This Labrador hospital is hoping to train the next generation of rural doctors

Labrador's central hospital is fully staffed and doctors hope to never be in a dire staffing shortage again thanks to a teaching program bringing in six physician residents each year. 

While the program isn't perfect, the staff at the Labrador Health Centre in Happy Valley-Goose Bay say their focus on life outside of the hospital helps draw in future doctors to consider a life in rural and remote locations throughout Newfoundland and Labrador. 

"It's not just the nine-to-five … it's also the community, it's also the coast," said Dr. Robert Forsey. "So that's part of building an attraction to the place."

Towns throughout Newfoundland and Labrador face physician shortages. Emergency rooms are temporarily closing and doctor's offices shuttered due to a lack of staff. It's a situation the staff at the Labrador Health Centre are too familiar with.

In the 1980s, Happy Valley-Goose Bay was in desperate need of doctors, Forsey said. 

"We were more or less in free fall because we were losing doctors left, right and centre," Forsey said. 

Dr. Michael Jong was teaching a program in St. John's when he had the idea to develop a rural academic teaching site in Labrador. The program was created with Memorial University and Labrador-Grenfell Health and launched in 1991. 

"You would open their eyes to it," Forsey said. "Some of them are going to like it and they're going to come back, which is really what happened."

Locally called the NorFam program, it has grown to a two-year residency program that accepts six resident doctors each year, and 12 total at a time. 

Newfoundland and Labrador Health Services said over the past five years the program has gotten an average of 146 applications annually.

The Canadian Resident Matching Service allows students to apply for an unlimited amount of programs and rank them to their preference. It then pairs the six most compatible students to the Labrador program. 

Focusing on supporting doctors outside of the hospital

Dozens of doctors have stayed on either for their entire careers, for multiple years or as a locum following the two-year training. Forsey said he believes it's because they do things differently in the remote Labrador location when compared to elsewhere in Canada. 

The program combines simulations, emergency room shifts, obstetrics and outpatient clinic practice but is unique in focusing on supporting doctors outside of the hospital, Forsey said.

Residents spend time outdoors with local people, camp during the winter, hunt on snow machines and learn about the Labrador Innu and Inuit cultures. 

"We send the first year residents off to the Innu gathering and they spend a week on the land with some of the first people in this area," Forsey said. "Some of the elders will come and teach us about what it was like to grow up on the land."

Forsey said he hopes hospital staff hope they are never back in the desperate situation they were in the 1980s. 

"I think here we haven't struggled as much with staffing and I think it's largely because of our relationships with each other," said Dr. Karen Horwood, who works and teaches out of the Labrador Health Centre. 

Horwood was born in Port aux Basques and grew up in Lewisporte. She came to Happy Valley-Goose Bay in 1995 as a medical student and found the support was more than expected. 

More than 30 years later, Horwood is still in Happy Valley-Goose Bay.

She has an appointment with Memorial University and said those relationships played a role in her choosing to stay. 

Program not 'perfect' but centre fully staffed

NLHS announced earlier this month that all 16 permanent positions have been filled at the Labrador Health Centre. 

Dr. Gabe Woollam, chief of staff at Labrador Health Centre, went through the program in 2007. He said while it isn't perfect — the still being a wait list as an outpatient — the program has been a success.

The majority of permanent staff physicians came through the program. 

As well, almost all the doctors in the locum pool — used to relieve staff — are graduates who know the area and its people, Woollam said.

"A lot of places in this province and elsewhere in Canada, the locums that come and go have no attachment to the place. And I think where people have already spent two years training here, they're able to provide a much better service even if it is on a locum basis," he said.

Future developments include potential specialties

While the program is for general practitioners, NLHS is facing a shortage of obstetricians and gynecologists in Labrador. Woollam said they are working through barriers to have specialty residents in the future in obstetrics, pediatrics or psychiatry.

In the future, there's hope to expand the program to take residents to Labrador West and the south coast to increase their knowledge of those areas as well and potentially recruit more future physicians to the area, Woollam said. 

Horwood said she hopes other people from small towns and throughout Labrador consider medicine as a career.

"You can do it. You don't have to be from a big city, You can be a doctor from a little place."

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