A reflection on community learning experiences in Marathon 

All of us can make contributions to communities, no matter where we are. Medical professionals and medical learners often have skills, interests, ideas, and energy to contribute to community life beyond what they offer in health care.

This summer, Logan Brennan, fourth-year NOSM University medical student, spent two weeks on a rural generalist elective in Marathon. Coincidentally, one of the high school volleyball coaches was hosting a volleyball camp in preparation for the coming season.

Logan—who has played at the varsity level and was a member of the Canadian National men’s volleyball team—offered to support the local team development in the evenings while he was on placement.

Coach Ray Lake, in an email after Logan’s elective, noted “What has astounded me is how well Logan can communicate how to do skills through words. I’ve seen growth in the players after three days that I have not produced in three years. It is a real gift for these kids to have someone of Logan’s calibre work with them.”

Dr. Sarah Newbery, Associate Dean of Physician Workforce Strategy at NOSM University, has been impressed over many years with the terrific ways that medical students contribute to community life. “As medical students learn in communities, there are opportunities to which we, as community preceptors, can invite their participation—whether in sport, music, or local events,” she says. “The sharing of skills, and gifts of time and energy impact people and communities in such positive ways.”

Logan reflecting on his experiences noted that rural medicine is all about community. “Health care and education are the backbone of a community,” he says. “Without stability, structure and opportunity in these key pillars, it is difficult to foster and grow community. Marathon is blessed to have exceptional community members who have demonstrated and taught me what rural medicine and community are all about.”

“On the first day of camp, I told the athletes that defence is 90% effort and 10% skill,” says Logan. “In some ways, rural medicine is similar. You may not be the most specialized or skilled, but if you show up every day with a purpose and the goal to be your best for your community, good things happen.”

“My goal for the athletes—and the physicians’ goal for me during my elective—was to demonstrate that great things happen in small places when good people come together to form a community.

“The best things around that I have ever seen, came from small towns and big dreams”
– Paul Brandt

“I am incredibly grateful for the opportunity to learn, coach and explore Marathon this summer. It is a wonderful community with exceptional opportunities and potential,” says Logan.

Long-time Marathon physician and NOSM University Professor, Dr. Eliseo Orrantia, reflected on his gratitude for hosting learners in the community. “Formally, they are here to learn from us, but we also learn and grow through them. That bidirectional learning is essential in the formation, development and importantly the maintenance of rural generalist skills and how we respond to the needs of the community together.”

Have a story to share about the impact of NOSM University students in your community? Let us know at communications@nosm.ca.

“It was minus-40 and it was January,” recalls Dr. Akila Whiley, recounting her arrival in the small community of Red Lake, some 500 km northwest of Thunder Bay. “It was a dark night,” she remembers. “I had no clue where I was. The person who cleans the runway drove me home… I didn’t have my luggage.”

“It was just crazy!”

Dr. Whiley was born and raised in Halifax. Following an undergraduate degree at McGill University in Montreal, she went back to Halifax to attend Dalhousie’s medical school. She then earned a spot at the University of Toronto and was working through a family medicine residency. She says that because her experience to that point had been in large urban settings, the emphasis seemed to be on specializations—anything but rural generalism and family medicine.

“That really wasn’t what I wanted,” she says about weighing her options for the final year of her residency. “And so I truthfully mapped out all of the places I could go… and I picked the furthest place on the map.”

That place was Red Lake, and in the early days of her residency there, Dr. Whiley says, “it took a lot of bravery. It was really scary.” But she must have put on a courageous face, because she made a very good impression. On her final day, a local doctor asked her to come back to Red Lake to practise.

“I hadn’t thought about it,” she recalls. “I got on the flight and I left. And then I had just a really sinking feeling that I’d never come back. And so that was my sign.”

“I wrote him back a week later and said, you know… I’m gonna be all in.”

Four months later, Dr. Whiley was back on a plane to Red Lake.

“You just do it,” she says of establishing her practice. “I think you know in the moment. I knew that going to Red Lake was what I wanted, but in hindsight, you have to be brave.”

Dr. Whiley recalls in her first year in the community, despite perhaps experiencing a little bit of “imposter syndrome,” she knew she had the training to be a good rural generalist and family physician. She also knew she wasn’t alone. “In communities like ours, I always felt like there was somebody there that would help me if I needed it.”

And need help she would. In her first three weeks of practise, Red Lake’s hospital had to be completely evacuated due to encroaching forest fires.

There’s a number of things you can prepare for,” Dr. Whiley says of that surreal experience. “And then there are those that require the courage to step up to, with the leadership skills, commitment to community, and trusted resources you have as a clinician.”

Every single patient was evacuated safely, and Dr. Whiley now reflects on how that frightening event galvanized the community even more.

“It was just this remarkable group effort. There’s so many people I see and I’m reminded of our sense of connection because we went through that experience together.”

She says people in Red Lake have been so supportive and appreciative of her efforts in the community.

“I just feel so welcomed, and I feel really validated in the work that I do,” she says.

“You know, there’s just something so special about serving in a community that is small and unique and tight. It’s difficult to describe the feeling. You really do care for people at all stages in their life. I have found so much fulfillment.”

This NOSM University Campfire Chat was made possible by the generous sponsorship of Weaver Simmons.

Dr. Adam Moir (MD 2009, Family Medicine 2011) says one of the things that has helped him as a rural generalist is finding mentors. “If I have one skill, it’s recognizing people that I admire and identifying them as a mentor. I reach out to physicians from different fields of medicine with different skill sets than me and I try to emulate their passion for clinical work or teaching.”

He recalls how, in his early days of medical school at NOSM, he made connections with mentors that he still values to this day. Some of his earliest placements included the north shore communities of Terrace Bay and Marathon. “I spent the entire third year of medical school in Huntsville and had some exceptional support from clinical teachers.”

“I think good clinicians want to be mentors, so they enjoy when people reach out,” he shares.

“When we think about practising rural medicine, we tend to think that we’re isolated and that we don’t have a clinical network or clinical community. But the fact is, you’ve got a network that’s much broader. Those mentors and connections from across Northern Ontario really sustain you when you’re working in a rural setting.”

Dr. Moir is quick to point out that it’s not just the physicians that create a support network for him.

When you work in a small town like Dryden, Dr. Moir says the whole community picks you up. Sometimes people will bring him blueberries, cookies or homemade pickles. Other times, they will clean his driveway before he gets the chance. “People show me that they appreciate me as a physician every single day. It’s always nice to feel appreciated. Small communities do that by leaps and bounds. All that appreciation really nourishes my soul.”

He emphasized that he learned to schedule time for self-care and family, and still remains passionate about his practice in a way that continues to sustain his career. He notes that health human resources challenges have been longstanding in Northern Ontario, and many communities have been in and out of crisis for a long time. Dr. Moir encourages learners to accept that reality and not be deterred, but also not make too many self-sacrifices because he says, “staying healthy and well enables you to have a longer, more fulfilling career.”

Dr. Moir hopes that many more medical students have similar experiences to his. By learning in communities, he believes students gain a wide network among preceptors, find mentors and support with one another, all of which he says is important for practise as a rural generalist.

“NOSM University learners bring incredible energy, make a valuable impact while learning in communities across the region,” Dr. Moir says.

“Medical students inspire me! They are a jolt of energy—they are passionate about learning, hungry for experience and very appreciative. That enthusiasm inspires and energizes me, making me a better physician.”

This NOSM University Campfire Chat was made possible by the generous sponsorship of Weaver Simmons.