Rural family medicine program draws residents for study and keeps some, too

When Dr. Andrew Welton was looking for a place to do his family medicine residency, he knew he wanted to do it in a rural setting with an integrated program. Along with his wife, Welton looked at several provinces before settling on Dalhousie University's South West Nova teaching site centred in Yarmouth.

Welton was drawn by the program's setup, he liked the hospital and both he and his wife liked the town.

"Now, that was in January, but we liked it enough in January we figured, you know, it was a place we could see ourselves," he said.

When the two-year program was launched in 2013, the idea was to distribute five residents a year through Yarmouth, Digby and Shelburne counties. Residents are paired with the same preceptor for the full two years, in what is considered a comprehensive, competency-based program.

And rather than doing units in multi-week blocks, the way many residency programs work, this one sees residents working in family medicine clinics the entire time, while also gaining exposure to other specialities.

Dr. Abir Hussein, the program's director and a preceptor herself, said the approach ensures continuity of care for patients because residents are working with them for the full two years.

"The residents that graduate from this program are able to provide comprehensive care to their patients and they're more prepared to provide the care depending on the different community they end up in or the evolving needs of their communities," she said.

"They learn what the family physician can do [from] family physicians."

Being attached to the same preceptor for two years is a major advantage, said Dr. Sean Davis, a second-year resident who is paired with Hussein.

"Sometimes I think she knows my strengths and weaknesses better than I do myself," he said.

"You're really able to address shortcomings, you're able to address things that you need to work on, I think, far better than somebody you're with sporadically."

There are also advantages to practising in a rural setting, said Dr. Gurleen Dhanoa, another second-year resident. Getting to know patients outside the hospital is much more likely in small communities and that can provide valuable information, she said.

"It allows you to develop a more intimate relationship with your patients, understanding what are some of the social factors that could play into their care, which I think is a huge part of being a family doctor."

While the program was intended to provide residents interested in rural family medicine the chance to train in that very setting, it was also viewed as a potential recruiting tool for communities. On that front, it's also finding success.

In the program's first two years, three graduates remained in the area to set up practice. Hussein said four out of five members of this year's graduating class are exploring options to stick around.

'They're ready to go anywhere'

Dr. Michelle Dow, a family doctor in Meteghan Centre and a preceptor for the program, said "it's one of the best things that we could have done."

"[Residents] do everything and they're part of the medical community from day one. I believe that once they're finished their two years they're ready to go anywhere."