gill already knew about the long list of features the area has to offer, but had yet to experience medical education near her home community.
“I grew up knowing that I loved the area, especially all of the recreational activities, like skiing and hiking,” she said. “I love the community feel in a smaller town, so for me, coming back here this year, was all about learning what it was like to practice medicine in a small town and get a real look at what it would be like to do that in the future.”
Small-town medical training hasn’t been around the Kootenays forever. The program at KBRH, and five other hospitals across the province, was introduced in 2011, and has had a successful run for the last four years. Gill is an example of the program working the way it was planned.
“I have had such a great experience here that I can definitely see myself coming back here, or somewhere like it,” she said.
Part of what makes the rural medical education program so successful, at least from Gill’s perspective, is the personalized experience she gets on a day-to-day basis.
“There are only four of us, as opposed to various medical schools that have tons of students in various stages of medical training,” she said. “Because there are so few of us, we get to have the run of hospital. We get to do a lot of things that you might not get to do in a bigger hospital, just because they are busier and students aren’t necessarily always at the front of the line for who gets to do a procedure or who gets to go first. It is personalized.”
Dr. Cheryl Hume, ICC program director at KBRH, says the quality of education the students receive through the program is second-to-none.
“There is a lot of one-on-one mentorship with the students,” she said. “They get a lot of direct experience and they get to really know their teachers and their teachers can really help them learn and assess how they are learning.”
Working in a smaller community also provides Gill and the other students with the environment to get to know the patients she is treating and seeing day-to-day.
“There is a lot of opportunity to work with patients one-on-one,” she said. “That is the integrated part. We are here, interacting and getting to know people. We only have one half-day a week in a classroom environment, and the rest of the week, it is clinical learning time. It is definitely exciting to be out of the classroom.”
Dr. Hume sees the student-patient relationship as a huge plus within the ICC program.
“The most important thing, is that the students gets to see patients over the course of the year,” she said. “They really understand the patient care journey and how care can progress or how health and wellness progress instead of going in and seeing a patient once and trying to learn about a disease that way. There is that continuity.”
With the ICC program, Gill and her fellow third-year students, are in the process of taking different medical specialities for a test-drive in everything from surgery to family practice. Soon, she is going to have to pick a specialty to focus on, dictating the rest of her education and future career.
“We do a few weeks at a time in each specialty, then we rotate through them later in the year,” she said, adding that she is going to have a hard time coming up with a future specialty. “I liked aspects of all of my rotations, which is making it very difficult to decide what I am going to do next.”
One of the options Gill has for her fourth year of medical training is to apply for the brand-new UBC Rural Residency Program, launching this summer. The new program provides medical students with the opportunity to continue their studies in a small town setting, and hopes to attract doctors to small town life.
Dr. Hume says the new rural residency program is the next logical step for medical students already learning in a rural environment.
“We are taking students to the next level with this two-year training program we have built on top of what we have already done (with the ICC),” she said, adding that the program will be taking in its first four students this July. “This is where we get young future physicians exposed to rural medical practice. Especially if they were already here for a year in the ICC program, they would be here for two years after that in a rural environment.
“The chances of them returning to a rural environment to practice is much, much better. It will go a long way to fixing our physician recruitment concerns. It is all part of the big picture.”
For more information on the ICC or the Rural Residency Program, visit www.mdprogram.med.ubc.ca