Knowing that a doctor I’ve mentored can take the torch is making the transition much easier.
Dr. Michelle Dow
Guiding the Next Generation
It’s always a good sign to see medical students and family medicine residents being mentored by doctors and nurses at a family practice clinic, especially one in rural Nova Scotia.
That’s often the case at Clare Medical Centre, a collaborative family practice clinic in Meteghan Centre, a small Acadian community in southwest Nova Scotia.
“It’s fun having young people at our clinic,” says family physician Dr. Michelle Dow, the clinic’s medical director. “We learn something new from them and are also challenged by them on a daily basis.”
Six physicians, a nurse practitioner and a family practice nurse practice provide care in the collaborative centre, plus a steady rotation of medical students, residents and other learners. It’s become a welcoming, vibrant place for people to hone their skills and see what it’s like to practise medicine in a rural area.
“My big passion over my career has been recruiting doctors to our area,” says Dr. Dow, who has been practising medicine for 34 years.
In the early 2000s, the community was struggling to recruit and retain family doctors. Dr. Dow joined a physician recruitment committee made up of local councillors, health professionals and community members. They banded together to build the clinic in 2008, financed by the Municipality of Clare.
One key to their success has been tapping people from the area – a process that starts before students even apply to medical school.
“If I hear of a local high school student who’s interested in medicine, I’ll ask them about their plans and invite them to visit our centre. I’ll talk to them about medical school, the application process or discuss any other questions they may have about medicine in general,” says Dr. Dow.
If the student goes on to medical school, the recruitment team stays in touch with them during their training – sending care packages and organizing Christmas luncheons. “They know we care about their success and that someone from home is thinking of them,” Dr. Dow says.
That approach promotes the clinic and the community not only to med students from the local area, but also to their friends and colleagues. “We welcome them to do their first- and second-year community electives at our clinic and invite their friends to come along, too,” says Dr. Dow.
Dr. Dow is a preceptor for residents in the longitudinal integrated residency program at the Southwest Nova teaching site of Dalhousie Family Medicine. Residents in this program work in the same rural clinic with the same preceptor for two years, learning the ins and outs of family medicine.
“We form a very special bond with our longitudinal residents,” says Dr. Dow. “After graduation, some may choose to stay and practise in a clinic such as ours where they can be mentored by the doctors working there.”
The mentorship also helps early-career physicians feel confident to pursue leadership roles. “We help them see their potential at a time when they’re still feeling somewhat insecure,” says Dr. Dow, who has served numerous roles over the years, including President of Doctors Nova Scotia. “I see leadership potential in my residents and encourage them to take on various roles during residency and afterwards as early-career physicians.”
Family physician Dr. Erica Lasher was the first resident Dr. Dow recruited from Southwest Nova’s longitudinal residency program. Originally from Clare, Dr. Lasher had done two electives with Dr. Dow as a med student before starting her residency at the Clare Health Centre in 2014.
“I had no intention of moving home and opening a practice,” Dr. Lasher recalls. “But Dr. Dow convinced me to give the residency program a try. She helped me find such passion in rural family medicine.”
Most of all, Dr. Lasher says, she felt supported. “When I walk down the hall and knock on her door, Dr. Dow is never far away. And now, she sometimes knocks on my door, which is pretty awesome.”
Today, Dr. Lasher is a staff physician at the clinic and also works in the emergency department at Yarmouth Regional Hospital. She has also pursued her own gift for teaching and has developed a new program at the site offering simulation and skills sessions for medical emergencies.
Dr. Dow’s latest resident is Dr. Emma Leon, who is in her final year of her family medicine residency. Dr. Leon grew up in Schomberg, Ont., and was a nurse before studying medicine at Dalhousie. The two met at a DNS seminar in Dartmouth, when Dr. Leon was a fourth-year med student.
“We sat at the same table and Dr. Dow told me about her collaborative clinic,” recalls Dr. Leon. “I knew I wanted to work with other providers, so we could all work to our full potential.
“I feel supported here and that’s part of the reason I want to stay. In the first five years of practice, you’re still learning and it’s great to be able to ask a colleague for advice. Some things are difficult to teach in medical school, like the business of setting up a practice. Being able to talk about these things with my mentor has been incredibly helpful.”
The plan is for Dr. Leon to integrate into the practice while Dr. Dow eases out of it. “I want to retire one day and spend more time with my grandkids and travel with my husband – things I’ve been putting off,” says Dr. Dow.
One of her biggest fears was leaving her patients without a family doctor. “Knowing that a doctor I’ve mentored can take the torch is making the transition much easier,” she says. “I can leave my patients with someone who has trained at our clinic, who knows the ins and out of the clinic such as the referral process and the local specialists, so she’s not starting from scratch with new patients and new staff. I know my patients will be in good hands and I know they will trust her because I trust her.”
Ultimately for Dr. Dow, mentorship means ensuring that her practice has the doctors needed to care for the community right now, and a pathway to nurture and sustain physicians into the future.
“Within the next five years, I’m sure Emma will become a preceptor to a medical student or a longitudinal resident. The circle will be complete.”