. " I 2016 NMPT AGM Agenda- #Sf I

Student Essays

NMP Rural Electives

NMP Urban Electives

Family Nurse Practitioner Electives

Rural Weekend Shadowing Program

2015-16

. c

Student Essays- NMP RURAL

BCMD2B

"Anything But Commonplace"

A UBC :fd Year Medical Student reflects on the poetry of life in medicine, as

experienced in a single day of his Integrated Community Clerkship

By Greg Costello

Phone: 778-808·6159

Email: g.costel/o@alumni.ubc.ca

Word Count: 839 (was 1000)

"Nothing will sustain you more potently than to recognize in your humdrum routine, as

perhaps it may be thought, the true poetry of life - the poetry of the commonplace; of the

ordinary man, of the plain toil-wom woman, with their loves and joys,

their sorrows and their griefs."

- From "The Student Life" by Sir William Osler

The doors to the Fort St. John Hospital slide open and I brush the snow off my

shoulders and stomp my boots. I say hello to the passing housekeeping staff coming

and going in the bustle of the early morning shift change. Unsung heroes of the facility,

they are omnipresent and always willing to help a hapless medical student find his way.

Soon I've grabbed a scrub shirt and cracked one of my textbooks, trying to make a

miniscule dent in my monstrous reading list before rounds; it only grows as I progress in

my Integrated Community Clerkship.

she is much more comfortable and appreciative of my assistance all those weeks ago,

and of my current presence, even if it's only a few minutes. She dozes off, and I think

about doing the same when a buzz in my pocket reminds me of where I am slated to be

for the rest of the day.

With each shift in the Emergency Department I have come to appreciate the

unique perspective on a community it offers. Each patient with their particular injury or

illness gives one piece of a cross-sectional view of a region. An uptick in the number

and severity of industrial workplace accidents reflects a boom in oil and gas activity in

the region. The patients with extraordinarily exacerbated chronic disease suggest a

profound shortage of family physicians in the area.

In addition to this, I often see people I have passed in the street on stretchers in

the EO-the mother of a local hotel manager, the clerk at the grocery store, a nurse from

another part of the hospital. As we exchange smiles of mutual recognition, the privilege

and responsibility of medicine and confidentiality weigh on my mind.

I flit from room to room getting histories and doing exams when I encounter a

young girl with appendicitis. In short order I find myself in OR scrubs watching the angry

organ, hinted at by my physical findings, being removed on the laparoscopic screen.

Afterward, as I consider going home to catch up on bookwork, a call comes in

from Maternity. The time had arrived for the patient I had met earlier, and an hour later I

take part in the joyful moment when she is presented with her child. I leave the room,

making a note to check on them tomorrow.

..

TO: Northern Medical Programs Trust, UNBC

RE: Christina Boucher, NMP Class of2016 Report on rural experience in Fraser Lake, BC

To the NMPT members,

21 December 2015

Thank you for your support of my undertaking of a rural elective in my fourth year of study at UBC Medicine. I'd like to share some of my experience in that elective with your group in order to communicate the value of being supported in doing these types of electives in medical training. I traveled to Vanderhoof in December 2015 for a two week family practice elective under the supervision of Dr Shannon Douglas. Two of the features that stand out to me are the varied geography of her practice as well as the opportunity to Jearn about rural cancer care.

I got to work with Dr Douglas in several facilities: StJohn Hospital in Vanderhoof, the Saik'uz First Nations Health Centre in Vanderhoof, the Fraser Lake Medical Clinic, the Nadleh Whut'en First Nation Health Centre in Fort Fraser, and also the Lakes District Hospital in Bums Lake. Seeing so many different locations in one 2-week rotation allowed me to learn about the different styles of practice applied in these settings. For example, in Vanderhoof hospital, we discussed indications for transferring a patient with suspected stroke to obtain aCT head. In the more remote health centres, we discussed the risks and benefits of doing procedures such as mole excision or IUD insertion in a setting without support staff or emergency resuscitation equipment. During these types of conversations, I began to gain an approach to practical issues like resource allocation, resource availability, and safety in clinical decision making.

Another aspect of Dr Douglas' practice that was beneficial to my learning was her work as a GP-Oncologist, and the many opportunities lent by her practice to learn about cancer care. Once a week, we saw patients in the Vanderhoof hospital oncology room regarding either active chemotherapy or post-treatment follow up. 1 got the opportunity to do history and a focused physical for many of the patients; this was a patient population I had little previous experience with and thus, this was a very valuable part of the rotation. Additionally, we had a lot of time to spend with each patient, owing to the way in which Dr Douglas has organized her time in her service contract for the region. 1 had not yet been exposed to a physician who works within a service contract rather than the fee-for-service method, and this feature of my experience was one of many that Dr Douglas was happy to discuss and answer any questions r had.

Overall, this rotation was a very valuable experience for me in tenns of exposure to new areas of BC, different types of facilities, the cancer care patient population, and a new type of payment structure and method of practicing within that structure. Although many of these aspects are somewhat unique to rural practice, they were learning experiences that will be helpful to me wherever I decide to practice. I am very happy with my experience, no small part of which was the afternoon that we took off to go horsebackriding on Dr Douglas' farm with her horses! Again, thank you for your support in this part of my medical training.

Regards, Christina Boucher, NMP Class of2016

Dear Northern Medical Programs Trust Members,

My name is Aimee Kernick and I am a fourth year medical student at the University of British Columbia who has received NMPT funding for my one month elective in Prince Rupert this November. Thank you for this kind contribution to my education, and for making this elective experience possible.

In Prince Rupert I workedJrimarily with Drs. Gillaume and Corneli Coetzee and Dr. Vander Wart in the 2 Avenue Medical Clinic. My time was split between regular clinic days, shifts in the emergency room, assisting on orthopedic surgeries with Dr. Smith and Gynecological surgeries with Dr. Pienaar, assisting in the delivery of newborns, and rounding on patients on the ward and in the long-term­care facility, Acropolis Manor. I had a wonderful experience in each of these areas. In the clinic, I typically had my own examination room and was able to see patients independently, reviewing the diagnosis and management plans with my preceptor. In the emergency room I had similar opportunities, but also gained some procedural practice with suturing and punch biopsies, and observed the anesthetist do procedural sedation, insert central lines and arterial lines. In the operating room I was able to assist on knee replacements, foot surgeries, an ectopic pregnancy surgery, and even a leg amputation. During my entire elective, I chose to be on call for deliveries, and I was able to attend several births throughout the month. I also enjoyed rounding on inpatients that I had seen in the emergency room, and later following up with them in the clinic after discharge, illustrating the wonderful continuity of care in Family Medicine.

Although the clinical experience was unbeatable and really solidified my interest in Rural Family Medicine, it was the community and people that captured me the most. All of the family physicians, specialists, nurses, MOAs and allied health professionals in town made me feel welcome, and I made friends with many of them. I also got to know many of the patients in my preceptors practice and enjoyed.seeing them each week and asking about the challenges they were working through in their life, outside of their medical complaint. 1 would see patients in the community working in the grocery store, driving taxis, or selling their art at the craft fair and they would be happy to see me and catch me up on the latest developments in their health. Despite only being there for four quick weeks, 1 really felt like I was part of a community. Prince Rupert is a wonderful town for a medical elective and I am grateful for the NMPT funding to support this experience. I hope many more students and physicians will have the opportunity to practice in Prince Rupert.

Sincerely,

Aimee Kernick

Northern Medical Programs Trust- Reflections on Williams Lake Cynthia Kong

UBC Medicine Class of 2016

With the majority of my medical school training in the Lower Mainland, I admittedly was not sure what

to expect for my Williams Lake Emergency Department rotation. My only other Emergency experiences

were at the bustling departments of large center hospitals. While I had learned very much from my

patients and preceptors, the saturation of other learners, specialists and subspecialists sometimes made

it difficult for hands~on opportunities as a medical student.

To my delight, being at the Caribou Memorial Hospital (CMH) was an incredible experience. I do not

hesitate to say that in my whole year and a half of clerkship so far, I did more splinting, casting, suturing,

and primary trauma surveys here, than all my other rotations combined. The staff was amazing to work

with, and the hospital culture was welcoming, friendly and collegial. I looked forward to each shift with

the nurses that I got to know well, excellent physicians who took the time for student teaching, and

patients whose rural lifestyle was so interesting to me compared with the city life that I knew.

In addition, some of the presentations I saw in this town were different from the average Vancouver

emergency patient. There were patients who lived in such remote areas, a severe laceration sustained

while camping had stopped bleeding by the time the ambulance had driven 2 hours to our department.

Medical management was also challenging at times, including limited resources available for

subspecialty referral, outpatient surgery, and specialized imaging. Though it had barely snowed during

my rotation, I also could imagine the difficulty involved if urgent patient transport was necessary during

harsh weather conditions.

Even more striking was the presentation of primary care needs in the Emergency Department. This

rarely occurred in my bigger city rotations, where most patients had ready access to their family

physicians. Unfortunately, Williams Lake and its surrounding communities has a surplus of patients

compared to the number of general practitioners available. As a result, we saw patients with long­standing musculoskeletal complaints, minor exacerbations of chronic disease, and even drug

prescription renewals because to see their family physician in the next two weeks was not possible.

With all the challenges that rural medicine presents, I was inspired by and looked up to the physicians

and multidisciplinary staff I worked with. Their perseverance, dedication, and caring for their community

was clearly evident. Some had actually grown up in town, others from different regions of the country,

and still others had trained internationally before coming to Williams Lake. Each brought their own

strengths to the medical care team, and I strongly agreed with patients as they expressed how lucky

they felt to have these physicians serving in their community.

In my time outside of work, the vi be in Williams Lake had a distinct smaller town feel, but also

surprisingly busy enough to sustain a Walmart, Bulk Foods, and even Sport Chekll stayed with several

other medical students and residents, all visiting from different regions of the province, and had a

wonderful time exploring the city and visiting local restaurants and shops.

My rotation in Williams lake built my confidence and skills in Emergency Department care. I was able to

strengthen my diagnostic workup, initial management and discharge planning for common patient

presentations that I encountered. I had the opportunity to perform many hands-on procedures, first

with supervision, and then independently as I gained experience and confidence in these skills. Most of

all, it was a window for me into the joys and challenges of rural medicine. I had the pleasure of exploring

the city, meeting many members of the community, and working with the cohesive team at CMH. I am

not sure where residency training will take me yet, but my time In Williams lake inspires me to pursue

further training in other rural medical institutions in the future.

November 27, 2015

Dear Northern Medical Program Trust Board,

Today I completed my four weeks in Smithers where I was immersed in true rural family

medicine. It is challenging to adequately sum up this phenomenal experien~e that indisputably

ranks as one of the best electives I have had.

I spent a large portion of my time in a wide variety of clinics and all of the family

physicians were very receptive and went out of their way to ensure the best learning

experience possible. Their enthusiasm and love for their specialty was inspiring. I was also

fortunate to have worked with GPAs, GPSs, a GP oncologist, a general surgeon, in the ER, and

with a GP in her methadone clinic. Never was there a dull moment I

In addition to the wonderful physicians many of the allied health professionals played a

large role in making this experience unique. I worked with a physiotherapist, a massage

therapist, dieticians, home care teams, an ultrasound tech, and an optometrist. I had a warm

reception from all these professionals who made the effort to give me a comprehensive

exposure to their world. The collaboration between physicians and these allied health

professionals was definitely something I hope to incorporate into my future practice.

Outside of work the community itself was a positive learning environment. The patients

were supportive of student teaming and I was contacted by the town mayor who I had the

pleasure of having coffee with.

Overall, these four weeks reinforced my desire for a future career in rural and remote

family medicine. There are many tips and tricks I learned during my stay from all levels of

medical care and I am eager to see how I can incorporate my experiences into future practice.

Thank you for supporting northern medical students so we can continue to have such

positive experiences with rural family medicine in the north.

Marci Smit

MD candidate 2016 University of British Columbia marci.smit@alumni.ubc.ca 250-617-6242

October 18, 2015

Northern Medical Programs Trust

c/o Office of University Development

University of Northern British Columbia

3333 University Way

Prince George, BC V2N 4Z9

To Whom It May Concern

Kesh Smith

502·2646 Cook St

Victoria BC V8T 3Sl

I had the privilege to visit MacKenzie, BC from September 7-201h for a rural family medicine elective as

part of my fourth year, medical undergraduate studies. As you know, medical school and the 41h year in

particular, can be very expensive. For this reason, I am grateful to the Northern Medical Programs Trust

for supporting my decision to a rural elective in northern BC with a bursary of $1000.

My rotation in Mackenzie was a fantastic experience. In two short weeks I grew to appreciate some of

the unique challenges faced by rural family physicians. I learned about some great benefits of practicing

in Mackenzie. The community is home to 7 family physicians who share 5 full-time equivalents at the

health centre. This makes for a great work-life balance and something that the doctors there could not

stress to me enough. I learned that they are well compensated for practising in a rural community and

that they see a variety of medicine as they also work in the hospital emergency department. The doctors

there are all young. They are new graduates form residency training programs in BC or have been in

practice for less than 10 years. One by one, they had been recruited to work in Mackenzie by Dr. Card, a

UBC grad and huge rural medicine proponent. I found there to be an unparalleled atmosphere of

collegiality amongst the doctors. They all support each other in their practice. Overall, I found Mackenzie

to be a desirable place to practice, and would certainly consider joining the doctors there should the

opportunity ever arise.

I have been considering rural family medicine as the first step in my career exploration. Visiting

Mackenzie allowed me to experience rural family medicine first hand. Having had time to reflect on this

experience, I am sure that rural family medicine is what I want to do. In addition, I now know which

qualities of the professional environment I would look for in a community. The doctors in Mackenzie

were amazing hosts for my short time there. I am grateful for the experience I have had and once again

wish to thank the NMPT for supporting my time there.

Sincerely,

Kesh Smith.

October 2, 2015

Dear Northern Medical Programs Trust,

Thank you for considering my application for your support in my pursuit of

rural medicine. I am a current fourth year student in the Northern Medical Program.

I was born and raised in the Bulkley Valley and have a goal of returning to the area

when I have completed my training. I was fortunate enough to spend the month of

September in Smithers taking part in a rural family practice elective. I had such a

positive experience in Smithers in a multitude of ways.

One of the many aspects that makes this elective unique is the opportunities

to shadow different members of the multidisciplinary health team. In addition to

working with physicians, I spent half days with local optometry, physiotherapy,

home care, oncology, diabetic, and ultrasound clinics. Not only did I get to interact

with my future colleagues, I got a deeper understanding of the roles of the different

team members. During these interactions, each discipline provided different tips,

such as important information to include on referrals and how to navigate the

systems. Another unique element was the opportunity to travel to neighboring

Hazelton for a day of clinic. This opened my eyes to the idea of being able to do

outreach to outlying communities while still being based in a central community.

Being the only student in a community eager to teach, allowed me to

strengthen my treatment, management and clinical skills. I was also able to

experience the barriers to treatment and transfer in a rural area. In addition, I was

able to learn and ask questions about the non-clinical details of having an

individual/group practice in a rural setting. Prior to this elective, I knew I had a

desire to pursue rural medicine. However, having the opportunity to experience the

clinical and non-clinical aspects of a rural setting has only strengthened my desire to

pursue such a challenging and rewarding career. As someone who calls the North

home, I thank you again for your continued support of our communities.

All the best,

Samantha Van Horn

Northern Medical Program MD Candidate 2016

January 7, 2016

Dear Northern Medical Programs Trust,

Thank you for considering my application for your support in my pursuit of

rural medicine. I am a current fourth year student in the Northern Medical Program.

I was born and raised in the Bulkley Valley and have a goal of returning to the area

when I have completed my training. I was fortunate enough to spend two weeks in

Prince Rupert with Dr. Marius Pienaar completing a rural obstetrics and gynecology

elective this past December.

This was one of my favorite electives that I have completed thus far. Dr.

Pienaar is an amazing teacher and his commitment to rural practice is inspirational.

It was a unique experience getting to work one on one with such a respected

specialist in the North. I was able to have numerous one on one experiences. My goal

is to have a women's focused family practice in the North, so it was very beneficial to

learn specific barriers and constraints to providing this service within a rural,

Northern setting. I was able to learn about the different OB/GYN services that are

offered within the Northern corridor, what services I could conceivably offer in my

future practice, and what services I may need to refer to different communities.

In addition, I am hoping to complete my residency training in Terrace as I

wish to practice in this area. As part of the Terrace residency program students

spend one month in Prince Rupert. I was able to meet many of the family physicians

that work in Prince Rupert I felt so welcomed into the medical community, it made

me look forward to a residency program in this area even more. In addition, Dr.

Pienaar offered for me to come back in my residency program for further exposure

to women's health. This is a connection that I am very thankful for.

As someone who calls the North home, I thank you again for your continued

support of our communities.

All the best,

Samantha Van Horn

UBC MD Candidate 2016- Northern Medical Program

Randi Nicole Woodbeck 738 Irwin St Prince George, BC, V2M 2X7 250-961-9145 r. wood beck @alumni.ubc.ca

December 10111, 2015

c/o Deanna Brown Northern Medical Program University Hospital of Northern British Columbia 1475 Edmonton Street Prince George, BC, V2M I S2

Dear NMP Trust,

I would like to take this opportunity to sincerely thank you for your generous donation of two NMPT bursaries, each valued at $1000, to support my rural and urban elective experiences in 4th year.

I was first supported by the NMPT during an emergency medicine rotation in Williams Lake. I was able to experience first-hand what it is like to work in an under-serviced community. Cariboo Memorial Hospital has a very busy single-coverage emergency department that serves Williams Lake and several outlying communities along Highway 20 towards Bella Coola. Some patients were driving over 3 hours from reserves to seek care for medical problems that were quite advanced at presentation. I had the opportunity to see and manage these patients on my own and perform procedures such as cardioversion, intubation, bedside ultrasounds, suturing of skin lacerations, and casting/splinting of fractures and sprains. I worked with a number of passionate physicians who were very dedicated to the community. A11 were keen to teach me and help me develop confidence as a senior student.

Having an interest in internal medicine, it was necessary for me to gain broad exposure to this specialty on a busy clinical teaching unit (CTU). I therefore undertook a 4-wcek elective at Vancouver General Hospital for which J was again supported by the NMPT. Although at times I felt like a little fish in a big pond, this experience was extremely valuable. I was exposed to a variety of clinical cases including some rarer presentations that will better prepare me for managing such patients at a smaller centre with fewer staff. I met some patients from Northern BC who were very grateful to have a NMP student on their team!

Rural communities are very much a part of who I am. It has therefore been a great privilege to have had the opportunity to complete most of my medical school training close to my hometown and support network in Houston, BC. I come from a modest working-class family and I can assure you that your donations have meant a lot to them as well. Thank you again for making this last year of medical school a little easier!

Sincerely,

~ Randi Woodbeck, B.Sc. (Hons) MD Candidate i UBC Class of 2016 Northern Medical Program, Prince George, BC

Student Essays- NMP URBAN

Lester (Todd) Alec PO Box 854 230 Carrier Rd Fort St. James, BC Lester.Aiec@alumni.ubc.ca

January 8, 2015

RE: THANK YOU LETTER FOR NORTHERN MEDICAL PROGRAM TRUST URBAN ElECTIVE FUNDING

Dear Northern Medical Trust Foundation,

I would like to thank you for your support for the NMPT Urban Elective funding. The assistance allowed me to take electives in Vancouver during my fourth year to be a well rounded Family Physicians. These experiences were invaluable as I had the opportunity to work with specialists that I would not have had the opportunity if I stayed in the North. For instance, there are no Dermatologists in the North and had an elective that will help me in Family Practice in the future . Plastic Surgery introduced me to clinical scenarios that I have not considered such as ruling our flexor tenosynovitis. My last example which was probably the most valuable was working in Orthopedic Trauma at VGH and gaining a better understanding of a great residency program that was conducive of optimal learning environment. This is now a priority going into the CaRMs application process to find a Family Medicine program that emulates a similar learning environment.

Snachailya,

Lester Alec, BHSc. UBC NMP MD Candidate of 2016

I decided to do an elective in ICU to try and gain competence in managing acutely

ill patients. My career aspirations will likely take me far away from the setting of the ICU

but nevertheless 1 felt these were important skills to learn. I plan to practice rural family

medicine including working within the emergency department. It is very likely that

during my career I will have to manage patients that are quite ill and may not have

specialists available to help guide the clinical decisions required. I had the great benefit

of getting hands on exposure throughout my clerkship time in Prince George but felt I

didn't get a lot of exposure to this particular patient population. The chance to round out

my education in a bigger center and to develop skills I might not have gained otherwise

will benefit me greatly in my future career.

During my month in this rotation I got to be involved first hand in the

management of a variety of diseases, a majority of which would be relevant in a rural

emergency setting. These included asthma, sepsis, diabetic ketoacidosis, trauma patients,

and strokes. I really felt the being involved in the initial management of these patients

would serve me weB in developing approaches to stabilizing them before they would be

transported to bigger centers. The rotation itself was fairly flexible and allowed me to get

involved in the different aspects of care that the ICU team is involved in including

performing some of the initial consults in the emergency room. There was also an

opportunity .to get experience doing procedures, which included paracentesis,

thoracentesis, and central lines.

This was my first experience of doing a clinical elective in a bigger center so it

was also a great opportunity to compare this to my experience in a smaller regional center

like Prince George or my other rural elective I have done so far. I found the number of

learner in a large clinical center to take away from the learning opportunities but did

seem to have more formal teaching and unusual cases that you got to follow along to

discharge which you may not get to experience in a smaller center. Overall I found the

experience to be valuable in both broadening my skill set and understanding some of the

difference between learning at a regional and tertiary care centers which will help me

make decisions as I decide where I want to apply for residency.

Reflective Essay on my Urban Experience

December 2015

NMP Class of 2016

I want to thank the Northern Medical Program Trust for supporting my travel and expenses incurred

during my elective in Surrey, British Columbia. The elective was in Emergency Psychiatry and allowed me

to gain experience in interviewing, diagnosing and treating a variety of psychiatric il lnesses. Some of the

more notable presentations included drug induced psychosis, drug intoxication, alcohol withdrawal,

acute episodes of psychosis and depression, as well as suicide attempts and suicidal ideation.

I worked tirelessly from Monday to Friday, from 0800 to 1700 hours, seeing different patients, calling

collateral informants such as family members and treating mental health teams, as well as presenting

the information to my supervisor and formulating admission or discharge orders. After this elective, in a

notoriously busy emergency department, I find myself experienced, well versed in diagnostic criteria for

psychiatric illne~. and ready to implement this knowledge into my practice. As outl ined in my

application, I find that this will be very helpful given that the north has issues with drug use and mental

health illness is everywhere. I also gained experience in safety and dealing with aggressive patients.

Lastly, I want to express my gratitude for the NMPT, and the support it has given me and other health

care professionals in the north. I think this trust has an excellent mandate and I want to thank all of

those that invested in the management of its funds.

Sincerely,

Nathan Teegee

September 30, 2015

Dear Northern Medical Program Trust Board,

I am approaching the end of my four week dermatology elective in Saint John New

Brunswick and here is a brief summary of my experience:

The weeks were packed with one on one teaching by Dr. Baxter at both the regional

hospital and her personal clinic. Dr. Baxter draws not only from the city but from a large

surrounding area resulting in large patient volumes. She runs a diverse practice which gives

extensive exposure to both common and rare conditions. She constantly challenged me to

further my skills having me trying to diagnose red rash after red rash after red rash (which used

to be a nightmare before this elective). With every diagnosis she pointed out little tricks to help

set them apart and what would be a red flag. As the Northern Medical Program lacks a resident

dermatologist and there is very little exposure to dermatology in other rotations these four

weeks in a busy city were invaluable.

Not only did I get excellent exposure to dermatology but being in an East coast urban

center gave me the chance to experience and learn from New Brunswick's medical system and

their norms of practice. It was interesting that despite being the same country there was a

variation in challenges and techniques.

Overall these four weeks have significantly improved my dermatological skills and have

given me a broad basic foundation. I am excited to see how my new skills will come in handy in

my upcoming rural family practice elective In northern BC.

Thank you for supporting northern medical students so they can have the opportunity

to experience u,rban practice and be exposed to valuable but difficult to obtain electives.

Marci Smit MD cand idate 2016 University of British Columbia marci.smit@alumni.ubc.ca 250-617-6242

December 10, 2015

Dear Northern Medical Programs Trust Committee,

I am a fourth year student in the Northern Medical Program and my ultimate goal is to practice full service family medicine in Northern communities. I would like to thank you for your generous

support which allowed me to complete a one-month Critical Care elective in Kelowna this past November.

As a member of the Intensive Care Unit team I was responsible for the evaluation and management of critically ill patients. I worked on an interdisciplinary team comprised of

intensivists, family practice residents, nurses, pharmacists, dieticians, physiotherapists, and social workers. We performed daily team rounds on up to 12 critically ill patients. I had ownership on 3 .. 5 patients at a time and was responsible to formulating daily management plans

for them.

Over the course of the month I did 8 on-call shifts, in which I was first call for issues in the ICU

and also evaluated new consults. This provided an amazing opportunity and allowed me to

continue to refine my management of common on-call problems as well as expand my general medicine knowledge. I was part of the team that responded to code blue and critical care outreach team (CCOT) calls. I also gained invaluable procedural experience, learning how to

place central lines, dialysis catheters, and pleural drains.

Throughout my elective we received teaching on a variety of topics, including bedside ultrasound and basic ventilator management for doctors in a rural setting. We also had daily discussion of the physiologic basis for our patients issues and how best to manage common

ICU presentations.

As a tertiary care center, the Kelowna ICU provided care for local patients but also accepted transfers from hospitals throughout the province. I gained experience transferring critically ill patients, both on the sending and receiving end.

My goal is to continue to train and eventually practice in the North. This elective provided me with the experience to evaluate and initiate treatment for a critically ill patient. In the event that a higher level of care is needed, I have learned how to best prepare them for transport as well as how to prepare a proper handoff to the receiving facility, including appropriate transfer

documentation.

Thank you again for your generous support.

Best regards,

Matthew Wahab, MD 2016

~

Student Essays- FAMILY NURSE PRACTITIONER

Tasenka Kushner 404-33430 Bourquin Place Abbotsford BC V2S6V8 Phone:604-309-2477 E-Mail: kushner@unbc.ca

March 16, 2016

Northern Medical Programs Trust University of Northern British Columbia 3333 University Way Prince George, BC V2N 4Z9

To Whom It May Concern,

Thank you very much for selecting me as a recipient of financial support from the Northern Medical Programs Trust for my clinical placement in Qualicum from September to November 2015. I would like to take this opportunity to thank you for your kind contribution to my education at the University of Northern British Columbia (UNBC). The financial burden of graduate studies is great, thus I am very appreciative that I have been afforded such generosity.

I am completing my studies at UNBC in the Masters of Science in Nursing, Family Nurse Practitioner program. I aim to complete the program full-time in two years and will be unable to work in the current final year of the program. This presents a significant financial challenge, especially as a single person without a second household income to rely on. Financial support from programs such as yours lessens my financial stress, and helps to aid my success in completing this graduate program.

During my placement in Qualicum, I was given the privilege to practice in a family practice office with Dr. Hugh Fletcher, who was very supportive of my learning. The populations of patients I saw were largely adults, with many older adults. The health conditions I saw included episodic concerns, such as musculoskeletal injuries from a recent car accident, respiratory tract infe'ctions, and urinary infections; acute diseases, such as newly-diagnosed low-grade breast cancer and H. Pylori infection; chronic diseases such as atrial fibrillation, diabetes, heart diseases, chronic pain, and anxiety; and palliative diagnoses, such as advanced lymphoma in a patient over the age of 90. I was also able to practice some procedural medicine, including biopsies and suturing. In addition, I visited an assisted living and long-term care facility with Dr. Fletcher, where we saw a patient with an acute urinary tract infection, and another dementia patient with pneumonia. My clinical experiences during this placement provided me with a variety of learning experiences, from simple to complex.

When I graduate and register as a nurse practitioner (NP), I foresee myself working either in partnership in a local physician's office or as part of a team at a community health center or program providing primary health care to the adult population. As I gain competence, I would be interested in pursuing specialty practice in chronic disease management or palliative care. I may even wish to pursue specialty training or other advanced degrees in the future.

Opportunities like this are exciting and remind me of why I entered the nursing profession years ago. With the help of the Northern Medical Programs Trust, I am one step closer to my goal of becoming a NP. I would like to again express my gratitude for your financial assistance.

Sincerely, Tasenka Kushner

Tasenka Kushner 404-33430 Bourquin Place Abbotsford BC V2S6V8 Phone: 604-309-2477 E-Mail: kushner@unbc.ca

March 27,2016

Northern Medical Programs Trust University ofNorthern British Columbia 3333 University Way Prince George, BC V2N 4Z9

To Whom It May Concern,

Thank you very much for selecting me as a recipient of financial support from the Northern Medical Programs Trust for my clinical placement in the communities of Fort St. James and Smithers from January to March 2016.1 would like to take this opportunity to thank you for your kind contribution to my education at the University ofNorthem British Columbia (UNBC). The financial burden of graduate studies is great, thus I am very appreciative that I have been afforded such generosity.

I am completing my studies at UNBC in the Masters of Science in Nursing, Family Nurse Practitioner program. I aim to complete the program full-time in two years and will be unable to work in the current final year of the program. This presents a significant financial challenge, especially as a single person without a second household income to rely on. Financial support from programs such as yours lessens my financial stress, and helps to aid my success in completing this graduate program.

During my placement in Fort St. James, I had the privilege to practice in a family practice setting with NP Eunice Finch, who was very supportive of my learning. The population of patients I saw were all ages, and largely Aboriginal. We worked out ofthe Tl'azt'en and Nak' azdl i health centers and Stuart Lake Hospital. I saw a wide variety of health conditions; including acute respiratory tract infections, sexually transmitted infections, H. Pylori infection, diabetes, hypertension, depression and anxiety, and substance abuse. I did many women's health visits and pelvic examinations. My clinical experiences during this placement provided me with a variety of learning experiences, from simple to complex, and complimented my previous experiences in Qualicum by providing me with more experience with children and women's health.

During my placement in Smithers, I had the privilege to practice with registered midwife Bobbie Adkins. My patients were all prenatal and postpartum females and their newborns. Many visits were conducted in the patients' homes, and some in the office. The patients we saw were largely healthy, and the pregnancies did not have many complications. I was able to attend an amazing home water birth, where I completed the immediate postpartum and newborn assessments. My clinical experiences during this placement provided me with a stronger basis in prenatal and postnatal care, as well as newborn assessments.

When I graduate and register as a nurse practitioner (NP), I foresee myself working either in partnership in a local physician's office or as part of a team at a community health center or program providing primary health care to the adult population. As I gain competence, I would be interested in pursuing specialty practice in chronic disease management or palliative care. I may even wish to pursue specialty training or other advanced degrees in the future.

Opportunities like this are exciting and remind me of why I entered the nursing profession years ago. With the help of the Northern Medical Programs Trust, Jam one step closer to my goal of becoming a NP. I would like to again express my gratitude for your financial assistance.

Sincerely,

~ Tasenka Kushner

To whom it may concern,

Thank you so much for your generous funding which allowed me the opportunity to complete a practicum placement in Kitimat, British Columbia. The scenery is not only beautiful, but there is also a peaceful energy that is felt, and it is a welcome contrast to the busyness of the city where I live.

During my time in Kitimat, I worked at the clinic located at the Kitimat Modernization Project. The patient population consisted mainly of men who varied in age from 18 years old to in their 60s. I saw a large spectrum of health concerns, including even a couple of patients who required emergency care. These patients enabled me to sharpen my skills regarding identifying individual who require immediate investigations and care. I saw a multitude of musculoskeletal issues, skin conditions, infections, and even some mental health. I also saw some complex patients with extensive histories that challenged my assessment and diagnostic skills. I was given the opportunity to learn a few procedures including incision and drainage and subungal drainage. I had such a wide ranged and well-rounded experience, and again, I must thank you for enabling me to do so. Thanks again,

Suzanne Liu

Date: Aug 1, 2015

Northern ivledical Program Trust

University of Northern British Columbia

ssss University Way

Prince George, BC

V2N 4Z9

Dear i\:lcmbers of the Northern Medical Tmst Program:

Agata Lofts tOi1:1 l'vtcn:s Hd• Hc1·elstokc, BC VoE :!1\u

Phom!: ~:'iO-fl:J7-1!!t:fo • E-Mail: lnfts@unbc.ca

I would like to take the opportunity to thank the Members of the Northern Medical Program Trust

(NMPT) for their generous financial support.

For my clinical experience I was placed in Fraser Lake for 6 weeks. The clinic is located in the Fraser

Lake Community Health Centre and staffs s physicians and 1 nurse practitioner.

The clinic serve~ Fraser Lake and surrounding communities. The clinic provides medical services such

as prenatal care, welJ baby-child exams, chronic disease management and episodic events. Also, the

hospital has a daytime emergency room, x-ray department and lab.

The funding provided by the NMPT allowed me to pay for my rent in Fraser Lalte.

During my clinical experience, I was able to explore Fraser Lake and appreciate its beauty. I have

included a few pictures of the outstanding scenery.

Again, thank you for the generous financial support!

Sincerely,

Agata Lofts Family Nurse Practitioner Student

To Northern Medical Programs Trust,

This letter is to thank you for your generous support this past semester. I had the

privilege of spending 6 weeks in Hazelton, BC at the Wrinch Memorial Hospital in their primary

care clinic. I was also able to do outreach work to the surround Aboriginal Health Centres. I

worked with both MDs and NPs at the clinic. All were inclusive of myself and open to providing

me with learning opportunities.

The communities of both Old and New Hazelton were warm and welcoming. I

appreciated have the local gym in New Town and the beautiful scenery of Old Town. The Mayor

Alice Maitland is very involved and concerned about the issues relevant to the residents of the

area. Council member Nick Marshall was approachable and provided me with some great

information about the community and current affairs.

Once again, I would like to express my gratitude for the generosity of the NMPT for

supporting this wonderful experience.

Regards,

Shandalin Marks, Nurse Practitioner Student

Dear Northern Medical Trust Program,

My name is Danielle Raiser and I am a nurse practitioner student at UNBC. I was fortunate enough to

receive funding from you for the fall 2015 term. Thank you so much for your generosity. My practicum

experience was on Quadra Island, BC at the Quadra Island Medical Clinic, with remote visits to Read

Island, Cape Mudge (a first nations reserve), and the community center. The experience I received on

Quadra was very valuable and varied from infants to the elderly. Quadra Island medical clinic has been

welcoming, and I was able to meet the local MLA. Receiving funding from your organization enabled me

to visit my children, ages 10 and 9 in Squamish, BC where I reside, as well as offset costs of lodging on

Quadra island.

Thank you very much for the experience and assistance with my education travels.

Sincerely,

Danielle Raiser UNBC FNP student.

Date: i\-Inrch !.!!?, ~0 16

Attention: 1\risti Boon and Christine Dillahaugh,

Parveen Sangha mmo II\~ s treet, S11rrcy, B.C. V:JS~J5

Phone: CiO Hi I J..:li 10 • !.::-Mail: sarlgh;rp@unhe l'H

Dear Uni\'ersity of Northern British Columbia and the Northern Medical Program Trust (NPMT),

I am writing this letter to prod de you all with" brief summilry of my clinicnl experience that took place ilt the Oceanside

llealth Center in Parks\'illc BC. Oceanside is u community healthcare center that prO\·ides a\\ ide range ofhealthcare

scn·iccs fi>r the public, including primary care, urgent care, medical imaging, outpati(•nt laboratory services, tclehealth,

mental health, integrated community health, medical day care {support clinic) care, en\'ironmcntal health and specialty

care sen·ices.

I had the pleasure to do a clinic-al rotation at Oceanside llealth Center in Primnry Care. During this rotation I completed

~!.!0 hours with a Filmily Nurse Practitioner (FNP) as my preceptm~ My main role at this clinic wa:~ to provide clients of

all ages with primary care scn·iccs. r-.Jy typical day at Oceanside consisted of 4· toG pre-arranged client appointment~ in

the morning and approximately+ toG same-day/walk-in appointments in the afternoon. Clients would either malcc

appointments for their primary care needs O\ er the phone or in person. During this experience I c:~reu (OJ' exist ing dient!i

as \\'elias welcomed ne'' clients, moNtly without f.1mily doctors, into the clinic .. In ord£>r to ensure the primary care needs

tilr all clients where being met nnd followed-up with, sel'\·ices pro\'idcd by the primary care clinician, such as myself, ''ere

linl;ed to other pro!,'1'ams within O(•canside llealth Centre \rhen possible.

A large focus at the Orcansidc primilr}' care clinic included prO\·iding primary and secondary pre\'entati,•e henlth care

sen·ices to all dient!i. Primary pre\'ention scr\'ices that I provided to clients at Oceanside included implementing lifestyle

modific:rtions, such as with diet and exercise, to achii:,·c nn O\'erall healthier life as well as continuously updating clients

with immunization liS needed, such ns Td:~p and influcnrn. Secondary prc,·cntion sc1·\·iccs that I pro,·ided for all clients nt

Oce:~nside includt!d screening for dyslipidcmia, diabetes and h)1>ertcnsion nrnong potients identified as high risl\ for

cle\'eloping wron:~ry artery diseotsc. :\nothcr large focus of this clinic included chronic disease management. Some

common chronic disenscs I co-managed with my FNP preceptor included depression, hypertension, dyslipidcmin, anxiety,

pharyngitis, skin infections and lesions. I also performed many in-office procedures with guidance and support from rny

FNP preceptor. For example, 1 performed skin procedures such as punch biopsies, suturing, and cryotherapy. I also

conducted medical procedures that screened for diseases such as, pap tests for· cen·ical cancer scrcming and anlcle-brilchial

index for peripherol \'ascul:~r disease screening. Additional sen·ices I prodded during my time at Oce;rnsiue llcnlth

Center included routine wellness ,·isits :~s \\ell as referring clit•nts to specialists for more co-management of more

complex health care concerns/ disease:;,

Lastly, as a graduate s~dent in the UNBC MScN FNP Program J would like to take this opportunity to thank the

NMPT for pro\·iding me with financial support. The funding I received from the NMPT supported the travelling costs

that were associated with my clinical rotation at Oceanside Health Center, particularly with the transportation and

accommodations that were required to successfully complete this rotation. Titis funding allowed me to better explore

healthcare in rural communities, such as Parkville, Errington and Qualicum Beach. From this experience I was able to

gain the sldlls and confidence needed to potentially work as a Nurse Practitioner in a rural community setting in the

future.

Sincerely, Pan.•een Sangha

Student Family Nurse Practitioner, UNBC

Student Essays- RURAL WEEKEND SHADOWING PROGRAM

RURAL WEEKEND SHADOWING PROGRAM 2015 2016- THANK YOU NOTES FROM STUDENTS

Sophie Walton & Vanessa Wheeler- Mackenzie, April 24·26, 2015

The weekend shadowing program in Mackenzie was amazing! Vanessa and I felt extremely welcome by

the doctors, nurses and support staff at the hospital. Or. Dobson and his wife are both young physicians

who shared their Insight into training and practicing as physicians in BC. It was great to be able to ask

questions, not only about medicine, but about finances, work-life balance and career goals in a more

relaxed and social setting. Throughout the weekend we visited in-patients and shadowed in the

emergency room. Or. Dobson provided lots of opportunities for us to take patient histories and practice

out ENT, respiratory and cardiovascular physical exams. We even got a crash course in casting while the

Emergency Department was slow!

Being from the Southern Interior this was a great chance to explore a little more of Northern BC and get

a feel for what it would be like practicing medicine in rural setting. I am so thankful that the NMP runs a

program like this one II will definitely be applying for opportunities like this in the future.

Thanks, Sophie

Adrienne Steadford & Kristin Erickson -Vanderhoof May 1-3, 2015

My weekend shadowing experience was amazing. We had a busy weekend on-call with a few local physicians and reamed so much! I was able to get great insight to what exactly rural physicians do as well as the lifestyle that can go along with the job. Prior to the weekend, I was unsure if rural family medicine was the right path for me. After my experience In Vanderhoof, I was motivated in my studies and Inspired for my future career as a rural physician.

Thanks, Adrienne

In first year of medical school, we have the opportunity to visit a family practice office one afternoon per week, and apply for a limited number of one-off shadowing mornings in Prince George. We learn about a lot of conditions and interesting things in the classroom and read about them in textbooks, but I hadn't ever had an opportunity to get a real sense of what this might look like in an Emergency Department, on a weekend, in a small northern BC community. I was very excited to be able to participate in the Rural Weekend Shadowing program in Vanderhoof. Vanderhoof is a place that I have driven through on the highway hundreds oftimes in my life, but never stopped there for anything other than the Tim Hortons. Once I turned off the highway, however, I found a vibrant community nestled on the Nechako River with a beautiful park, welcoming people and a great group of doctors serving the hospital.

From the first t ime we stopped by the EO on Friday night, we were welcomed by the nursing staff and the physicians. I was surprised to discover that the family physicians group in Vanderhoof provide a wide range of services including not only family medicine but also surgery, obstetrics, oncology and geriatrics to name just a few, in addition to staffing the ward, the Emergency and the clinic. Dr.'s Nicole and Sean Ebert and Or. Jeff Obayashi graciously invited us to shadow them in the ED for the weekend. We were invited to spend as much time as was available in the Ebert home when we weren' t busy seeing patients in the hospital, and they hosted us for several meals alongside their family

RURAL WEEKEND SHADOWING PROGRAM 2015 2016- THANK YOU NOTES FROM STUDENTS

and friends throughout the weekend. From the first call that they got, we were at the hospital as well. We were given the opportunity to interview patients, practice presenting to a preceptor, and observe procedures that I had never seen performed before.

There were also a number of community events happening in Vanderhoof that weekend including a trade show and the Wild Goose Chase running race. We were ready to participate in the race, but ended being tied up in Emergency. I was not really sure what to expect heading into the weekend, but r feel that I had an excellent experience. If all rural communities have the kind of collegial group practice with the kind of dedicated doctors that work in Vanderhoof, it would be the perfect fit for the medicine that I see myself practicing and the lifestyle that I would like to have some day.

Kristin

Dayle Ostapluk & Crystal Bostrom- Mackenzie, June 19·21, 2015

The shadowing weekend in Mackenzie was an enjoyable adventure. We were able to observe the doctors engaging in a variety of cases. Their flexibility and resourcefulness was remarkable as they met the needs of the patients, the patients' families, their own healthcare team, and us, the students. Our inclusion in all aspects of patient care was appreciated and the stories were treasured . There was rarely a moment of silence or rest but t ime was always put aside to answer our numerous questions. The experience was that of a teaching and mentoring opportunity as information was freely given along with career advice. All in all, it was a great experience and one that I highly recommend. · Dayle Ostapiuk

My experience with the rural shadowing program in Mackenzie was spectacular. A colleague and I were able to shadow a physician (and his partner) who were immediately welcoming and made us feel at ease as students. These rural family physicians went out of their way throughout the weekend to answer any questions we had about rural practice and give us insight into the day to day life of a rural physician and why they loved and chose rural practice. He and his partner not only made us feel welcome, but also made sure we were very involved with patients, enabling us to practice crucial skills including history taking, presenting to a physician, thinking through a differential diagnosis, and learning first hand treatments for different conditions as patients were seen. We were able to be on-call throughout the weekend and were able to see first hand what a difference in someone's life access to good medical care can be. While I grew up in a rural community and had ample experience with the medical system as a patient, I had never experienced medical care from the side of the rural physician. My experience shadowing in Mackenzie enabled me to put myself into the shoes of a rural physician for a weekend, learn the positives and negatives of working in a rural setting as a health practitioner, and solidified my excitement to p·ractice medicine in a rural setting. I have also not had the opportunity to explore rural communities in the north. This experience allowed me to explore what Mackenzie has to offer as a potential future practice location and meet and interact with the close-knit team of welcoming physicians practicing there. I am so grateful to both the physicians and the patients who allowed me to gain such an amazing experience and insight into the practice of rural medicine in a northern setting.­Crystal Bostrom

Megan Enos & Crystal Bostrom- Valemount, June 12·14, 2015

RURAL WEEKEND SHADOWING PROGRAM 2015 2016- THANK YOU NOTES FROM STUDENTS

I had the pleasure to spend the weekend at Valemount Health Centre with Dr. Stephen DuToit as part of

the Northern Medical Programs Rural Shadowing Experience. This was an extremely beneficial

opportunity, which introduced me to the experience of practicing medicine in a rural community. The

staff at Vale mount Health Centre were exceptionally welcoming and open to any questions we had, and

greatly enhanced our experience. We were on call for the first time in our medical careers, which

allowed us to get a glimpse of how smaller medical centers handle emergencies, and issues surrounding

medical care for Individuals in rural communities. We were also extremely fortunate to be allowed to

audit an ACLS course that was occurring that weekend for medical professionals from Valemount and

McBride. The course allowed us to apply all the knowledge we learned in our cardiac block to real life

scenarios. I thoroughly enjoyed our weekend and thought It was a great way to see first hand the

benefits to practicing rural medicine. I enjoyed how tight knit the healthcare professionals were

between Valemount and McBride and the Valemount area is extremely beautiful. My partner was also

able to join me, and it was also great for him to see what it would be like if we were to live in a rural

community. He also enjoyed the experience and is also drawn to us finding a rural community to settle

in after I finish school. After this weekend, I can' t wait for more opportunities to visit rural communities

and shadow rural healthcare professionals in order to hopefully find my future home. - Megan Enos

My experience with the rural shadowing program in Valemount was amazing. A colleague and I were able to shadow a physician who was immediately welcoming and made us feel at ease. The team of physicians in Valemount were taking a training course in advanced cardiac life support the weekend that we were shadowing. Because of this, we were not only able to see patients and experience on-call nights, but also were able to audit the advanced cardiac life support course and work alongside and interact with the physicians and nurses from both Valemount and McBride (helping during CPR as the team of physicians and nurses ran codes and solidifying knowledge and learning about the real-world application of medications and physiology we had just learned in cardiac block!). Throughout the weekend, we were made to feel extremely welcome and were able to gain insight from a variety of physicians and nurses who practice in these two rural communities as well as a medical student doing a rotation in the community. As a student, I was able to interact with a number of health care practitioners and learn about rural practice in the north and what challenges and opportunities rural practice poses in these two communities. Through this experience I felt like I gained an excellent sense of how valuable respect is between healthcare practitioners and what a strong team these two communities have. We were also able to explore Valemount as a potential future location to practice in throughout the weekend, finding yummy local food locations and artisans during our t imes on-call. I am very grateful to all of the healthcare practitioners in these two communities for welcoming us during our shadowing weekend and especially to the practitioner whom we shadowed, for allowing us to gain so much experience into the life of a rural physician. -Crystal Bostrom

Gisele Adam & Jessica Burian- Vanderhoof, Oct 2-4, 2015

Thanks to the Northern Medical Programs Trust we had an informative weekend shadowing in Vanderhoof that exceeded our expectations. The welcoming and friendly attitudes of everyone was encouraging and positioned Vanderhoof on our radar as a potent ial place to practice in, in the future. When we initially arrived at the hospital we were greeted by the nursing staff who took the time to show us around the hospital and make us feel at home. This was the start of an action packed weekend

RURAL WEEKEND SHADOWING PROGRAM 2015 2016-THANK YOU NOTES FROM STUDENTS

of getting to know what practicing medicine and living in Vanderhoof might be like. Dr. Dhillon and Dr. Obanyashi were both very patient and skilled mentors. They talked positively about their experiences with full scope practice ln Vanderhoof. The medical variety and long-term relationships they had with their patients was enticing. The nursing staff, doctors, technicians and ambulance attendants in Vanderhoof have a great working relationship with one another. The mix of inside jokes, quality care and respect for each other and their patients makes for a cohesive well-functioning medical team. We witnessed the domino effect of a tragic event over the weekend. In bigger centers a doctor may only treat the primary patient of an incident. When a tragedy occurs in a small town there is a ripple that moves through the community. Those effected by the incident sought health care from the same doctors who treated the people involved in the initial event. This demonstrated to us the deep connection a rural physician has to their community. Incidents are seldom Isolated. When a rural physician treats one patient they must also bear in mind the community members they know who may also be effected. We were also humbled by the patients' willingness to let us be involved in their care over the weekend.

We cannot express enough the sense WELCOME we received over the weekend. The Obanyashi Family graciously had us over for breakfast one of the days we were there and took us on a lovely hike with their family the following day. We made a fire, cooked hot dogs and roasted marsh mellows while getting to know each other better. We were taken on a tour of the city by the Mayor of Vanderhoof, Gerry Thiessen, before going to his house to enjoy a delicious home cooked meal made by his wife. We learned that the city is a recreational playground. Whether you are into cross-country skiing, fishing, hiking, biking, camping or running there is no shortage of places to pursue recreational interests in and around the city. We received a tour of their state of the art sturgeon fish hatchery. The facility was impressive. The tour was guided by_ who was very enthusiastic about the project. We learned that the community is greatly involved in the hatchery. It became clear to us that the locals valued their environment and teaching their youth about Environmental Science to make them more informed about the world they live in. During dinner at Mayor Thiessen's house we were joined by the Principal of the High School and his wife, and Dr. Dhillon and his wife. If the rapport we observed between the six people at dinner was any indication of the connection that exists between the community members of Vanderhoof than this community has an admirable sense of companionship. Everyone was very kind and welcomed us to come back to Vanderhoof anytime we'd like. We are internally grateful to the Trust and the community of Vanderhoof for this opportunity.

Sincerely,

Gisele Adam and Jessica Burian

Kirk Dixon & Ross Williams- Valemount, Oct 16-18, 2015

Weekend shadowing was an absolute blast and I am very grateful lor the opportunity. We were shadowing the ER and clinic In Valemount and got a chance to do IV's, make a cast, do ultrasound imaging, suturing, and perform slit lamp exams. 1 feel like we got a chance to feel what the day and lila of a rural physician is like and the lifestyle that goes along with being a rural physician. After this experience I am now beginning to understand how competent a rural physician has to be as they have to provide care to a community with not a lot of support in a emergency type selling. I enjoyed how the shadowing experience made me realize how creative rural physicians were as they might not have all the tools at their disposal in comparison to a larger centre however they always seem to make it work with the tools they have through

RURAL WEEKEND SHADOWING PROGRAM 2015 2016- THANK YOU NOTES FROM STUDENTS

Improvisation skills. Furthermore, I really enjoyed how I was able to see how close a rural physician is with his or her patients and the unique relationship between the patient and rural doctor. Between breaking out the guitars and jamming with my colleague and a 4th year medical student on a surreal river, and getting a chance to practice medicine that we haven't covered it was unequivocally an experience I will not forget. I would highly recommend this experience to anybody that is interested in rural medicine as well as people that aren't Initially interested in rural medicine because it might change their mlndl Kind Regards, Kirk Dixon, MD Candidate 2018, NMP Social Rep

I spent this last w~eekend in Valemount for the rural weekend shadowing program. Kirk and I shadowed Dr. Stefan Du Toit for the weekend, as well as Caleb De Putter, a NMP 41

h year. My experience was extremely favourable. Dr. Du To it had such a passion for teaching, and spent a lot of time with us talking about rural medicine and its unique challenges. We learned about the administrative side with regards to patient transfer, on-call responsibility and the benefits of salary. He also explained to us the success of the team-based approach, the community engagement and the lifestyle of working rurally. Caleb and Dr. Du Toit taught us how to start IV lines, put on casts, use the ultrasound machine, use a panoptic scope, and use a slit-lamp for an ophthalmologic exam. We also got to meet the mayor, Jeannette Townsend, who also told us about Valemount and the rural experience. I am grateful for the experience and the education I received this weekend, and would do it again in a heartbeat!

Ross Williams

MD Class of 2018 I

Christina Thompson & Sophia Peng- Mackenzie, Oct 30- Nov 1, 2015

Before moving to Prince George for medical school, I had little idea of what the North had to offer. I knew that there would be snow and lakes to skate on in the winter but I didn't know that there would be so many uniql;le communities. Through the rural weekend shadowing program, I was able to explore the community of Mackenzie. I was well-stocked for the two hour ride, filling the trunk of my car with non-perishable foods, shovels, salt, and snow traction mats. Luckily, none of this came to use and the commute to Mackenzie was a fun road trip, especially as we passed beautiful lakes like Mcleod Lake. After checking in at our hotel, we were eager to get to the hospital where we met Dr. Mackenzie and the hospital nurses. Throughout our weekend, the hospital crew became our teachers as we learned how to do suturing and casting for the first time. We practiced our history taking skills on many patients and along the way, we learned how happy they were to call Mackenzie their home. Many of the folks we talked with had lived there for more than 20 years. One of my most memorable patients was a gentleman who had deeply cut his finger while field dressing a moose. Being in the bush, he wasn't able to seek care right away so he wrapped himself up and continued with his work. It seemed to be a recurring theme that patients here would fight through their pain and were always eager to get ba.ck to work. As much the hospital opportunities were incredible, my richest experiences came from our time within the community. On Halloween night, we attended the Mackenzie fireworks where it appeared as if every soul in town had come out despite the chilly weather. We then went to a legion dance and the next day, we had time to go skating and shopping in the local mall. We had so much time to casually talk to people and see what being In this community would be like. Leaving Mackenzie, I was tired but more excited about medicine than ever. I feel incredibly privileged to be able to participate in programs like the rural weekend shadowing program. I am excited that I may be able to work and live in towns like Mackenzie, a town where your patients definitely are not strangers. Christina Ross

RURAL WEEKEND SHADOWING PROGRAM 2015 2016- THANK YOU NOTES FROM STUDENTS

1 really enjoyed my weekend at Mackenzie with Dr Mackenzie. On the weekends at the hospital, there is only one doctor and a small team of nurses and on-call technicians. I got to see the importance of history and physicals for a rural ER where some labs and imaging are not readily available. Though our weekend was qui te quiet compared to mostweekends, I heard some stories about the abundance of interesting cases that the hospital sees and deals with, in contrast to the automatic specialist referral in a bigger centre. This really emphasized the broad spectrum of practice in a rural setting and the competence rural training brings. Through the stories of the staff and the patients, I also got a sense of flexibility in the practice of a rural doc. Another great thing about the quiet weekend was the opportunity to explore the town. I visited the malls, rec centre, a few of the restaurants, the bowling alley, and the legion. It was refreshing to have everything in walking distance and I felt very welcomed by all the locals who were happy to strike up a conversation. I will be willing to consider Mackenzie for a rural elective if the opportunity presents. Best, Sophia Peng

Jessie Holbek & Scott Matlock- Mackenzie, November 6-8, 2015

I had a fantastic experience shadowing in Mackenzie this past weekend. Scott and I were working with Dr. Penman for the weekend, as well as an R2 in family medicine who was up on a placement from Chilliwack. We immediately felt welcome at the hospital. We got called in to observe our preceptor stitch up a lacerated finger, and subsequently were introduced to suturing. Dr. Penman gave us some instructions and then set us up with kits to practice whenever we had time throughout the weekend. On Saturday we saw a whole variety of patients. We got to practice our history and physical skills in the ER, as we went in to see patients first and then reported our findings to either the resident or our preceptor, who would then come in with us to confirm our observations and discuss management. Dr. Penman also included us in all the procedures he performed, went over investigations such as x-rays and ultrasound with us, and really went out of his way to ensure we had a good learning experience. We also got to try out casting and ultrasound the next day. It was great to see what the scope of practice is for rural family physicians, see how the hospital is run in a small town like Mackenzie, and find out what these physicians love about their jobs. We got a chance to explore the community, visiting both Williston and Morfee Lakes, and Dr. Penman had us over for lunch along with a couple other of the local doctors. I am appreciative of Dr. Penman taking time to teach us, and for the unique opportunity we had to visit Mackenzie to shadow for a weekend through the NMP! Thanks, Jessie

We had a great drive to Mackenzie as the roads were clear and the scenery was nothing less than spectacular! We arrived to town and found our way to the hotel to check in. We quickly phoned Dr. Penman to determine when we were to go to the hospital. He mentioned that there were no patients slated for that first night, but that he would l~t us know if something came up. We went to a local pub called "The Office" and low and behold right after we finished our dinner we got the calli That was the beginning of an interesting night that saw us leaving the hospital just before midnight. The next day, Dr. Penman had many interesting cases for us, and we were able to explore around the town a bit. On Sunday we started off the day practicing putting casts on each other and working the ultrasound machine with the local family resident. We ended our trip with a fantastic meal at Dr. Penman's house, with another loc~l doctor. This was a fantastic trip that really let us experience what rural medicine is . We got to see a glimpse into the lifestyles the doctors have, and see what responsibilities they have to

their community. I had a great time and would recommend going on a rural weekend trip to all of my classmates! I hope that I get to visit Mackenzie again soon. Thanks, Scott