Northern Exposure

UAlberta pediatrics residency program provides a unique experience in rural medicine.

Dave Von Bieker - 27 November 2017

Pediatrician Sam Wong, '96 MD, finds the variety of challenges encountered while practicing in Yellowknife rewarding. "I'm the neonatologist, I'm the intensivist, I'm the endocrinologist, I'm the cardiologist until they actually arrive and do clinics," said Wong, UAlberta associate clinical professor in pediatrics. "In one day you'll have a GI patient, you'll have a cardiology consult, and you'll have behavioural issues that you have to deal with."

Wong began his own Yellowknife rotation during his 1999 U of A general pediatrics residency. He remains drawn to rural communities, and Indigenous communities in particular. "The practice I have is part based in Edmonton, part based in Yellowknife. I work with three different distinct First Nations and Inuit populations of the Denè and the Cree in Northern Alberta and the Inuit in Nunavut … and I see patients on occasion from the Metis population in Northern Alberta."

He says providing pediatric care in rural populations brings him face-to-face with poverty and access to care. "When you work up North, every patient you see has challenging living conditions. It's not well-baby checkups and well-child checkups. There are a lot of social determinants of health that are problematic up there including overcrowding of houses and poor access to food. If you live in a community that has no drive-in access, like the majority of the communities in Nunavut, you're not going to have access to mental health."

Wong and his team now facilitate six residency rotations per year in Yellowknife. "We like having residents there because I think we really enjoy what we do, and if we can convince more people that this is a great career choice, then that's good for all of us."

Erin Boschee began her Yellowknife third-year residency rotation with Wong in March of 2017. She agrees it has been valuable to have the chance to experience and understand the triaging and managerial skills that are necessary in a northern rural pediatric practice.

"Seeing the patient journey to access medical care firsthand has given me a great appreciation for the strength and resiliency of many northern families," Boschee said. That journey requires frequent travel across long distances, isolation from their homes and cultural communities, and limited access to allied health resources.

While there are unique challenges, Wong does not see his work in rural practice as involving personal sacrifice when compared to an urban setting. Far from isolating, he finds Yellowknife socially and culturally vibrant. He has formed strong connections with those he serves, having discovered "the sense that you're with these people and you take care of them, that you're part of the community."

View from Old Town, Yellowknife, Northwest Territories. Photo credit: Erin Boschee.