December 16, 2016
Inside This Issue:
A Message From the CEO
At this time every year most of us start to reflect on the past several months and think about the opportunities, challenges, highs and lows that we've experienced. As a provincial physician recruitment agency, we’ve experienced many opportunities and challenges in 2016. We did so in collaboration with many partners, all of whom we’ll continue to work closely with in 2017.
While we do this work, changes to the provincial health care system continue to unfold. All of us want to recruit and retain the best and the brightest to deliver high-quality, safe and accessible health care through high-quality health care teams. This past fall, the provincial government appointed an Advisory Panel to review the structure of our health care system with the goal to achieve improvements in patient care, while finding administrative efficiencies. We do not know the outcome, but we can expect changes to improve our health system. At saskdocs, we will continue to work with existing and new partners to ensure we continue to attract the best and brightest to Saskatchewan.
This issue of saskdocs’ e-newsletter highlights some of the opportunities and challenges we’ve experienced, but also more about those remarkable individuals who continue to call Saskatchewan home.
You’ll read more about how both locally-trained and internationally-trained medical graduates are working together to make safe and high-quality health care accessible to people in rural, remote and urban communities. You’ll read about how one physician, originally from Prince Albert, travelled far and wide only to discover what she really missed – short commutes and a great team – were less than an hour away from where she grew up. Finally, you will also read more about how we’ve been working together with other western provinces to create a “wow” factor at select international career fairs. The Western Canada – Welcome Home exhibit has been around for several years now and continues to attract attention (and physicians) from far and wide.
Looking ahead to the next year, I’m confident there will be more opportunities than challenges. We’ll continue to recruit locally-trained physicians and help our partners assess and license internationally-trained physicians to deliver health care services to the people of this province.
While our recruitment efforts continue, we’ll also focus more on retention. By reducing turn-over and staff burnout, we’ll help employers and employees realize a more stable and sustainable work-life balance is the best recruitment tool to have in the tool box.
Season’s greetings from all of us at saskdocs and best wishes for a safe and prosperous 2017!
Physician Trained in US and Canada’s Big Cities Returns Home to One of the Best Jobs in the Country
Nicolette (aka Coco) Sinclair is a champion of Saskatchewan in many ways. She fulfilled one of her earlier dreams, which was to see the world, after graduating from high school in Prince Albert. Then she fulfilled her professional dream of becoming an interventional radiologist (IR) in Saskatoon, not far from where she grew up.
Sinclair’s road to becoming an IR in her home province wasn’t a short one. After graduating from Carlton High School, Sinclair landed a soccer scholarship at the University of South Carolina-Upstate, where she completed an Undergraduate Degree. After that, she graduated from the University of British Columbia (UBC) medical school, and then did five more years of residency training at the University of Saskatchewan (U of S). Sinclair decided to spend another year completing a post-residency fellowship to specialize her skills even more. She did this in Toronto at the University Health Network, where she learned more about IR before accepting a permanent position in Saskatoon.
“When I was completing my undergraduate degree, IR definitely wasn’t something I ever thought I would be pursuing. I knew I always wanted to be a doctor, but IR wasn’t even on my radar. But now that I am practising IR here in Saskatoon, I know I have one of the best jobs in the country – there’s no question!”
It wasn’t until long after she moved away from Saskatoon and her home province that Sinclair realized that what Saskatchewan has to offer is quite enviable.
“I must admit when I initially moved away after residency I thought I was going to love living in downtown Toronto. But, as great as my fellowship was, I was ready to leave. I found the city exhausting and impersonal. The training was excellent and I consider myself lucky to have had an opportunity to train there, but also felt very fortunate to come back to Saskatoon to practise. No one was more surprised at this decision than myself when I committed to coming back to Saskatchewan to work, but it was certainly the best decision for me professionally and personally.”
Sinclair likes that she is able to work with a great team of physicians, technologists and nurses on patients who come from all walks of life and truly appreciate the care they receive. IR brings non-invasive medical techniques together to intervene in a medical condition, saving the patient the potential side effects often associated with a major operation. Also, by using radiological imaging, the IR employs specialized surgical procedures to take a very localized image of a patient (e.g. artery blockage) and intervene with a specialized radiological procedure if need be (e.g. stent placement).
Sinclair is glad to be back in Saskatchewan and says her family is ecstatic that she’s back as well. She appreciates the learning and help she’s received along the way. But, when she adds up the work-life balance equation to her career and home, this just makes sense for her.
“Saskatoon is an exceptionally easy city to live in. I have a friend who commutes an hour and a half to work and an hour and a half home again. That is three hours in his car every day! My commute to work is 12 minutes. We may not have all the options for nightlife that Toronto or Vancouver offer, but I’ve been impressed with the changes I’ve seen here in the past few years with regards to restaurants, concerts, events and festivals. The people are amazingly friendly, which makes a huge difference to my daily life. It’s nice to go to the grocery store and have someone smile at you and say hello. You do not get that in Toronto.”
Sinclair loves the team of health professionals she works with and really likes being back home in Saskatchewan. She wouldn’t want it any other way and looks forward to championing the province and its opportunities to colleagues near and far.
Regina Students at the Heart of Conference Awards
Written by Amanda Woroniuk and originally published by the University of Saskatchewan’s College of Medicine - December 1, 2016
The Dean’s Summer Research Project has opened the doors to a love of clinical research
Danny Meyer and Abdalla Butt may be undergraduate students in the College of Medicine, but they were at the heart of the Canadian Society of Vascular Surgeons (CSVS) conference held this past September in Halifax, where the pair took top honours for their research.
Meyer, a third-year student at the college’s campus in Regina, received the Josephus C. Luke Award, recognizing the best clinical or basic research abstract presented at the annual meeting.
Meyer shared a bit about his experience, explaining that his paper focused on research that was conducted for a Dean’s Summer Research project in the summer of 2015. Given the significance of the award and considering the company he was in at the conference, Meyer was surprised to take home the award.
“It feels incredible. I wasn’t considering myself to be that strong because there were such senior researchers,” said Meyer. “I knew I was eligible, but was surprised when I heard my name. All the hard work I put into it made it meaningful.”
Hard work is nothing new for Meyer. In addition to working with Dr. Nermeen Youssef in Fort Qu’Appelle to complete his Physician Recruitment Agency of Saskatchewan Rural Externship Program (PREP) over the summer, he’s been involved with the Student Medical Society of Saskatchewan (SMSS) for the third straight year.
Meyer’s paper, Investigating factors that delay carotid endarterectomy (CEA) in patients with symptomatic carotid artery stenosis, was his first opportunity to pen a research paper.
“Generally, when people have a stroke or stroke-like symptoms, there are several reasons,” he explained. “Plaques within the carotid arteries of the neck are an important cause of stroke in Canada and worldwide.”
Meyer described that the research goals were to identify the proportion of patients who had the plaque surgery within the suggested two-week timeframe following a stroke, and for those who didn’t, identifying the factors that led to a delay in surgery.
Meyer reviewed six years of data from patients in southern Saskatchewan and found that only a third who exhibited stroke symptoms met the 14-day guideline to have surgery. He found two factors were significant: the type of symptom first experienced, the more severe, the more likely they could have surgery; and the setting in which the patient initially presents to i.e. the emergency department versus outpatient clinic.
While the reason for this wasn’t clear, Meyer acknowledged that the findings were consistent with results elsewhere in the world and further study needs to be done.
“The next step is to put these findings into action and try to change practice,” added Meyer. “In order to fix these issues, we could reach out to the Heart and Stroke Foundation of Canada who runs the FAST Campaign.” (FAST is a stroke awareness campaign of the Heart and Stroke Foundation)
While this opportunity gave him a chance to experience research first-hand, Meyer hasn’t settled on a specialization yet.
“In the future I undoubtedly plan to include clinical research in my career no matter the specialty I end up choosing,” said Meyer.
“I believe that the College of Medicine is taking excellent steps in order to provide a phenomenal education and great opportunities for its students. The Dean’s Summer Research Projects opened the door (for me) to a love of clinical research.”
Like Meyer, Abdalla Butt is also a third year Regina-based medical student, who worked with Dr. Kopriva for his Dean’s Summer Research Project. Butt won the Sigvaris President’s Award at the CSVS Conference, which recognized the most outstanding abstract dealing with venous disease.
Butt’s research, Economic Implications of Publically Funded Endovenous Saphenous Vein Ablation (EVA), looked at the cost of two publicly funded procedure options to treat varicose veins: the older and invasive surgical stripping technique, and the less-invasive endovenous ablation technique. While the former requires several days of recovery, the latter is a same-day procedure performed in an outpatient setting.
“My supervisor, Dr. Kopriva, and I wanted to submit our research project to this conference, because we knew it would spark a lot of debate and discussion,” Butt explained about why he chose his topic. “This research topic has never been addressed, prior to our research, in the research community.”
He added that Saskatchewan is the only province in Canada to publicly fund medically necessary varicose vein treatment. In other provinces, the procedure is done in private clinics, making it expensive for patients.
Butt’s research found that the endovenous ablation method was a more cost-efficient option because it didn’t require an overnight hospital stay. He added that there’s an opportunity for other provinces to embrace the endovenous ablation method as the varicose vein treatment standard, and to publicly fund it, allowing greater access for patients.
“It challenges the framework of privatization and publicly funded health care systems,” commented Butt. “We understand that public health care comes at the cost of taxpayer dollars, while privatization impairs many patients financially from getting a treatment they may need or want. However, this research shows that providing public health care dollars for endovenous ablation is actually cheaper than the surgical stripping, which was the previous go-to treatment option, hence should be publicly funded.”
What’s next for Butt in terms of his medical career? He’s leaning toward surgery, but is also equally excited about future research and additional Dean’s Summer Research Project possibilities.
“While I don't want to jinx my chances in any specialty, I think I am certainly leaning towards surgery because I see myself as a hands-on guy who loves the operating room,” said Butt. “Winning this award certainly shows that vascular surgeons appreciate my work, hence, vascular surgery probably would make a good contender for my surgical specialty.”
The Town of Shaunavon Welcomes a New, Full-time Family Physician
Originally published by Cypress Health Region – September 13, 2016
Dr. Hong Tran joined other physicians and health professional colleagues who make up the town’s primary health care team at the Shaunavon Hospital. Tran joins Dr. P. Louwrens, Dr. O. Akpoigbe and Dr. I. Barretto who work closely with nurse practitioners Sherry Hornung and Chester McCuaig.
“We are very pleased to welcome Dr. Tran as a member of our medical team in Shaunavon. He is an excellent physician who is looking forward to providing medical services to residents of Shaunavon as a member of the primary care team,” commented Grant Browne, Medical Affairs Coordinator for Cypress Health.
Before arriving in Shaunavon, Dr. Tran received extensive medical training at a number of prestigious medical schools across the country and world. Originally from Chestermere, Alberta, Dr. Tran completed his pre-med education at the University of Calgary where he received a B.Sc in Biochemistry and a Masters of Biomedical Technology (MBT) Degree. From there he moved down under and obtained his Medical Degree (MD) at the University of Queensland in Brisbane, Australia. After completing his MD, Dr. Tran returned to Saskatchewan and recently completed his medical residency in North Battleford. While there, he served as chief resident and remains a member of the Resident Doctors of Canada. Dr. Tran is renowned for his keen interest and abilities in emergency medicine, family medicine and long-term care. He received his certification with the College of Family Physicians of Canada (CCFP) upon completing the accredited Family Medicine Residency and passing the Certification Examination in Family Medicine.
Connecting With Our Own
Saskdocs’ Recruiters Engage With University of Saskatchewan (U of S) Medical Students and Residents
Saskdocs’ staff members had a busy fall meeting with U of S medical students and residents at a number of career fairs both in and out of province over the past few months. Three of the more focused events were the Saskatchewan Emergency Medicine Annual Conference (SEMAC) VII held in Saskatoon October 16-17, the Canadian Society of Internal Medicine (CSIM) annual conference held later that month in Montreal, and the Family Medicine Forum (FMF), which attracts family physicians from across Canada, and took place in Vancouver in November.
The SEMAC VII event, organized by emergency physicians and the U of S College of Medicine, is designed for family physicians, emergency physicians and a number of other health care providers who manage patients in acute care settings. This is a great opportunity for saskdocs recruiters to connect with these professionals as many of them are in high demand not only across the province, but across Canada.
Saskdocs’ recruiter Ashley Miller said there was a lot of interest in the emergency positions.
“I know there are a few places around the province right now looking to fill spots for emergency physicians. Attending events like SEMAC gave us a chance to tell others about those vacancies, and some of the people I interacted with at this particular event were really interested in the available opportunities. It’s important to note that the recruitment of these doctors isn’t something that happens overnight, so I look forward to attending more events like SEMAC to make sure we keep engaging with these physicians and eventually help fill those much needed vacancies.”
Later that month, internal medicine specialists (internists) from across the country gathered in Montreal to attend the CSIM annual conference. In the crowd were many internists from Saskatchewan. While saskdocs was able to connect with many of them, the event also gave saskdocs recruiters a chance to tell other internists across the country about the opportunities in Saskatchewan and how we stack up against the rest of Canada. CSIM attendees also heard from internationally recognized researchers, educators, and clinicians and discussed how general internists can provide the best available care to patients.
Finally, one of the last annual, pan-Canadian events that our recruiters attended in 2016 was the Family Medicine Forum in Vancouver. The annual meeting draws family physicians from across the country, so saskdocs recruiters set up shop at the FMF to tell family physicians about the opportunities and benefits of choosing a family medicine career in Saskatchewan.
The agency looks forward to talking with more physicians in 2017, especially those whom we met at these career fairs across Canada who are interested in either returning, or calling Saskatchewan home.
Experiencing Shellbrook – Through a Physician’s Eyes
It isn’t every day that a busy medical student gets to travel to a rural or remote community to experience the sights and sounds of what Saskatchewan has to offer. Luckily for Ryan Verity, a University of Saskatchewan medical student, that is exactly what he got to do this past summer in Shellbrook.
Verity and more than 45 of his peers saw the sights and sounds of rural communities and medical practices in Saskatchewan thanks to the Physician Recruitment Agency of Saskatchewan Rural Externship Program (PREP). University of Saskatchewan medical students between their second and third years of study are eligible for the program, which gives them great hands-on experience to shadow a practicing physician in a rural or remote community for up to two months every summer. The experience helps students develop their clinical skills and gives them a better understanding of what it is actually like to practise in a health facility outside of Saskatchewan’s larger cities.
When we talked to Verity this past spring, he was about to embark on his PREP experience in Shellbrook and was really looking forward to it, especially since his experience was giving him a close, family connection to the community, located about 45 kilometers west of Prince Albert.
“My dad grew up in Shellbrook. And my grandparents lived there until I was about 10 years old, so I spent a lot of time there. I like to think I have some form of connection to Shellbrook. My grandpa, Ray, was a pharmacist in Shellbrook and my grandma, Joan, was a lab tech. I decided I should try and keep our family tradition of health care in Shellbrook going, even if I’m only there for a month.”
Reflecting on his experience this past summer in Shellbrook, Verity said, overall, it was great. The experience gave him an opportunity to learn more about medicine and once again experience the community that he remembers so well from years past.
“I was only in Shellbrook a short time, but still was able to play in Men’s Night at the golf course and spend some time at the local gym. PREP taught me a lot about rural medicine, and the wide scope of practice the physicians need to have to accommodate the communities they work in. Dr. Ryan (Dr. Christine Ryan – Prince Albert Parkland Health Region) was a great example of providing high-quality care to rural communities, and I was very lucky to be able to learn from her for a few weeks. I learned a lot about evidence-based medicine, and got a lot of valuable experience in patient management and everyday operations of hospitals and clinics.”
PREP gives medical students like Verity a great opportunity to spend less time looking at books and more time in the field. The program would not be possible without the financial commitment and support of the University of Saskatchewan’s College of Medicine, the Saskatchewan Medical Association (SMA) and the regional health authorities. These key partners each play a pivotal role in delivering the program to ensure medical students and employers benefit from it.
The program is beneficial for saskdocs since it gives medical students an opportunity to experience medicine in a rural or remote setting, which increases the likelihood of that student practising in that community or region after graduation.
Verity was glad he squeezed the experience into his busy summer schedule. “I view my PREP experience as a very valuable part of my medical education, and I am very thankful to everyone that worked hard to provide such a positive experience.”
Registration is now open for PREP 2017. Apply today and follow this link for further information.
How Does Saskatchewan Do It?
Work continues on recruiting and retaining local and internationally trained physicians to Saskatchewan. However, compared to only a few years ago, the situation has greatly improved.
Saskdocs works with a number of people and organizations to not only find physicians who want to live and work in Saskatchewan, but also to keep them here. Some of these organizations and agencies include those that provide compensation and benefits to physicians like provincial health regions, organizations that speak for the interests of physicians like the Saskatchewan Medical Association (SMA), and, of course, the institution that trains the physicians - the University of Saskatchewan’s (U of S) College of Medicine.
“All of us are working collaboratively with one common goal in mind – and that is to train, recruit and retain more physicians here in Saskatchewan,” said interim CEO Erin Brady.
The retention of U of S medical graduates has gradually improved over the past three years from 58 per cent to 75 per cent. One of these graduates is Dr. Rob Haver from Moose Jaw. Originally from Saskatoon, Dr. Haver completed his medical degree overseas and then completed his residency training in family medicine in Saskatchewan.
“Wherever you do your training, you’re far more likely to stay. Residencies in family medicine are two years in duration, so if you stay there a couple of years that’s usually enough time that you will consider staying around,” Dr. Haver said.
"Privileged to introduce these 3 doctors in @SKLegAssembly! All U of S Rural Medical Grads! Dr's Amanda Waldner, Rob Haver & Brent Janzen!" (tweeted October 31 by Hon. Greg Ottenbreit, Minister Responsible for Rural and Remote Health)
Dr. Haver is one of many U of S medical graduates who continues to call this place home. Reasons for staying here include being closer to friends and family, and really believing that what you’re doing is making a difference in people’s lives.
Dr. Haver and many others completed their medical residencies thanks in part to the work and efforts of the U of S College of Medicine’s Distributed Medical Education (DME) program. The program’s smaller size means that their learnings from other physicians during their residencies are much more hands-on. This smaller community model also allows for more of a one-on-one experience between the resident and the mentoring physicians. While the program is based out of the U of S, one of its strengths is its distribution. The Family Medicine-DME program is delivered in different sites throughout the province, outside of its two major centres – Regina and Saskatoon. The program’s curriculum is set up according to the College of Family Physicians of Canada standards for accreditation, but there is a lot of flexibility built into it with elective time over the two years.
Another program that helps us annually increase our collaborative recruitment numbers is the Saskatchewan International Physician Practice Assessment (SIPPA) program. SIPPA assesses internationally trained physicians to work in this province. The number of SIPPA graduates grows each year to make this sector of the health workforce a prominent one. SIPPA is a unique and highly coveted program that has allowed many international medical graduates to practise medicine here in Saskatchewan. The SIPPA program has assessed and allowed more than 190 doctors to practice here since it began in 2011.
Because of the collaborative work and the mutual support, the work we do together is making a difference in physician recruitment and retention. Since saskdocs began in 2011, it has helped or directly recruited 600 physicians with its partners. Retention rates continue to climb, and communities and regions are working together to keep it that way. That is how we do it and saskdocs is more than happy to tell others how we all work together toward a common goal in Saskatchewan.
Saskdocs and Western Provinces Collaborate on Overseas Recruitment
Physician recruiters from saskdocs, Manitoba’s Health Care Network, Alberta’s Rural Physician Action Plan (RPAP) and Health Match BC were well represented at prestigious and internationally renowned physician recruitment fairs this past October in Ireland and the United Kingdom. All four western provinces combined their efforts, talent and resources to make the Western Canada – Welcome Home exhibit a show stopper.
“It’s always a lot of work to plan and prepare for these events, but once we pull them off and look back on some of the physicians we talked to and keep in contact with, it is so worth it,” said saskdocs Physician Recruitment Consultant Rhoda Yakubowski, one of the western recruiters.
The four western provinces secured prime exhibit locations at both the Irish Medical and British Medical Journal career fairs. Each of these fairs drew thousands of physicians from across Europe, many of whom are interested in opportunities in western Canada.
“When we’re engaging with physicians at these career fairs, we’re finding that they are not only looking for more opportunities to further their medical careers, they are also looking at a way of life that is better for them and their families,” said Yakubowski. “Some are more eager to move than others, but the four western provinces have many things those candidates are looking for like wide open spaces, affordable living, and safe and inviting communities in rural and urban areas.”
In Saskatchewan a big draw for the internationally trained physicians is the Saskatchewan International Physician Practice Assessment (SIPPA) program. The program allows these physicians to apply to the program, be assessed and possibly begin practising medicine in Saskatchewan in less than six months in some cases. One of those physicians is Dr. Jimi Akinsete who moved from the United Kingdom and successfully completed SIPPA in 2012. "Canada was our first choice, and Saskatchewan was my first choice in Canada,” said Dr. Akinsete. “The people sold me on Saskatchewan as a beautiful place with a growing population. I never explored any other option." Dr. Akinsete has been practising medicine in Estevan ever since.
The four western provinces have combined their resources, talent and time to establish and grow a strong presence at these international career fairs. “These fairs have been around a long time, and in past years it was very difficult for a province like Saskatchewan to compete against countries like Australia, the United Kingdom and others. Now through this combined effort I think it is fair to say that the Western Canada – Welcome Home display is one of the premiere displays that physicians from around the world see first when they arrive at these events,” said Yakubowski.
New this year was the involvement of the Canadian High Commission in the United Kingdom. The western Canadian recruiters were very successful at drawing delegates to the exhibits, while High Commission staff was extremely helpful at providing delegates with further, more specific information on immigration requirements, timelines and what people can expect when they move to Canada.
Watch for us again at these events in 2017 and watch for saskdocs at many other conferences and fairs abroad and at home in the months ahead.
September 8, 2016
Inside This Issue:
A Message From the CEO
An Important Goal for Medical Students and Residents
Pursuing a career in medicine involves a long journey. It begins with a desire to become a physician, followed by a decision to act upon that desire.
Along the long journey that ensues, the many moments of victory may be punctuated with struggles, doubts and setbacks. But for most who gain admission to medical school, the journey culminates with a coveted medical degree. And, after completion of residency training, we’re granted a license for independent practice.
The term “independent practice” carries a number of different connotations. Most significantly it denotes the fact that our daily professional decision-making is no longer subject to legal supervision by a more senior physician. The word “independent” conveys a sense of autonomy, and professional autonomy that is deeply valued by our profession.
Over the centuries much has been written about professional autonomy in medicine. There’s extensive literature on the subject and one might expect a very high level of consensus among physicians around the world on the meaning and implications of autonomy. In real life, that is not the case.
At the recent Canadian Medical Association General Council there was spirited discussion about what autonomy should mean for Canadian physicians in 2016 and beyond. Concerns were raised about whether clinical decisions made by physicians should be influenced by the cost implications of those decisions. After all, every dollar allocated to the care of one patient may constrain the care options for another patient. Because most of our services are delivered in a publicly funded system, much discussion focused on our shared responsibility for wise stewardship of those public resources.
During the passionate debate that occurred about professional autonomy, one perspective surfaced which I consider of paramount importance to medical students and residents throughout their journey toward independent practice. Many colleagues expressed a view that the terms “independent” and “autonomy” must never be construed to mean that our profession is not committed to effective teamwork.
Indeed, many colleagues pointed out that effective care is so often dependent upon teamwork that it is oxymoronic for health professionals to consider themselves independent from one another. Many high-performing integrated healthcare systems explicitly select members of their medical staff for their commitment to effective intra-professional and inter-professional teamwork.
In the journey of medical students and residents toward careers in medicine, each summer and fall marks an important transition. Residents progress from one year to another in July. First-year students commence their studies in September and senior students return from their summer break. It’s a time of new beginnings in the medical education journey.
As each medical student and resident at the U of S begins this new phase, I would offer you a very important recommendation: I would urge you to make an effort throughout your undergraduate and post graduate education to build your capacity to work effectively as a team member.
I’d recommend that you closely observe faculty members who function effectively in teams and seek to understand the attitudes and behaviors that make them effective team players. Don’t hesitate to ask them for help to build your own team skills.
In the world in which you will practise, I believe team competencies will prove to be increasingly valuable. I sincerely hope that each of you will be successful in building and applying those skills.
While the prospect of change may induce some anxiety, at saskdocs we perceive this as an opportunity to take stock of what’s working well and strive to make our system even better.
Since saskdocs was established in 2010, our highly committed team has worked diligently to create and sustain collaborative working relationships with staff within each RHA. We recognize the challenges that RHAs often face in ensuring continuity of public access to medical care in some communities. We appreciate how difficult it can be to ensure seamless physician succession when RHAs often receive very short notice of the intention of physicians to leave a community.
The Short Term Locum Relief Program managed by the SMA offers locum coverage for rural family physicians in small groups to enable them to take vacations and participate in professional development activities. It does not have the capacity to back-fill physician vacancies of several months duration.
The funding provided to RHAs to contractually engage up to two family physician locums has enabled RHAs to more effectively backfill multi-month physician vacancies. However, troubling service gaps still occur in small rural communities.
It’s ironic and noteworthy that small communities in our three northern RHAs enjoy higher reliability of medical service continuity than do many of our southern rural communities. For over three decades Northern Medical Services (NMS) has recruited and engaged family physicians in a variety of service agreements that rely upon team-based interdisciplinary primary care. We have much of value to learn from the NMS model.
I perceive considerable potential for synergy between the system redesign dialogues being concurrently led by the Government of Saskatchewan and the SMA. Among the potential system improvements that may emerge from this concurrent dialogue, I am hopeful that we might design a proactive province-wide medical human resource strategy that will eliminate the service gaps now occurring in rural communities.
The track record of NMS clearly shows that this goal is achievable. We need to apply the lessons learned from the NMS experience.
Without limiting the range of medical human resource magnet strategies that might better serve the people of this province, saskdocs eagerly awaits the opportunity for input into the planning process. We’re also ready and willing to accept a leadership role in implementation of the strategy that is designed through broad stakeholder consultation.
Dr. Dennis Kendel, CEO
It’s the start of another school year. Whether you’re a medical student just starting your training at the beautiful University of Saskatchewan (U of S) or a medical resident who’s been hard at work since the summer began, welcome!
The staff at saskdocs have been meeting regularly with medical learners over the past several months at barbecues, lunches, professional development retreats and information sessions to ensure that medical learners are well informed about the services we provide and the opportunities waiting for them.
“The staff and I travelled to a lot of places over the summer months to meet new family medicine residents who just started practising in the DME (Distributed Medical Education) sites and with medical students at various events elsewhere in the province. It was great to meet so many of them. We look forward to helping them make career choices here in the province,” said Dr. Dennis Kendel, saskdocs’ CEO.
saskdocs worked closely with partners like the U of S College of Medicine, MD Financial and the Saskatchewan Medical Association (SMA) to make sure as many medical learners as possible had a chance to engage with staff and learn more about all that Saskatchewan has to offer.
This fall saskdocs staff will be out and about once again attending and hosting career fairs, professional development events and conferences in collaboration with our partners to inform students and practising physicians about what it is like to live, work and play in this great province we call home.
Please come see us at one of the following events this fall:
Prince Albert: A Great Place to Be
It’s mid-morning and Dr. Erin Sullivan is sipping on a warm drink at Dr. Java’s on 15th Street East in Prince Albert, Saskatchewan. It is one of Erin’s favourite places to unwind after pulling a long shift at the Victoria Union Hospital in Prince Albert. Dr. Sullivan savours these moments because they don’t seem to come often enough as she is one of the many family doctors meeting the health care needs of the Prince Albert Parkland Health Region’s growing population.
“Last night was really busy. I came off a shift where we had a number of expecting moms coming in to deliver their babies. Almost all of them had different health care needs. It was really busy, but that is something you can expect when you practise medicine here in Prince Albert. In one year alone I think the health region had 1, 600 deliveries, but I wouldn’t want it any other way.”
Dr. Sullivan, a University of Saskatchewan (U of S) Enhanced Surgical Skills (ESS) Resident, lives in Prince Albert and loves the diversity of the medical practice in that city and the experience she gains in that setting. Originally from Entwistle, Alberta, Erin followed her grandfather’s footsteps and decided to go into medicine. Although nursing was her first career choice, becoming a doctor was always her long term plan. That was when Dr. Sullivan decided to complete her medical degree overseas and return home to Canada to start her professional career.
“My grandfather was originally a family physician in Devon, Alberta and then went on to become a cardiologist and professor emeritus at the University of Alberta (Edmonton). Medicine was obviously a big part of his life and our family life and so I became a nurse and worked as a nurse for a while and then, sticking with my long term plan, I eventually decided to take the plunge and go into medicine.”
A lot of what appeals to Dr. Sullivan about Prince Albert are the number of professional opportunities that she feels may not be available anywhere else. Even though communities like Prince Albert are smaller than Saskatoon or Regina, the health care needs and challenges of the general population are both similar and diverse. Dr. Sullivan thinks one of the main differences is that you have more face time with the specialists already practising there, which presents a great learning opportunity.
“Having to travel long distances to other centres to get certain procedures done makes it very difficult for the patient. Therefore, if places like Prince Albert can offer some of those procedures it not only benefits residents like me who want to enhance their skills a little bit, but it also makes it easier for those patients to not travel quite as far to get something done.”
Practising medicine in Prince Albert and being close to professional colleagues is really appealing to Dr. Sullivan, but she freely admits getting used to moving back to Canada, let alone Prince Albert, was a bit of an adjustment for her after several years of studying medicine overseas.
“I enjoy my network of friends I’ve made, and the professional networks. I love the hospital and the people I work with. The only struggle for me was getting used to being in a prairie winter. I took my training overseas for 10 years and I had to get used to this all over again. In fact, on one really cold day I couldn’t find the cord to plug in my car so I was standing outside looking for it and I started feeling really weird and realized that this weird feeling was frostbite. It really struck me then that I had to become acclimatized to the cold weather all over again.”
Adding to the benefits of practising medicine in Prince Albert is the Enhanced Surgical Skills (ESS) program. This program allows people like Dr. Sullivan to not only practise medicine, but learn more about atypical medical procedures.
“The ESS program in P.A. is, to my knowledge, the only program in Canada where residents can have their training pertinent to the community you’re planning to practise in and the skill set you need to have it done. The program works very hard to ensure the residents have the competencies to do things like C-sections, tubal ligations, higher risk deliveries, appendectomies, open hernias and so forth. I’ve had a lot of my colleagues across the country say ‘I am so jealous that you get training in that stuff and I’d love to do some of that, but just don’t have the opportunity here.’ So we are really lucky to have something like the ESS program.”
Like many other U of S medical residents now calling Saskatchewan home, Dr. Sullivan is excited about what the future holds and loves the fact that many of her program colleagues are close by. This really supports a peer network approach to delivering care.
“I have six family medicine residents in my year all practising medicine here or close by: three in PA, one in Shellbrook doing locum, another in Melfort just opening her practice and another in Saskatoon. It’s nice to have the network of colleagues close by. It is great to be here.”
Program Improves Services for Rural, Remote Patients
Excerpts of this story were originally published in Inside the Region – the official newsletter of the Prince Albert Parkland Health Region (June 2016)
A Victoria Hospital program aimed at improving access to surgeries in smaller and more remote communities is gaining more recognition across Canada. The Enhanced Surgical Skills (ESS) program is operated through the University of Saskatchewan, and is based at the Victoria Hospital in Prince Albert.
“The purpose of the program is to support family physicians to obtain skills for specific procedures, so that patients in more rural or remote locations do not have to travel as far to receive the service,” said Dr. Ruth O’Carroll, a general surgeon who is the lead for the program at the Victoria Hospital.
Dr. O’Carroll said the program is flexible depending on the interests of the residents in the program. The focus is on general surgery and obstetrics and gynecology; however, residents will often spend some time in orthopedics, urology, and otolaryngology (ear, nose and throat). Specialists from those groups work with ESS residents, and are ultimately responsible for assessment of skills for different procedures.
“The program is focused on specific procedures and ensuring that the resident is able to perform them. It does not replace a specialist with broader skills within those areas.” Dr. O’Carroll said. Procedures can vary, but usually include things like:
- Caesarian sections
- Tubal ligations
- Some higher risk births
- Vasectomies and circumcisions (with urologist)
- Tonsils (with ear nose and throat specialist)
- Carpal tunnel (with orthopedic surgeon)
Dr. O’Carroll said there have been some challenges in getting the program accepted. “We needed to demonstrate that the program’s training was appropriate for the type of procedures being done.”
The ESS program took a step forward when its curriculum was published in the Canadian Journal of Surgery (December 2015), and it was featured at a summit meeting in Banff in January 2016. This meeting included representatives of the College of Family Physicians of Canada, the Royal College of Physicians of Canada (certifies specialists), the Society of Obstetricians and Gynecologists of Canada, the Canadian Association of General Surgeons, and the Society of Rural Physicians of Canada.
Part of the increased acceptance of the program is meeting a variety of criteria for the physicians who are expanding their own scope of practice. They need to ensure continuing medical education is available, developing specific programs for those physicians to maintain skills and be up to date on procedures, techniques, technology, and any changes for best practice.
The program must also undergo a regular evaluation with patient safety as a focus. “Patient selection is very important,” Dr. O’Carroll said. “They may consult with a patient, and then decide to refer that patient to a specialist because it is not something they are comfortable doing. This could include someone with more complex health issues.”
Patients with more complex health issues, such as heart disease or other health concerns, may be assessed before being referred to a specialist for the surgery. It is about the skills of the individual, as well as the support for patients, and the availability of other services such as an intensive care unit.
As part of the application process for the program, physicians need to demonstrate that they have support from a community and host hospital, to ensure other staffing (anesthetists, nurses), equipment purchases and operating room time is available. While it is currently the only program of its type in Canada, there are others in development. The Prince Albert program has graduated 11 people, with two more to complete their training in June 2016.
At the end of the program, each of the specialists provides a letter stating the ESS resident has obtained the competencies for specific procedures. The ESS participants are not considered a specialist in the general areas. Program participants currently work in Saskatchewan (Prince Albert, Meadow Lake), British Columbia (Revelstoke, Vanderhoof), Alberta (Rocky Mountain House, Taber, Pincher Creek,) Manitoba (Neepawa) and Nunavut.
To read more about Dr. Sullivan and the ESS program in PAPHR, please download a copy of the June 2016 issue of the PAPHR’s Region Reporter newsletter.
New $1.9 Million Housing Complex Opens in Prince Albert Helping to Recruit and Retain Students and Doctors
Originally published on Tuesday, July 5, 2016 by the Prince Albert Parkland Health Region (Author: Doug Dahl)
Earlier this year a number of local dignitaries cut the ribbon on a new $1.9 million housing complex for health care students, locum physicians and visiting health professionals in Prince Albert.
“The opportunity to retain health care professionals in rural and regional centres is increased by exposing students to these settings early in their career during training,” Rural and Remote Health Minister Greg Ottenbreit said. “There is no doubt that having new, modern housing available close to Victoria Hospital will help attract health care providers to the Prince Albert area.”
Named after a former saskdocs/Health Careers in Saskatchewan (HCIS) Board member – Dr. Tom Smith Windsor - the new house, with 21 suites and apartments, replaces housing on the grounds of the former Pineview Terrace Lodge. Students and visiting health providers are now being housed in the new building.
“The health region is proud to support students who are here for a short stay,” Prince Albert Parkland Regional Health Authority board chairperson Brenda Abrametz said. “It gives them an opportunity to see our community and facilities and to see what is possible if they choose to pursue their careers in Prince Albert Parkland.”
The land and buildings at the former Pineview Terrace Lodge were sold by Prince Albert Parkland Health Region in February 2015, but the region has continued renting the old units until students finish moving into the new building. Funds from the sale were used to fund this construction project.
Students in medical school or other health professional programs (registered nursing, psychology, respiratory therapy and medical laboratory work) use the housing services while they pursue training in Prince Albert. The health region also provides housing for locum physicians (visiting physicians, often filling vacations or other leaves to ensure continuous on-call coverage) and physicians in the Saskatchewan International Physician Practice Assessment (SIPPA) program.
The Prince Albert Parkland Health Region provides services and programs to about 80,000 people in one city and 40 towns, villages and rural municipalities as well as 12 First Nations. It is a major referral centre for health care services for residents of northern Saskatchewan.
Rural Externship Program Offers Benefits
The following blog post was published by Danny, a U of S medical student who starts his clerkship this fall. Danny writes about soaking up experience and all that PREP (Physician Recruitment Agency of Saskatchewan Rural Externship Program) had to offer him this past summer. Watch for the PREP 2017 information and application package this fall in one of our upcoming e-newsletters.
To any student reading this post, I urge you to consider applying for the PREP program in the summer of your second year. You will definitely not regret it.
July was an amazing month. I had the pleasure of taking part in the PREP Program in Fort Qu’Appelle under the direction of Dr. Nermeen Youssef, a family physician who provides service for residents of Fort Qu’Appelle, Lestock, and Balcarres.
Time spent in the valley was my first real taste of clinical medicine and I now eagerly await the start of my first rotation later this month when I become a clerk (JURSI). We saw many patients of all types of backgrounds with varied complaints ranging from topics I have seen before to topics I had the pleasure of seeing for the first time. Academically, PREP was very useful in that I learned therapies for conditions I was unfamiliar with, and also I could reinforce what I had already learned in class for those that I was familiar with. On a personal level, it was equally as rewarding in that I was able to meet and get to know all kinds of people including patients, nurses, and other staff to learn who they are, where they come from, and what life is like in a rural community.
Friends and family have asked what my favourite part of the entire program was and I must say it is not an easy choice. However, if I had to choose I would say my favourite part was getting a chance to see what long-term follow-up with a patient is like. In some cases I saw the same patient three, sometimes four times during my four weeks in the valley. They knew my name and I knew theirs; this was truly the first time I could build a relationship with patients. I felt a sense of common achievement with my patient when we would open the EMR (electronic medical record) to see that their labs were closer to target based on a medication regimen that we mutually decided upon.
Walking out of the Fort Qu’Appelle Primary Health Clinic on my last day was bittersweet. On one hand, it meant my time in the valley was now through and I would no longer be able to see the staff I had come to know in the Fort, Lestock and Balcarres or follow up with the patients I had spent the last month getting to know. On the other hand, a brand new adventure awaits: my clerkship/JURSI. I am very excited to delve deeper into the world of clinical medicine with the start of my first rotation coming up shortly. There is an immense amount to learn, but after my time spent with Dr. Youssef I now feel more confident in my ability to interact with patients and to apply what she and my education thus far have taught me.
To any student reading this post I urge you to consider applying for the PREP program in the summer of your second year, you will definitely not regret it.
I also enjoyed the company of family and friends at my cabin throughout my month in the valley. My sister, who traveled home from Alberta, along with friends and family, enjoyed a fish fry, campfires, cribbage, and catching up. The combination of this along with PREP was the perfect denouement to an overall excellent summer. From here, I’ve been preparing for my first rotation, am continuing to pursue my solo certification in skydiving and am keeping in touch with old and new friends.
I look forward to what the next two years will bring and I am forever grateful for organizations like saskdocs, the SMA (Saskatchewan Medical Association) and the College of Medicine for offering programs like PREP and supporting us through our education during the academic year as well as in the summertime.
Highlights of 2015-16
The 2015-16 fiscal year saw the Physician Recruitment Agency of Saskatchewan (saskdocs) and Health Careers in Saskatchewan (HCIS) respond to significant changes in the provincial health work force.
On the physician side, we continued to scale back our recruitment efforts internationally. The Agency continued to combine its efforts with Manitoba, Alberta and British Columbia to jointly attend international career fairs like British Medical Journal (BMJ) Careers Fair, Irish Medical Careers Fair (IMCF) and the Family Medicine Experience (FMX) through the American Academy of Family Physicians (AAFP). The majority of international medical graduates (IMGs) who come to Saskatchewan do so through the Saskatchewan International Physician Practice Assessment (SIPPA) program, which is managed by the University of Saskatchewan’s (U of S) College of Medicine and promoted by staff throughout the year. We continue to make great strides on recruiting U of S medical graduates by assisting and guiding them to vacant opportunities throughout the province as they continue their studies.
Another highlight of the past year that will assist us and our partners in our physician recruitment efforts was the Tool for Physician Resource Planning, which was released by the Ministry of Health in February.
Regarding the recruitment of other health professionals, staff continued recruiting to positions that support team-based care. The hard-to-recruit positions continue to be therapies, nursing, sonography and medical imaging. The HCIS staff and regional recruiters combined their efforts to promote vacant opportunities to potential candidates both in Saskatchewan and out-of province.
Read more on our efforts by downloading your own copy of the saskdocs-HCIS 2015-16 Annual Report today.