From Iqaluit in the Northwest Territories to Pender Island, UBC's medical students are finding out what it means to be a doctor in a small town.
This year's summer rural practice elective program has 109 second-year students working with doctors in 56 communities around B.C., the Yukon and the Northwest Territories. Some students also work in underserved facilities in Vancouver.
Students select their location and work a minimum of 40 hours per week in four- to eight-week terms. For most students, this is their first clinical experience. They are supervised by doctors who volunteer their teaching time.
"Variety is the best part of this assignment," says Shannon Douglas, who is completing a five-week term at Fraser Lake, a town of about 2,000 people west of Prince George.
"I've helped care for a dying patient, removed a set of tonsils and helped deliver two babies - all under supervision of course," she says. "Any time anything interesting came up, I was called."
Douglas lives in a trailer on her parents' property near the diagnostic and treatment centre where she works. She loves the northern countryside.
Many local doctors seem to have a more active life outside their practice than city doctors, she says, an aspect of rural practice she finds appealing. Long unpaid hours on call, however, are a negative feature. Overall, she says the experience has reinforced her desire to become a general practitioner in a rural community.
Student Cathryn Brown, working in a Queen Charlotte City clinic and hospital, agrees.
"There's an incredible amount of variety - everything from the flu to motor vehicle accidents to cancer," she says.
She was surprised by the doctors' encouragement to perform procedures herself - she had expected to observe only.
A life-long Vancouver resident, Brown has also been impressed with northern living.
"Everyone up here seems to be a character," she says.
Communicating with students and doctors who are widely separated geographically has been a challenge for administrators. This summer, they introduced a Web-based network designed for dialogue and as a teaching supplement.
"We chose palliative care as the subject for the pilot because it's a universal concern," says Dr. Bob Woollard, director of undergraduate programs in the Dept. of Family Practice.
The network provides a link to on-line periodicals, palliative care Web sites and a secure chat group where students and Vancouver palliative care specialist Dr. Doris deGroot can reflect on their experiences. A committee of students and faculty will be evaluating the effectiveness of the network at the end of the summer.
Students receive a stipend of about $200 a week from provincial government grants and charitable donations. Students do their own fund-raising during the year to supplement these sources.
The rural practice program, an elective since 1974, becomes a required part of the revised undergraduate medical curriculum in 1999.