My first two years of medical school were a whirlwind of new experiences and learning, as I began to envision what my future as a physician could look like. I entered medical school with an interest in family medicine, but with a limited understanding of the breadth of what the specialty really encompasses–especially in a rural setting. It was a weeklong experience at the end of first year that was the spark that lit the match in my decision to pursue a career and life as a rural family doctor. I really believe that every medical student should be exposed to such an enlightening experience in rural medicine early on in their training.
Community Week is a particularly unique opportunity that Queen’s provides where students are placed in a small community in Ontario to explore rural medicine. I was placed in Barry’s Bay, Ontario, and worked with an incredibly passionate community leader, Dr. Jason Malinowski. I saw and experienced firsthand how diverse and vital the role of community generalists are. Dr. Malinowski practices all types of medicine, is a key community advocate and leader, and most importantly, is committed to and deeply loves his community. The positive experiences I had in Barry’s Bay motivated me to pursue a rural medicine clerkship experience two years later.
At Queen’s, clerks are offered the opportunity to participate in a longitudinal integrated clerkship experience, where we complete Family Medicine, Pediatrics, and Psychiatry in a rural community over 12 weeks. Because of my experiences in Barry’s Bay, I knew that I wanted the ability to work with preceptors at length, to create space and opportunity to build meaningful professional relationships. I won the clerkship lottery when I was placed in Perth, Ontario, with three phenomenal preceptors: Dr. Anil Kuchinad, Dr. Dan Kruszelnicki and Dr. Bob Van Noppen.
Each of these physicians wear many different hats in Perth and practice a wide variety of clinical medicine. Over the 12 weeks, I gained exposure to a broad scope of clinical work, including office-based family medicine, inpatient hospitalist, obstetrics, emergency medicine, surgical assist and palliative care. Working in Perth and Barry’s Bay shone a light onto how diverse and rewarding rural family medicine can be, and the flexibility there is in molding your practice to fit your passions and interests.
My preceptors invested the time in fostering confidence in my clinical knowledge and skills and encouraged me to take ownership of my patient’s management plans and follow up. One of my favourite parts about being in Perth over those three months, was that I had the ability to follow up on my patients’ admissions or visits to the Emergency Department, allowing for extended continuity of care. Working in a rural setting is unique in that it is not uncommon that you are the person to see the patient in the ED, admit them, round on them, discharge them, and even follow up with them in clinic days later. I learned an incredible amount from my preceptors, but also from patients who I grew to know well because of this continuity.
In Canada, we are sparsely populated geographically and there are major barriers to healthcare access that exist because of this. It is absolutely vital that undergraduate medical curricula engage their trainees in the importance of serving rural communities as a way to fulsomely serve all Canadian patients, ensuring access and equity. My exposure to rural medicine in Perth and Barry’s Bay was invaluable in demonstrating the reciprocal value in practicing in small underserved communities and was an absolute privilege to be a part of.
Marika Moskalyk
MD Candidate | Class of 2022
Queen’s University School of Medicine
