NunaFam: training Family Physicians in the Canadian Artic

Resumo

Introdução: Nunavut Territory was created in 1999. It is a large (2 million sq km) Arctic territory with a small (32,000) mostly Inuit population who live in 26 small communities. Iqaluit, the capital, is the largest community with 8,000 population with the only hospital. Primary health care is delivered by nurses in most communities with support from family physicians who largely act as consultants to the nurses.

Objetivos: Most family physicians in Nunavut are short term "locum" physicians. This project attempts to improve retention of family physicians in Nunavut and to establish family practice as a viable career path through creation of a family practice education program in Nunavut.

Metodologia ou Descrição da Experiência: In 2010, Nunavut, in partnership with Memorial University, received a $4.8 million Health Canada grant over 6 years to create 8 additional training spots at Memorial and establish an education centre in Iqaluit, Nunavut modeled on the successful NorFam project by Memorial in Labrador. The program would provide a significant portion of the residents‘ 2 year training in Nunavut. It would also offer significant educational support and continuing professional development opportunities for the physicians working in Nunavut in order to improve physician retention.

Resultados: To date there have been 15 PGY 1 and PGY 2 family practice residents through the program in Nunavut. An education centre has been established in the Qikiqtani General Hospital where most of the residents are based. At mid point of the project there are significant challenges: the distance from Memorial to Nunavut; the different work cultures of the Department of Health in Nunavut and the University; staff turnover in Nunavut; staff turnover in the project team; establishment of a teaching program in a busy rural/remote practice and creating an educational culture among the medical staff in Nunavut.

Conclusão ou Hipóteses: The project is undergoing a refocussing exercise to emphasize the unique aspects of the training program in Nunavut: Inuit culture, mental health, maternity care, community clinics as consultants to nurses. The program experience to date highlights the challenges of creating a teaching program de novo in a remote area.