Program introduces medical students to rural practice

Shadow program familiarizes students with pros and cons of small town living

Third year medical student Chris Young has his sights set on a practice in rural Saskatchewan.

To gain insight and hands-on experience, he signed up for the Physician Recruitment Agency of Saskatchewan’s Rural Externship program (PREP), offered by saskdocs, an organization that helps doctors who want to work in Saskatchewan, in conjunction with the Saskatchewan Medical Association and the University of Saskatchewan’s college of medicine.

The 2013 summer program allowed him to shadow Dr. Jessi Warren in Weyburn, Sask., share notes with her and conduct supervised medical procedures.

“Rural family medicine, for me right now, it’s at the top of what I’m considering,” Young said.

He said the experience revealed the pros and cons and dispelled many myths about rural health care.

Resources and quick access to laboratories are limited, but Young said that meant doctors rely more on their expertise, diagnostic tools and lab skills for diagnoses.

“Doctors there have found ways to rely on their own skills,” he said.

Resources are limited, retirements and departures strain the remaining staff, doctors are on call more, the lifestyle is different than in urban settings and caseloads are large.

“Doctors do their best to cover, but it’s a struggle,” he said.

Provincial regulatory bodies cap the number of patients a doctor can accept. In addition, outside doctors are sometimes seconded to cover for local doctors on weekends.

Heavy caseloads mean keeping to a tight schedule when seeing patients, which Young said presents challenges.

“You try to maximize the time with patients,” he said.

“That was a big difficulty for me because I want them to go away feeling they got something from me.”

Young said rural doctors balance work and home life.

His supervising doctor took a weekday off to spend time with her two children and also made time to pursue her professional interests in women’s health at a Regina hospital.

“It might take a little bit of work, but you can make it happen,” said Young.

He received strong support from the medical community in Weyburn, had a good look at the city by living there and was encouraged to consider it upon graduation.

“I felt the love,” said Young, who is from Regina.

Seventy-two medical students have participated in PREP since its inception in 2011, receiving about $400 per week in wages and a weekly $250 tax-free living allowance.

Supervising physicians receive $1,500 per week.

Last year, students working up to 12 weeks were placed in 22 communities ranging from as small as Arcola to as large as Tisdale.

James Winkel and Jennifer Grunert of saskdocs said the program is an attempt to stem the tide of medical graduates leaving the province. Fifty-eight percent of those in family medicine remain in Saskatchewan after graduation, but only 29 percent of specialists stay.

“What I can say for sure is that we have one of the lowest graduate retention rates in the country, and PREP is one of the tools in our tool chest that we hope will help improve those results,” Winkel said.

Grunert cited several studies that show increased exposure increases the likelihood of medical students practising in rural communities.

Working alongside a doctor in rural clinics and hospitals exposes students to a typical work life and what the community has to offer.

“They see everything a family physician would see in rural Saskatchewan,” she said.