Swift Current – Saskatchewan’s Newest Emergency Medicine Enhanced Competency Program

My name is Emmett Harrison, a Swift Current-trained family medicine resident. I plan to continue my training in Swift Current’s 2021-22 FM-EM program under the leadership of program director Dr. Sheila Smith and site director Dr. Sarah Harrison (no relation).

Enhanced emergency medicine programs across Canada have a rural or regional emergency training portion in their curriculum, but few are directly based in regional centres.

The University of Saskatchewan (USask) has joined the list of universities that train family medicine–emergency medicine (FM-EM) residents with a site in Swift Current.

I intend on staying in Swift Current after my residency to join the competent and collegial group of family physicians in the community. My first love is, and always will be, family medicine.

However, after reflection, I decided the extra year of training in emergency medicine was an opportunity of a lifetime – to expand one aspect of my full scope rural practice. These are my reasons for applying to the Swift Current FM-EM program, which may help aspiring rural generalists choose Swift Current’s family medicine and emergency medicine training programs.

Swift Current’s longitudinal structure is unique in comparison to other Canadian FM-EM training programs. It incorporates family medicine clinic time and in-hospital obstetrics, which is helpful for new graduates practicing in rural/regional emergency departments. This training program also provides FM-EM training within a regional context.

Do I need to do FM-EM training to be a competent physician in the emergency department?

A rural-trained family physician who regularly spent time in a high-volume rural emergency department should be fine to practice in a regional emergency department, right?

Fear of practicing in a rural emergency department as a new family medicine graduate is a reality. I found this feeling was common among family medicine residents while conducting a research questionnaire as a medical student in 2016. The survey looked at Saskatchewan family medicine resident perceptions of the rural working environment.

I anticipated some anxiety when planning to practice in the Swift Current ED as a full scope generalist. I even worked with recently graduated peers, now my attendings, who practiced in these same emergency departments. I asked some of them if they would have considered doing the FM-EM program. Many of them answered yes. I believe FM-EM training to be competent, but confidence may come a few years earlier than for those individuals entering practice directly.

Talking with clinicians across the province, I believe you will challenge your skills and enhance your quality of patient care by seeking additional training in emergency medicine. Personally, I wanted to gain competency while I am young and motivated.

Is there a changing horizon for FM-EM training?

Two of the emergency medicine training stakeholders, the Royal College of Physicians and Surgeons of Canada (RCPSC) and the College of Family Physicians of Canada (CFPC), have established parallel training routes. Our health system requires all emergency medicine training routes since they all provide unique and important needs in our health system.

FM-EM and FRCP have practices that can complement each other. Tertiary centres need emergency physicians who are highly skilled, academic and research-oriented clinicians, while FM-EM trained physicians are equipped to deal with great acuity and academic demands. FM-EM provide a generalist perspective perhaps more useful in less resource rich settings.

Rural and regional emergency departments employ family physicians – some with extra training in emergency medicine – to fill the needs of the rural and regional population. There is skepticism that family medicine training is not able to keep up with growing academic needs in many areas, not just limited to emergency medicine. Providing this FM-EM training within a regional context can, in theory, help maintain diverse practice patterns and locations for FM-EM physicians.

I believe I am a rare breed of resident, one that loves academic medicine and research. I am excited to help contribute to the teaching in Swift Current for visiting medical students, family medicine residents, FM-EM residents and practicing family physicians alike.

Does training in family medicine in Swift Current streamline me for FM-EM?
I believe the quality of my acute care training in Swift Current helped me find my passion for EM, gain experience in this area, and aided in my application. All four of second-year residents who applied for FM-EM programs were successful, a testament to the quality of the EM training provided within our family medicine residency.

There were 10 Saskatchewan FM-EM positions in the CaRMs 2021 match, which is comparable to large institutions like the University of Montreal and the University of British Columbia, which serve larger populations and graduate more medical students and residents. To me, this puts Saskatchewan-trained family medicine residents at an advantage.

I am very excited for the 2021-22 FM-EM year in Swift Current to begin. I am confident the local system is able to support the growth I need as a clinician working in the emergency department, just as it has over the last two years of family medicine residency. It will be a privilege to maintain my generalist skills during this endeavour, which will assist me in entering full scope rural practice in 2022. If you are interested in rural family medicine with acute care as part of your focus consider Swift Current, Saskatchewan as your family medicine and/or FM-EM training site.

Dr. Emmett Harrison is an FMR2 in Swift Current, Saskatchewan.