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Solution to physician shortage is right at home

This article was written by Michael Robinson, November 7, 2017 in the Telegraph Journal and can be found here.

Dr. Donald Craig, founder of the New Brunswick Medical Education Foundation, and scholarship recipient Dr Catherine Becker, a Dalhousie Family Medicine Resident, at the Saint John Regional Hospital on Sunday morning.

Photo: Michael Robinson/Telegraph-Journal

Retired family physician Dr. Donald Craig believes he has the key to bolster the number of doctors in New Brunswick.

Craig is the founder and former chairman of the New Brunswick Medical Education Foundation Inc., a not-for-profit which distributes bursaries to help support and retain New Brunswickers who go on to attend medical school in an effort to encourage them to return to practise in the province.

In order to be eligible, New Brunswick residents aspiring to become doctors must have been accepted at an accredited medical school and be willing to sign a “return to service” agreement for however many years they received funding for.

“We don’t care what school they go to as long as its an accredited school and accepted by the provincial college of physicians and surgeons,” he said, listing off eligible institutions in the province and beyond, such as the University of Ottawa or Saba University in the Caribbean.

The value of each of these renewable scholarship ranges from $4,000 to $12,000 a year. Those who receive them but do not return have to repay any funding they were given.

According to Craig, it takes six years to “grow” or train a family doctor and costs taxpayers roughly $700,000. For specialists, it can take even longer with the bill rising to $1 million, he added.

One of the foundation’s first recipients, Greater Saint John-native Dr. Catherine Becker, received a total of $48,000 in scholarships from the foundation from 2010 to 2014. As a result, she is “on the hook” to provide four years worth of medical practise in the province – although it’s a caveat she is more than happy to comply with.

As a Dalhousie Family Medicine Resident, Becker practices at a couple of community care offices in Grand Bay-Westfield and Millidgeville as well as outside of St. Joseph’s Hospital.

Thinking back on her academic career, Becker says medicine is an extremely demanding course of study and no one goes through it “without either being independently wealthy or assuming student debt.”

The intense academic requirements make it almost impossible to earn money on the side, she said.

“People think of doctors being a wealthy profession and that is true in the later stages of the career for sure, I’m really blessed to be training in a field with job security… but those earnings do not arrive until the later stages.”

The funding she received from the foundation not only helped to cover her tuition but also provided more financial stability so that her and her husband could purchase a small home and start a young family.

Since its inception in 2010, the foundation has raised approximately $6 million – the majority originating from the private sector – in endowed funds, said Craig. His objective is to see other levels of government pitch in around the same.

When it comes to provincial funding, Craig said former premier David Alward’s government contributed a total of $750,000 in 2013. Since then, Craig said he has not had much luck getting other health ministers since then to commit their support.

“We are not unhappy with what we have done so far but we would like more financial support from the province,” he said, adding $1.5 million worth of scholarships has been given out to over 60 students since 2010.

And of the 29 who have since become eligible to practise, 27, or 93 per cent, are either already doing so within the province or completing their residency elsewhere but committed to returning back home, he said.

As of Oct. 27, 2017, there are approximately 38 vacant physician positions in the province, according to the Department of Health.

Since the beginning of Premier Brian Gallant’s government, both regional health authorities have recruited “130 family physicians and 171 specialists to the province,” said department spokesperson Bruce Macfarlane.

In an emailed statement, Macfarlane said this recruitment drive has resulted in a net gain of 90 physicians (41 family and 49 specialists) for the province, after factoring in retirements and departures.

The Department of Post-Secondary Education, Training and Labour currently provides both of the province’s medical schools, the Centre de formation médicale du Nouveau-Brunswick (CFMNB) and Dalhousie Medicine New Brunswick operating grants to train its students.

Citing a “recent study” undertaken by the CFMNB, Macfarlane said 87 per cent of its graduating students choose to remain in New Brunswick to practice.

A similar rate for Dalhousie Medicine’s New Brunswick program was not available, he explained. “It is too early to tell because there have been too few graduates to have completed their residency training to date.”

At the foundation, benefactors range from individual physicians to municipalities like the Town of Rothesay and even entities as large as BMO Financial Group and AstraZeneca, an international biopharmaceutical research firm.

Sponsor David Huestis said the annual scholarship ceremony brings “tears to your eyes.”

“Medical school is a long haul, it costs a lot of money and these scholarships at least help with student debt when they go through, especially when some of them don’t have the resources,” said Huestis, who has known Craig since the eighth grade and grew up alongside him in Port City’s west side.

After hearing from his clients who don’t have their own family doctor, Huestis said he was motivated, along with his wife, to share their fortune with others.

“The government tries with after hours clinics but there is no substitute for a physician who knows you and your family,” he said. “Medicine is personal.”

Craig said the homegrown strategy’s “real hook” is that it helps to cultivate genuine, interpersonal relationships between award recipients, their sponsors and members of New Brunswick’s medical fraternity.

As award administrators check-in with beneficiaries, they create a one-on-one meaningful rapport that can’t be replicated when signing a service contract with a government department, Craig argued.

Becker agreed.

“I had an opportunity to thank my donor every year and shake his hand, tell him how I’m doing,” she said of the annual award ceremony held at Saint John’s Imperial Theatre. “I touched base with physicians who are pillars in our medical community to talk to them about my plans.”

Becker said this allowed her to connect with mentors who were able to provide her with advice along her path of becoming a doctor.

When reviewing grant applications, Craig said students often talk of their motivation to enhance their communities – an objective the foundation can be a catalyst for.

“How are you going to get a medical student from Toronto go to Miramichi?” he asked. “But if you brought someone back to Miramichi who grew up there, they will have died and gone to heaven.

“That’s the advantage of bringing our own kids home.”

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