A steady stream of medical students from the South interning at H.H. Williams Memorial Hospital this summer may just be the solution to the health centre’s long-term staffing needs.
“It’s not just a matter of perhaps having them come back,” said locum Dr. David Wilson. “There’s a spinoff effect where they tell people back in Toronto and get the word out. If there’s someone thinking about it, if they hear something positive about Hay River, they’ll be encouraged to maybe give it a try.”
The hospital in Hay River is currently hosting two medical students – Andrew Cameron from Queens University and Sarah Farrow from the University of Toronto. At least three more are set to rotate in throughout the rest of the summer and into the fall.
Erin Griffiths, physician recruitment officer for the Hay River Health and Social Services Authority, said the program – new this year – is part of a long-term physician recruitment and retention strategy.
“I am constantly recruiting physicians,” she told The Hub. “Our goal is to have four permanent physicians and four permanent nurse practitioners. We are aiming to have a full staffing compliment for when we enter the new facility.”
The health authority currently employs one full-time physician and one full-time nurse practitioner. For the rest, Griffiths draws on a pool of 52 locum nurse practitioners and family physicians working with the hospital, 40 of whom are active locum doctors returning on a regular basis. The minimum period to which a locum must commit is two weeks, up to a maximum of three months.
Griffiths said the vast majority of locums return after their first visit. Indeed, several have signed up to spend two weeks per month, every month for a year in Hay River.
Despite the locum system, or as a result of it, Griffiths argues the continuity of care in Hay River tends to be much more consistent than in bigger centres.
“It’s the nursing and hospital staff who really work as a team to make it happen,” she said.
Cameron and Farrow agree. While neither has had extensive experience in hospitals in southern centres as of yet, they are both far enough into their medical careers to recognize a personal touch and the advantages of a smaller facility.
“In Toronto, I would be given the needle already prepped,” said Farrow in reference to her experience in the last few weeks learning how to give inter-muscular injections from nursing staff at H.H. Williams Memorial Hospital. “In big hospitals, there’s a tendency for things to happen and you don’t necessarily know who did it or when. That’s just not the case here. In shadowing the nurses, we’ve really seen the scope of their practice.”
Cameron concurred, adding that while the tendency can be to believe the locum system can lead to gaps in treatment, that has not been his experience.
“Continuous care is provided by the nursing and support staff,” he said. “Care is surprisingly contiguous and certainly not as siloed as people think.”
Permanent physician Dr. Coralie Boudreau said she enjoys having the medical students at the hospital for the extra energy they bring to the wards, but also because it has a tendency to elevate the care provided to patients even in the simplest situations.
“They ask questions and keep us on our toes,” she said, adding that part of a doctor’s mandate is to pass knowledge on to the next generation. “We end up teaching the patients more, too. The students ask questions that the patient wouldn’t know to ask or feel comfortable asking.”
Wilson said teaching doctors have the potential to be more thorough, as they are explaining everything as they go. He hastened to explain that does not mean doctors are less than thorough on occasions when they are not teaching, just that having to talk through a procedure means that protocols are better explained and specifics are laid out more clearly.
“The medicine gets better,” he said. “An answer of ‘come back in a few months’ isn’t good enough for a student, so we’re forced to pin it down and be more specific.”
As to whether Farrow and Cameron will return themselves at a later date, the signs are hopeful. Cameron said that, while they had both come in bright eyed, knowing full well it was too early in their careers to make any big decisions, Hay River and its people had snared them within the first few weeks.
“We were in the car, and I looked over at Sarah and I said, ‘Damn, they got us.’”
— Sarah Ladik