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Local physician participation in the Nova Scotia Practice Ready Assessment Program is one solution to much-needed family doctor recruitment for rural Nova Scotia

Dr. Michelle Saxon is a family physician in Middleton, Nova Scotia. She is the first to admit, there are definite challenges with practicing in rural Nova Scotia that go beyond physician shortages. In a perfect world, there would be more resources and supports available to physicians and more access to valued allied health professionals that keep the system moving.

Middleton is an area of the province with high patient unattachment, meaning there are many patients without a primary care provider. Dr. Saxon says she feels for the many patients without a primary care provider in her area of Nova Scotia. She has decided to lead by example and be part of the solution – providing support to the Practice Ready Assessment Program (NSPRAP) as a clinical field assessor.

Designed to introduce family doctors to underserviced Nova Scotia community practices, NSPRAP recruits international medical graduates who wish to practice family medicine in Nova Scotia. The purpose of the program is to ensure that international medical graduates who wish to practice family medicine in Nova Scotia possess the appropriate clinical skills and knowledge to provide quality patient care. Candidates of the program must complete two clinical field assessments with assessors who are experienced family physicians in Nova Scotia. The program can only be successful if it can recruit enough family doctors to perform the role as clinical field assessors.

Dr. Saxon explained that practice ready programs are being introduced in many provinces across Canada. “We don’t produce enough physicians locally to meet our needs and there is interest from international physicians to practice in Canada. It’s a route to expand physician resources in the province,” she explained.

Dr. Saxon works with an interdisciplinary team at the Middleton Collaborative Practice. “We have several physicians, two nurse practitioners, two family practice nurses, a licensed practical nurse (LPN), a social worker, an occupational therapist and a dietitian, all supported by a hard-working administrative team.  I enjoy the collaborative approach to medicine at the clinic,” she said.

After studying economics and working in the finance sector in Toronto for several years, Dr. Saxon and her family returned to rural Nova Scotia in 1996. “Medicine is something I always considered pursuing. Even at that time, there was a need for family doctors in the province.” With the support of her husband Paul, Dr. Saxon pursued her medical doctorate. “It was a hard thing to do with young children at home, but it was worth it,” said Dr. Saxon.

With her children now adults, Dr. Saxon joked that her husband Paul, who recently retired, is enjoying some downtime after his unwavering support during her medical studies and career. In their spare time, the couple enjoys spending time outdoors skiing, sea kayaking, and hiking.

Dr. Saxon said her role as a physician assessor supervising international medical graduates is an enriching one. “Our candidates are well-trained, eager to work, and well-chosen by the program.”

Candidates like Dr. Amel Aldrebi.

Dr. Amel Aldrebi completed one of two six-week clinical field assessments through the NSPRAP under Dr. Saxon at the Middleton Medical Clinic and Collaborative Practice. She says that Dr. Saxon provided essential support during her transition to Nova Scotia.

Born in Libya, Dr. Aldrebi completed medical school at the University of Tripoli, specializing in emergency and family medicine and received specialist training in internal medicine. Following the completion of the NSPRAP, Dr. Aldrebi accepted a family physician position in New Glasgow. “There is a huge demand for physicians, and it can be overwhelming. There are many challenging cases that are time sensitive.” Despite these challenges, Dr. Aldrebi says she feels welcomed by the community. “They appreciate me, and it makes me feel lucky and valued,” she said.

Dr. Aldrebi says the NSPRAP program is an efficient one, and she obtained the required licensure to practice in Nova Scotia in three months. She hopes to become a physician assessor in a few years when she gains the necessary amount of experience. When not practicing medicine, Dr. Aldrebi enjoys hiking and spending time in nature. She hopes to move her mother from Libya to Nova Scotia in the near future.

Dr. Saxon shared that family physicians who are interested in being an assessor will require a separate exam room for the candidate at their clinic as well as an interest in teaching and accessing candidates. She added, “it’s a great opportunity for family physicians working in Nova Scotia – it is rewarding to be a mentor and a real solution to shortages. I really enjoy working with the new physicians and helping them on their journey.”

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