A change of place

How the arrival of family medicine residents on the east coast of Vancouver Island has helped transform a medical community.

When Peter Gee first paddled the still, azure waters of Clearwater Lake, B.C., it was a moment that changed the course of his life forever.

“My family and I were on a kayaking trip, and I just kept asking myself how I could live and work in British Columbia,” recalls Dr. Gee, an English-born family physician.

Less than a year later — after exploring regions of the province facing family physician shortages — Dr. Gee and his wife took a trip back west, this time to visit the Comox Valley on the east coast of Vancouver Island.

“It was a matter of hours before we decided that this is where we needed to be, and thankfully our children agreed to the move,” says Dr. Gee.

Today, nearly six years after leaving behind the West Midlands of England, and his family practice of nearly two decades, Dr. Gee has not only settled into the community on Vancouver Island, taking over the care of patients at a well-established practice in Courtenay, but emerged as a central player in the education of the next generation of family doctors.

The development of a new training site for medical residents

“I’ve always been passionate about medical education,” says Dr. Gee, who began training medical students and residents in the UK back in 1994.

As luck would have it, the timing of Dr. Gee’s move to Vancouver Island aligned, almost impeccably, with UBC’s growing interest in developing a new training site for Family Medicine residents in the Comox Valley.

Back row (left to right): Drs. Peter Moosbrugger, Matt Robertson, Glenn Keyes, Tyler Falk, Stuart Gray, Greg Kutney, Glenn Kisman, and Andrew Schissler.

Back row (left to right): Drs. Peter Moosbrugger, Matt Robertson, Glenn Keyes, Tyler Falk, Stuart Gray, Greg Kutney, Glenn Kisman, and Andrew Schissler.
Front row (left to right): Drs. Wai Ling Dan, Judith Hammond, Peter Gee, Laura Bell, Tasha Maheu, and Natasha Rafo.
Photo credit: Dr. David Kenny

After learning about the potential establishment of the training site, Dr. Gee attended a meeting — led by Willa Henry, the Director of UBC’s Family Medicine Residency Program, and Oscar Casiro, who, at the time, was serving as the Regional Associate Dean, Vancouver Island — to learn about opportunities to serve as a preceptor.

And while Drs. Henry and Casiro were pleased to see physicians, like Dr. Gee, eager to teach incoming residents, what they were really looking for was a champion — someone who could make the vision a reality.

It wasn’t long before they recognized that Dr. Gee, with his passion for teaching, and strong track record of training residents in the UK, would be an ideal candidate for the job.

“I thought long and hard about it. I knew it would be a lot of work, but I was eager to get back into medical education and knew that this region of Vancouver Island was ideally set up for residency,” he says.

And so began a new chapter for Dr. Gee, as the site director of UBC’s Vancouver-Island Strathcona Family Practice residency site, which spans the communities of Comox, Courtenay and Campbell River.

A short nine months later, in July, 2013, the new site opened its doors to its first six medical residents.

Overnight changes and long-term impacts

Two and a half years later, the site (which now accepts eight residents each year) has helped increase service capacity in hospitals and clinics across the region. But there are also early signs that the new arrivals will have a lasting impact, helping to grow the community of family physicians in the area for the years to come.

Among the first cohort of residents, who wrapped up training last summer, five of the six have stayed on Vancouver Island to work.

Medical CheckupStuart Gray is one of them.

A graduate of UBC’s Island Medical Program, Dr. Gray arrived at medicine later than most.

At the age of 39, after years of working in the restaurant industry, followed by a career as a recreation therapist in forensic psychiatry, and later as a personal trainer and triathlon coach, Dr. Gray started medical school. Most of his classmates were 15 years his junior.

“It’s been a long road,” says Dr. Gray. “I feel very fortunate to go through the process and become a physician — it’s probably magnified for someone like me, who had a life before and gave it all up in pursuit of becoming a family doctor, but I feel that it’s an absolute privilege to do this job.”

Last fall, after completing residency with the Vancouver-Island Strathcona site, Dr. Gray started his own practice at Valley Care Medical in Courtenay. Already, he has several hundred patients under his care. And when he’s not in the clinic, he’s busy renovating a recently purchased home in the community, where he and his wife plan to stay to raise their children.

Others from the first cohort have taken over existing practices, or chosen to locum on the Island.

Glenn Keyes, also a graduate of UBC’s Island Medical Program, has committed to a year of running an existing practice in Nanaimo, an hour south of Comox, where he completed the bulk of his residency training. And like Dr. Gray, Dr. Keyes plans to stay on the Island long-term.

“I always wanted to be on the Island and in a community where I could build close relationships with my patients,” says Dr. Keyes, recounting his delight at seeing a young child, who he helped deliver only three weeks into his first few weeks of residency, take their first steps.

“I really like working in the community, and having that continuity of care in my practice,” recalls Dr. Keyes. “I have seen some family doctors work with people for 20 years; you learn so much from your patients that way. That’s why I went into family medicine.”

This summer, the second wave of Family Medicine residents with the Vancouver-Island Strathcona site will wrap up their training. And similar to the first cohort, many have expressed an early interest in staying on the Island.

In fact, some, like Greg Kutney, have already made plans. This July, Dr. Kutney, who spent his early childhood growing up in Haida Gwaii, will take on a position at a new clinic in Port Hardy, at the north end of Vancouver Island.

“I spent a lot of my time as a kid in Port Hardy,” says Dr. Kutney. “One of the best things about being offered a job in the area is that I get to come home. Truthfully, you can’t put a price on it.”

Andrew Schissler and Natasha Rafo

Andrew Schissler and Natasha Rafo

Other residents, like Natasha Rafo and Andrew Schissler, who met in their first year of medical school at the University of Western Ontario, and matched, as a couple, to the Vancouver-Island Strathcona site, have also shown an interest in the region.

“We’ve already committed to a year of locuming in Campbell River after we finish residency, but I think there’s a good chance we may extend that. We’ve established ourselves quite a community here,” says Dr. Schissler, who, together with his partner Dr. Rafo, has helped start up a simulation program for fellow residents.

For Dr. Gee, it’s encouraging to have current and former residents eager to stay in the region.

“It’s pretty incredible to see that many of our residents are interested in staying on to work in the communities where they’ve trained, and built ties as new doctors,” says Dr. Gee.

A change in culture

Opening up the east coast of Vancouver Island as a training ground for residents has also had an impact on the medical community at large.

Peter Gee and Stuart Gray

Peter Gee and Stuart Gray

“There was no formal education program here before, and when our first six residents appeared on the wards, you could feel the change,” recalls Dr. Gee. “There’s a whole new vitality, with family doctors and specialists coming together to talk about how we can support our learners, and how we can develop ourselves as teachers too.”

And that shift has not gone unnoticed by the trainees.

“Within the first month there was a change of culture that you could see,” says Dr. Gray. “People were more excited about their discipline because they were having to teach, having to explain things to residents and help them learn.”

“In my mind, the establishment of the residency site has brought the communities of Courtenay-Comox and Campbell River closer together, and has made for an all-around more positive, and dynamic medical community,” he adds.

Nancy MacPherson, another former resident, currently locuming in Campbell River and Comox-Courtenay, agrees.

“The arrival of the residents encouraged everyone — from GPs to specialists — to re-evaluate the standards-of-care being provided. As learners, residents ask a lot of questions, and that leads to physicians, some with decades of experience, to re-examine why things are being done in a certain way, and to improve upon them.”

Giving back

Beyond the hospital walls, the arrival of medical residents, many of whom participate in local outreach opportunities, has created a wave of care and support, flowing out through the communities of Courtenay, Comox, and Campbell River.

Dr. Andrew Schissler takes in the view of Comox Glacier on Vancouver Island.

Andrew Schissler takes in the view of Comox Glacier on Vancouver Island.

“Whenever there’s a community activity coming up, I do my best to go out and do it,” says Dr. Kutney, noting his excitement about being a speaker at an upcoming career fair for at-risk-youth on the Island.

If it’s one thing that connects the residents who are part of the Vancouver-Island Strathcona site — aside from their enjoyment of the many natural, surrounding wonders — it’s their enthusiasm for giving back to the communities that they’ve been welcomed into with open arms.

When they’re not working in the hospital or clinic, they’ll spend afternoons at local high schools, educating adolescents about the dangers of drugs and alcohol, weekends running clinics, teaching the community about diabetes or hypertension, or evenings supporting the needs of new arrivals, including Syrian refugees.

Some residents have also expressed an interest in giving back to the program, offering their time and energy as educators.

“Being one of the first residents to come through training with the Vancouver-Island Strathcona site, there’s this feeling of ownership. I’ve started teaching some of the current residents, and I want to be involved in the program going forward,” says Dr. Gray.

As the director of the residency site, Dr. Gee is delighted to watch how the new family doctors are bringing new energy and new hope to the communities of Comox, Courtenay, and Campbell River.

The training site that was once just a vision has now been realized.

Over the past decade, UBC’s expansion and distribution of medical education programs have significantly increased the number of physicians trained in British Columbia. Today, well over 1000 residents are pursuing postgraduate medical education at more than 100 sites across the province. UBC’s Family Medicine Residency Program — now the largest in Canada — accounts for the largest number (nearly half) of UBC residency positions.