CoM grad gives Swift Current community care a boost

Alexandra Akinfiresoye has found that General Internal Medicine was a bit like doing everything

It was a long, and seemingly random, road that took Dr. Alexandra Akinfiresoye from her home in Nigeria to Swift Current.

But it’s one that, in the end, hugely benefits the Saskatchewan town.

“When I was young I wanted to be either a doctor or an architect,” Akinfiresoye explained with a laugh regarding her choice to study medicine. “In Nigeria you go to medical school right out of high school, so I was just 16 then and had a big decision to make - eventually I decided to be a doctor because I would be able to help the community more personally.”

Her medical training and internship were all completed in Nigeria before she and her husband decided to emigrate, which lead to a five-year delay before she was able to get into a residency program. But, while working to help earn money for her growing family, Akinfiresoye got into the Physician Assistant Pilot Program in Toronto where she was introduced to internal medicine.

“Initially I had wanted to do gastroenterology,” she explained. “But I realized I’d be restricted. I like doing everything, and it’s a very flexible sub-specialty – you can make it what you want it to be.”

Akinfiresoye, who graduate from the College of Medicine last month, is one of the first students from the General Internal Medicine program to remain in the province upon graduation, one of the ultimate goals of the program.

“That’s what we’re trying to do – have the graduates from general internal medicine spread out to the mid-sized communities in Saskatchewan,” explained Dr. Heather Ward, the General Internal Medicine program director.

Newly identified by the Royal College of Physicians and Surgeons, general internal medicine trains physicians who can see patients with multi-system diseases – so, more than one disease – with the emphasis on collaborative practice. This enables smaller cities, which may not have a wide selection of specialists on hand, to treat more patients without having to send them to larger metropolitan centres.

“That’s what makes general internal medicine perfect for community medicine, especially in places like Swift Current where there aren’t any subspecialists,” Ward continued.  “You need someone with those generalist skills to be able to see a little bit of everything, and know when a sub-specialist in the city needs to be called in - but mostly to do as much as possible in the local community.”

And while general internists are less specialized than their sub-specialty colleagues, they’re more specialized than family medicine practitioners, which means they’re ideally suited for smaller communities.

“In general family medicine (they) are even broader generalists because they deal with obstetrics and pediatrics,” Ward explained. “General internal is just adult internal medicine – it’s diabetes, lung failure, heart trouble, a mix of all those diseases.”

“Generalism is very important to our health care system but unfortunately has been declining in the last decade, specifically in urban centres,” explains Tara Lee, who is the Family Medicine site coordinator in Swift Current. “When learners come to smaller communities they are exposed to the excitement and challenge of treating a variety of illnesses and the undifferentiated patient.

“They learn a vast amount of skills, are more inclined to choose community practice or practice in a smaller community.  The other advantage of rotating in a regional centre is to work closely with family physicians - this intraprofessional aspect of medicine is difficult to achieve in the larger tertiary centres but remains crucial in providing continuity of care to our patients.”

And for Akinfiresoye, it wound up giving her the perfect balance between giving back to the community and making use of her interest in treating a wide variety of diseases. So she packed up her family, and they moved from their home in Saskatoon to Swift Current.

“I wanted to come here because there’s a need here,” she responded when asked about the decision. “And it’s good to give back to the society and go where you’re appreciated.

“Moving was a big decision, but not a difficult one.”

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