Nunatsiaq Online
NEWS: Around the Arctic December 31, 2012 - 6:30 am

Aglukkaq’s doctor-nurse student loan relief plan to kick in this April 1

Rural doctor says long-term training of local people is the best solution

BRIELLE MORGAN
In a photo from February 2012, Nunavut’s director of medical affairs, Dr. Sandy MacDonald, and Nunavut’s director of medical education, Dr. Madeleine Cole, speak to reporters at the launch of the NunaFam learning centre at Qikiqtani General Hospital Feb. 27. This past Dec. 28, Leona Aglukkaq, the national health minister, announced a plan to forgive the student loans of doctors and nurses who agree to work in rural and remote areas, such as Nunavut, for up to five years. (FILE PHOTO)
In a photo from February 2012, Nunavut’s director of medical affairs, Dr. Sandy MacDonald, and Nunavut’s director of medical education, Dr. Madeleine Cole, speak to reporters at the launch of the NunaFam learning centre at Qikiqtani General Hospital Feb. 27. This past Dec. 28, Leona Aglukkaq, the national health minister, announced a plan to forgive the student loans of doctors and nurses who agree to work in rural and remote areas, such as Nunavut, for up to five years. (FILE PHOTO)

Third time’s a charm — apparently — when it comes to government announcements.

The Harper government first revealed plans to forgive student loans for medical professionals in rural communities back in 2011. The $9 million in spending formed part of the government’s 2011 Economic Action Plan.

Then in August of this year, the same plans were “announced” again at a press conference at the University of Manitoba.

Finally, on Dec. 28, Health Minister Leona Aglukkaq announced a start date: family doctors, residents in family medicine, nurses and nurse practitioners can start applying for debt relief on April 1, 2013.

According to a news release, eligible applicants “must have been employed for 12 months in a designated rural or remote community and must have provided in-person services for a minimum of 400 hours, or 50 days, throughout that year.”

Designated communities are defined as those with populations of 50,000 people or less.

Qualified applicants will be able to receive relief payments for up to five years.

Nurses and nurse practitioners could receive up to $4,000 per year, while doctors and residents could receive up to $8,000 per year.

Aglukkaq says the measure will not only ease the financial burden on young professionals, it will also improve access to medical services outside urban centres.

“By offering Canada Student Loan forgiveness, we’re doing our part to encourage family doctors and nurses to serve Canadians in rural and remote communities and improve access to primary health care,” Aglukkaq said.

But Dr. John Wootton, a family physician in the small community of Shawville, Quebec, says debt forgiveness alone is not a sufficient solution.

“Financial incentives have been used to recruit to rural communities for a long time, and are currently a feature of almost all provincial programs and territorial programs. If they characterize this as a big initiative, they’re mischaracterizing it.”

Wootton is the immediate past president of The Society of Rural Physicians of Canada, which includes members from Nunavut and the Northwest Territories.

According to data accumulated by the SRPC, while 21 per cent of Canada’s population is rural, only 9 per cent of physicians practice in rural areas.

The shortage is especially acute when it comes to specialists, only 3 per cent of whom are rural.

Wootton says the problem starts not at the job recruitment level, but deeper, at the training level.

“Increasingly the demographic profiles of physicians are individuals that come from affluent, urban families. The opportunities for rural kids to get into medical school have been getting worse rather than better.”

Currently there are only a couple of schools leading the pack when it comes to developing future rural doctors.

The Faculty of Medicine at Memorial University in Newfoundland is well known for its rural programming. According to MUN’s website, the Rural Medical Education Network will become a “key component” in ongoing curriculum reform.

In February 2011, the Government of Nunavut entered an agreement with Memorial University to staff a new family practice centre at the Qikiqtani Hospital with medical residents from Memorial.

The program, called NunaFam, is financed with a six-year, $4.6-million contribution from the federal health department.

Wootton also points to the Northern Ontario School of Medicine as a leader in preparing doctors and nurses for rural practice.

“Although it’s only one small school, it has – I think – demonstrated convincingly that recruiting from rural Canada does not produce the lower quality physician. In fact, their graduating class did as well or better than other universities,” he said.

Tweaking medical school curriculum is just one of the core recommendations SRPC makes in the national rural health strategy it’s been lobbying the federal government to adopt for more than a decade.

Convincing Ottawa to develop national health programs is a challenge, Wootton says, because health falls under provincial jurisdiction.

He described the debt forgiveness initiative as “a carrot,” an incentive to try out rural life, which complements existing financial and training incentives.

While these “carrots” may help fill vacancies in the short-term, Wootton says they don’t represent long-term solutions to rural health care issues.

“What’s needed is a comprehensive program of training and preparation… It has to start in medical school and it has to start very early with candidates who are already from rural Canada because those are the things that have been shown to predict subsequent practice in rural Canada.”

Nunatsiaq News hoped to include comments from Dr. William (Sandy) MacDonald, the Government of Nunavut’s chief of staff for health services. But by the time this story was prepared, GN staff had not been able to obtain the necessary permissions from MacDonald’s superiors.

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