On The Community :
Fantastic. Lovely people. The community is about 60% Nuxalk and 40% Caucasian and there are only about 1900 people in the entire Valley. Isolated community. Lots of unemployment and the challenges that come along with that. Worse substance abuse is EtOH, hardly any drugs other than T3s.
On The Experience :
Given lots of responsibility from day one, which was both daunting and exciting. MDs are all available to answer questions if you have them. MDs are used to having learners present and will call you for procedures or interesting cases. A lot of pathology for a small community, including Rheumatological conditions, ACS, pancreatic and bowel cancers. Also had the opportunity to travel to Anahim Lake, a small town “Up Top” where they only have a nursing station. Third world medicine there.
Challenges :
The remoteness and the sheer volume and complexity of the cases. For example, one night of call I was managing one woman with two different (and unrelated) forms of cancer with acute nausea, a 16 mo child with chronic renal failure, on dialysis who presented in hypertensive urgency and a man with ACS. You are responsible for helping to transfer these pts out – which is challenging but rewarding and a good experience. When on call you are also responsible for managing pts in Anahim Lake – the nursing station will call with questions that you need to manage over the phone. This isn’t city family medicine, and that was what I was looking for…but it can be a challenge!
