Two new rural medical education program training centres in Lethbridge and Grande Prairie are expected to help address the rural doctor shortage in Alberta, .
The province announced April 3 it is investing $224.8 million through Budget 2024, to help train more physicians in rural areas. That number is expected to total between 60-100 new medical graduates a year.
The expansion of the undergraduate medical program is “super exciting” news to Alberta physician, Dr. Stephanie Frigon, who has practiced at the Associate Medical Clinic for six years, but she feels more is still needed to address some of the underlying reasons for the doctor shortage in rural areas, particularly around adequate compensation and low morale.
“I think a lot of students that are interested potentially in working in rural communities will be drawn to these programs,” said Frigon. “That’s a giant addition to potentially training more doctors who would want to work outside of the big urban centres.”
Frigon completed her undergraduate medical degree at the University of Alberta and parts of her medical training, including her third year of medical school in Westlock, as an integrated clinical clerkship. She also completed her residency at a rural site, through a rural program in Red Deer.
The investment will help expand rural health care via collaboration between the University of Alberta, University of Calgary, University of Lethbridge and Northwestern Polytechnic and will be used to develop new rural medical education program training centres in Lethbridge and Grande Prairie. The expansion will see the University of Calgary partner with the University of Lethbridge to develop the new training centre in Lethbridge, while the University of Alberta will partner with Northwestern Polytechnic to develop the new training centre in Grande Prairie.
Money will be used for both capital and clinic operations in Grande Prairie and Lethbridge. This includes renovations to accommodate local student training, including the addition of classrooms as well as simulation and clinical training to meet accreditation standards. Of the total funding, $43.2 million in capital funding will be provided for the new training centre in Lethbridge, $55.6 million will support operating expenses for the training centres in both Lethbridge and Grande Prairie, and an additional $126 million from Alberta Health Services, will support the overall physician training expansion.
Currently, there are two doctor of medicine programs in Alberta — one at the University of Alberta in Edmonton and one at the University of Calgary.
Med students in Grande Prairie, Lethbridge
The rural medical education program training centres will use a distributed medical education model, a program in which universities partner with local institutions to develop regional training campuses where medical students complete most of their medical education outside metropolitan regions.
“All four years of that education will be provided at those sites. The medical students will go for four years to Grande Prairie or Lethbridge,” said Frigon, noting the current program offered at U of A is four years, while the University of Calgary is a condensed three-year program. “After those four years, then as a medical student, you apply to a residency program and that residency program will be specific to the type of doctor you’re going to be,” she added, noting that the minimum residency is a two-year training placement to become a family physician. “That’s where everybody differentiates from being a medical student into the type of doctor they’re going to be when they’re done their training.”
Frigon said although money isn’t everything, adequate financial compensation is a crucial part to solving the rural doctor shortage in Alberta, as is feeling valued for the work doctors do.
“I think there’s a very real shortage in our area and this is unfortunately something that we are seeing across the province now,” she said. “That we haven’t been able to attract and retain family physicians in rural areas for some time … in terms of getting Canadian graduates to rural Alberta, I think it’s a very, very real challenge, and it, unfortunately, I think has only become more challenging in the last couple of years.”
Reasons behind that include low morale among rural physicians and issues with compensation.
“As wonderful as this announcement is … I think it absolutely will do its job in potentially training physicians, both family physicians and hopefully some more generalist surgeons or pediatricians to stay in smaller centres and practice in smaller centres,” said Frigon. “Unless some very real changes happen in terms of the funding of family physicians and how family doctors are paid, those very skilled and Alberta trained doctors, they might choose to practice in another province.”
Alberta not competitive enough?
She said while it’s exciting to see the province graduate and train more family physicians who may want to work in rural communities, she thinks at the moment, “Alberta is not competitive enough to keep the majority of them here.”
Frigon said medical students and doctors completing residencies at local clinics are also seeing how family doctors are being affected by the current climate – something she said did not exist when she did her training in Westlock, but is something they cannot shield trainees from today, which may contribute to decisions to practice elsewhere.
“They’re there to learn, to learn about medicine and providing medical care, (but) they undoubtedly see the way that family doctors feel right now and the way that we feel we’re being treated by this government,” said Frigon. “They can see the burnout, the can see the low morale, they can see how the family physicians are feeling in these communities.”
She said there is no guarantee that trainees will want to stay and practice in rural Alberta and noted that doctors who come out of residency training have the option to work at only hospital-based or emergency medicine-based practices, where they don’t take on a panel of patients as a family doctor.
“Even if we graduate more family medicine graduates from residency programs, it doesn’t necessarily mean that it’s going to translate into family doctors working and living in rural communities,” said Frigon, adding that although her patients make her feel valued and express their gratitude for her and the work she does every single day, she thinks family medicine (doctors) in general, need to feel valued in their job.
“We do a huge, huge part of the workload for caring for patients. I think it comes back to the morale, it comes back to repairing the relationship with family doctors,” said Frigon. “A family doctor is unique in their training and the type of care they can provide and I think we need to be recognized that way.”
In the announcement Wednesday, Minister of Advanced Education Rajan Sawhney, was joined by several other guests including representatives from the partnering institutions, and noted the doctor shortage was being felt “more acutely in rural areas” of the province as only 6.6 per cent of Alberta doctors work in rural areas.
Digvir Jayas, president and vice-chancellor of the University of Lethbridge noted the expansion’s anticipated positive impact.
"The creation of a rural medical education program training centre at the University of Lethbridge in partnership with the University of Calgary will make an incredible long-term difference in increasing the number of physicians practising outside the major urban centres,” said Jayas. “Recruit local, train local, practice local.”
President and vice-chancellor of the University of Calgary Dr. Ed McCauley said, “75 per cent of students practice close to where they train,” and noted the number of expected graduates from the new program. “Both here in Lethbridge and in Grand Prairie, this program will produce 60 to 100 medical graduates a year thanks to this expansion.”
President and CEO of Northwestern Polytechnic in Grand Prairie, Dr. Vanessa Sheane, said they are excited for “the opportunities for enhanced education and enhanced health care services in the north, as this program develops and sustains a steady pipeline of medical talent and resources in the north.”
