This year marks the 10th anniversary of the Northern Medical Program and the Northern Medical Programs Trust.
In 2004 the first class of medical students began training at UBC before coming to UNBC in 2005.
UNBC vice-provost of medicine Dr. Paul Winwood said the unique partnership between the medical school, Northern Health and the Northern Medical Programs Trust -a nonprofit fund created to support medical education in the North -has allowed the program to offer students medical training in a rural environment.
"Among the things that influences where a physician practices is where they get their experience. It's really about trying to support healthcare students obtaining rural experiences, and therefore remaining [in rural practice,]" Winwood said. "Students who are thinking they want to practice rural medicine... tend to be attracted to our program. Rural doctors have to practice in more isolation than urban doctors, so they have to be more confident. We train practical, well-rounded physicians."
The first class of Northern Medical Program students graduated in 2008, and each year 32 students are admitted to the program. Once a medical student graduates, they must spend a further two to seven years in a residency program - depending on their specialty - before being able to practice independently.
The program has kept statistics on where and what type of practice its graduates go into.
On average in Canada, only 30 to 35 per cent of medical school gradates go into family practice, Winwood said. For the Northern Medical Program, more than 50 per cent of graduates become family physicians.
"Of those, nearly two-thirds are practicing in rural or northern Canada, about one-third in northern B.C. That's very encouraging," Winwood said. "Only 10 per cent of family doctors [in Canada] go into rural medicine on average."
In addition to the medical school, the Northern Medical Program operates a family practice residency program in Prince George, which is available to graduates from the program and other schools, he said. Of doctors who complete their residency in Prince George, 65 per cent have gone on to practice in northern B.C. and another 15 per cent in other northern and rural areas of Canada.
"[And] the results that our students get in national exams are as good as anywhere in the country," Winwood said.
Part of that success is because of the experiences supported by the Northern Medical Programs Trust.
The trust is a partnership between 24 municipalities, four regional districts and corporate sponsors Canfor, CN Rail, Rio Tinto Alcan and West Fraser. The City of Prince George and Regional District of Fraser-Fort George are both partners.
Since its formation, the trust has raised almost $6.5 million, which is used to provide about $150,000 in disbursements per year to support students and programs.
The trust provides financial support for students taking integrated clerkships in rural communities like Fort St. John and Terrace, Winwood said. Unlike traditional clerkships, where senior medical students spend a portion of their training focusing on hands-on learning in different areas of medical practice, rural students have to handle a wide variety of cases, he said.
"They basically see everything that walks through the door. There is some evidence its a better way of learning," Winwood said. "That's the reality of medical practice."
In addition, the trust supports opportunities for first-year students to job shadow rural physicians in places like McBride and Mackenzie, he said.
"They support [job shadows of] one physician who flies into First Nations north of Fort St. John. They go in by helicopter... for a week at a time," Winwood said. "They get to see clinical medicine in the raw."
The trust also provides financial support for students who have to relocate to Prince George and other rural sites for their education, he said.
"If you have to relocate for a year... it can be costly. The cost to the students would be quite off-putting," he said. "And some of these things would not be possible, period."
The benefit of the program is not just in the training of doctors, but in the attraction and retention of already-practicing doctors, Winwood said.
"There is no doubt that having a medical school here helps attract physicians here. I came here because of the [Northern Medical Program], and I'm not the only one," Winwood said "I think [for] physicians it just enriches their working life if they are teaching. It keeps you young and keeps you fresh, and keeps your knowledge base up if you're teaching."
The program has incredible support from local physicians, he added.
"In Prince George about 95 per cent of our physicians teach. I can tell you that is not true in other places," Winwood said. "We are... so grateful for the teaching they provide."
SURVIVAL TACTIC
Dr. Bert Kelly, executive director of the Northern Medical Society and longtime local healthcare advocate, is one of those teaching physicians.
Kelly was one of the early advocates for the Northern Medical Program, after almost 6,000 people packed what is now called CN Centre in a rally on June 22, 2000, to call for increased health services in the North.
"It was a survival tactic. We were, at that time, losing physicians faster than we could replace them," Kelly said. "Back in the day when we conceived this, we were laughed at... this was something impossible to do. [But] there is no doubt that this is working. Every year it seems to get stronger."
The program isn't just a victory for northern B.C., it's a victory for rural and northern communities across Canada, he said. Northern B.C. couldn't absorb the entire graduating class of the Northern Medical Program, Kelly added.
"If a Prince George graduate settles in rural Quebec, is that not a success? [It's] a Canadian medical program," Kelly said.
The program is providing aspiring doctors from northern and rural areas a chance to learn in a more familiar, comfortable setting, he said.
"Rural kids, northern kids... this is home, so this is where they want to stay," Kelly said. "[And] they go into the world feeling more confident than their urban colleagues in Vancouver."
Kelly said he is currently working with a student from Prince George in his family practice.
"He intends to come back here. This is where his family is, where his friends are," he said. "I just hope there is a position to offer him. Attracting them back will only be possible if we have the infrastructure to offer them, for example the surgical times."
It's critical to ensure Northern Health has the resources available to ensure doctors who want to practice in the North can, he said.
Kelly said it is important that the Northern Medical Programs Trust has expanded its focus to include support for other medical professionals besides physicians. In 2010, the trust began adding supports for students in the family nurse practitioner program and in 2012, supports were added for physiotherapy students at UNBC.
"It's programs plural," Kelly said. "It's impossible to have a modern medical service without these other professionals."
'NIGHT AND DAY'
Northern Health chairperson, and former UNBC president, Charles Jago said while there are still challenges facing healthcare delivery in the North, "compared to where we were 10 years ago, it's night and day."
"Ten years ago all the doctors [in B.C.] were being trained in Vancouver. Very few, if any, were coming into northern B.C. Predominately the North was being served by doctors from abroad, mostly South Africa," Jago said. "Now we have our full quotient of of family practitioners. [And] if you look at Mackenzie right now, all the physicians there are graduates of the Northern Medical Program."
Northern B.C. has gone from being "a purchaser of medical skills from abroad," to contributing to the development of new physicians and medical professionals in the province, he said.
"For Northern Health, stability of physicians is critical to us," he said. "The University Hospital of Northern B.C... is as major training centre for physicians as well as nurses and others. The Learning Development Centre we're building now will focus on that role."
Construction began last year on the $9.86 million, 14,692 sq. foot centre that will feature a clinical simulation centre, video conferencing suites, seminar rooms, library and study areas.
As president of UNBC during the development of the Northern Medical Program, Jago was instrumental to the creation of the Northern Medical Programs Trust.
"I started to travel from community to community to make sure community leaders knew we were creating a [medical] program for, not just for Prince George, but for the North," Jago said. "[The trust] anchors the Northern Medical Program throughout northern B.C. To the best of my knowledge there is nothing like it anywhere in the world."
The support from industry and communities across the North is evident in the success of the trust, he said, which continues to grow.
The Northern Medical Programs Trust is holding its annual Dr. Bob Ewert Memorial Lecture and Dinner fundraiser on Saturday, featuring Canadian astronaut and author Chris Hadfield as the keynote speaker.
"The Ewert lecture... where else do you find that level of community support and interest in healthcare services?," Jago said.
FROM STUDENT TO TEACHER
Dr. Heather Smith grew up in Prince George wanting to be a doctor. The Northern Medical Program gave her the chance to get her medical degree at home.
"I got to get a medical education in the place where I wanted to work: northern B.C.," Smith said. "I've gone from being a student to being a teacher in the medical program. And the new students are just as excited as I'm sure I was back then."
Smith, a general practitioner, has been practicing in Prince George since July 2010 and currently works at the College of New Caledonia Health and Wellness Centre.
She said people are enthusiastic and excited to meet her when they hear she's a graduate of the Northern Medical Program.
"Prince George has really taken it on as their own," Smith said.
While bigger centres can offer more access to specialists and more residencies, doctors in Prince George were eager to share experiences and knowledge with medical students, she said.
"In first year we were overwhelmed with people saying, 'come and take a look at this.' After ten years, there is still a willingness to work with [students,]" Smith said. "I saw that family practice, which is the type of medicine I wanted to do, could be practiced in such a diverse way."
Many family physicians in smaller centres have additional training, "and were allowed to use it," she said, which is not often the case in larger centres with more access to specialists.
The collegiate atmosphere hasn't ended now that she's a graduate and practicing on her own, she said. She still sees many of her former teachers and they are willing to provide their insight if she has a difficult case, Smith said.
"[And] in terms of colleagues, I have medical school colleagues who will call and say, 'I have this patient, what do you think?'" Smith said.
The support of the Northern Medical Programs Trust allowed her to spend two weeks in Fort St. John and Dawson Creek to get experience working in centres smaller than Prince George, she added.
"It's a great program," Smith said.
