I completed an 8-week rural family core clerkship rotation in Labrador as a third-year medical student. This was my first time visiting “The Big Land” and I was immediately drawn in by the breathtaking landscape. Early into day one, I joined a friend for a 12km trail snowshoe with the local Birch Brook ski club – getting a chance to meet new people, experience the tail end of the Labrador winter, and take in the beauty of the Mealy Mountains. I immediately felt at peace, knowing I had begun an experience I would never forget. 

The schedule for my first four weeks was filled with outpatient clinics, emergency room shifts, a week of inpatient care and a few OR assist shifts. My second month included a coastal visit to Hopedale and another to Rigolet – two excursions I was very much looking forward to. I was eager to meet the staff, the residents, the patients, and community members I had heard such good things about from learners before me. 

During a day in outpatient clinic, I saw an elderly man who had come for a checkup, accompanied by his wife. At the end of the visit, she explained how anxious her husband was about coming to the hospital and thanked me for making it such a comfortable and pleasant experience. This is just one of the many experiences that touched my heart and made me feel so welcomed and appreciated in Labrador. 

While my rotation was filled with inspiring and positive experiences, I was surprised by the continued lack of access and its association with communication or health literacy barriers. In particular, I recall one patient who had travelled from the coast to be seen in the ER for an infection, which may have been avoided or mitigated if not for the systemic limitations. The patient spoke little English yet nodded in agreement throughout our conversation. It was apparent that she was not entirely understanding of the minor procedure she had undergone just a few months prior and the follow-up care that was required as a result. Despite the communication, geographical, and cultural, and financial barriers faced, she remained polite and appreciative throughout the assessment. 

With each day, I was inspired by the gratuitous patients, welcoming healthcare team, encouraging mentors and incredible scenery. The connections that exist between staff and their associated coastal communities were like no other. My experience in Labrador showed me the value of emotional connections, the impact they have on people and places and, the reciprocal fulfilment they can provide. It reaffirmed my aptness for rural medicine and gave me a desire to return.

During my fourth, and final, year of medical school, I had the opportunity to return to Labrador for Memorial Universities Progression to Postgraduate (P2P) program – accounting for twelve weeks of selective clinical placements in a variety of fields, including hospitalist medicine, emergency medicine, general surgery, obstetrics, outpatient clinics, and indigenous health. After having spent a total in 5 months in Labrador, a vast part of my home province that I had previously never seen, I reflected on my unique experience.

With my phone to the window, I’m attempting to capture the beauty the is The Big Land. It was my first month in Labrador and I had the privilege of tagging along on a MedEvac to Hopedale to retrieve a child with suspected impetigo. We left the airstrip in Goose Bay just before sundown to incredible views of the Mealy Mountains. During my second trip to Labrador, I was fortunate enough to spend a week in Nain, the northernmost settlement in Labrador. Nain is serviced by a small runway which lacks lighting, thereby limiting the window through which planes can land – in addition to the occasional low ceilings and obscured visibility. Luckily, for my flight from Goose Bay to Nain the skies were clear, showcasing the spectacular land, so vast and untouched. At that point, I realized no picture could ever really capture the beauty of this land.

While in Nain a terminally ill patient presented to the clinic with a new GI bleed. The staff did an incredible job of managing him for several days while the weather was down – despite the clinic not being equipped for inpatients. Family and community members took turns visiting at all hours and even brought hot stew for the staff. This was truly an example of a community coming together, demonstrating how isolated and resource-limited settlements continue to thrive.  

On my last day in Labrador I shed tears knowing what I was leaving behind: an amazing three months of medical, cultural, and personal experience; incredible friendships; amazing mentors; and, so much more. As I drove away from town into what are arguably the most beautiful sunsets, upon a backdrop of the Mealy Mountains, I knew that this would not be my last visit to The Big Land.

Patricia Howse, M.D.

PGY1 Family Medicine

Queens University, Belleville, ON

For information on how you can experience Labrador during electives – check our MUN Family Medicine on the AFPC Portal or email ugme.electives@med.mun.ca for additional information.