Solutions: Residency program based at Royal Inland Hospital offers hope for future

Michael Marino is the kind of student that UBC is keen to lure and turn into the kind of doctor who will return to his Interior roots.

Kamloops born and bred, the 35-year-old graduated in May this year from UBC medical school based at the University of Northern B.C., in Prince George.

He's currently in a residency program at an Edmonton-area hospital, where he will spend two years training and writing exams before becoming a practising physician. And while the Kamloops resident is going to Alberta for further training, there is little doubt in his mind where he will end up.

"I'm not a Lower Mainland person. I don't want to go anywhere bigger than Prince George or Kamloops. It will be our size or smaller," Marino said, adding "but things change depending what your interests are."

With a shortage of dozens of physicians, Kamloops is considered rural for purposes of UBC's medical training.

Statistics provided by UBC show between three and eight graduates of Thompson Rivers University enter its medical school each year. That compares to about 130 at UBC's Vancouver campus.

UBC's distributed medical program locations are at Victoria, Kelowna and Prince George. While there are no plans for a medical school here, Kamloops' medical community is working with the university to start a residency program based at Royal Inland Hospital as early as 2014.

Newly graduated medical students from any of the UBC programs will come here for a two-year residency.
At the completion and after passing exams, they will be certified by the College of Family Physicians Canada.

UBC faculty and local physicians are in the planning stages for the residency program. The hope is with exposure to the community, family physicians will stay in the city to practise.

But rural politicians also have their eyes on the program.

"Part of it for us is we need to get someone in our rural communities for three to six months," said Clearwater Mayor John

Harwood. "They need to get an understanding."

Despite that goal, there are concerns that with Dr. John Soles as the only long-term physician
in Clearwater there is insufficient support for residents.

"What does that do for the stress and strain on his workload?" asked Coun. Shelley Sim.

While Marino is rooted here and understands the shortages in Kamloops, he's uncertain whether his wife and two children will be keen on moving to a small town in the region.

"In the end the decision is not all mine. I have other people to answer to. Physicians are needed in these places. I don't know if we'd live there. It's a family decision."

Those family decisions are increasingly becoming paramount for younger physicians, many of whom want a multitude of sports and educational options for their children. Their spouses may also have careers that can't be fulfilled in a town of only a few thousand people.

Kamloops agrologist Robson Rogan was born in Thunder Bay, Ont., and lived there until he was 13, one of three children of a pediatrician father and nurse mother.

The Rogans then moved to Barrie, a larger city.

"My dad was busy with a full-time clinic and being on-call six days a week, in addition to his regular practice," Rogan said of the life of a rural specialist.

UBC's Dr. Bob Woollard said while he set out to raise his family in a small town, ending up in Clearwater - similar to his own upbringing in Alberta - studies show young doctors don't have the same goals, or commitment to the long hours of yesteryear.

"I don't want to sound like an old fart, but evidence shows folks aren't willing to work as hard. They make lifestyle choices."

Beyond the dedication sometimes required, Woollard acknowledged rural life can be tough on family members.

"I used to say to my students, 'The best job in the world is a small-town GP.' The problem is the worst job in the world is the spouse of a small-town GP," he said.

"You become almost a single parent. You realize on a regular basis you come second. You have to know what you're supposed to know, and what you're not supposed to know."

Occasionally patients would come to the door, where they would be greeted by his wife, Erlene, in a town where the couple knew most of the residents.

"Even if I wasn't on call, people would come to the door. She'd say, 'He's been up for three nights and you have to see the doctor on call.' "

Rogan said his family loved small-town life in Thunder Bay and its recreational activities. But there came a day when his parents moved for their children.

"They were looking for greater opportunities for their kids.

That was the sole driving force. Thunder Bay was great and had a lot of recreation and small-town feel. They were looking to opportunities for university. That's why we moved."

Woollard said UBC is also learning that not only must it seek out students from rural B.C., it must tailor learning for its medical students and res-idents in order to make them independent.

"You can take the most rural folks and make them afraid to work 20 feet from an MRI machine," he said.

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