Neepawa hosts next generation of doctors
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- Published on Friday, December 11, 2015
By Kate jackman-Atkinson
The Neepawa Banner/Neepawa Press
Neepawa has a long tradition of opening its doors, and clinics, to medical students as they complete their training. For Dr. Brian Milligan, the experience has come full circle. Milligan, who first came to Neepawa as a medical student, has helped make Neepawa a site offering training for physicians completing their residency in family medicine.
The process of becoming a fully licensed family physician is long and at various stages, individuals will spend time working with patients. Milligan explains, 鈥淲e take learners across that whole spectrum, starting in medical school.鈥� Milligan, as well as other doctors in the Beautiful Plains Medical Clinic, have teaching positions at the University of 水果视频, which allows them to train young doctors.
A person studying to be a medical doctor begins by completing an undergraduate degree. They then enter a four-year MD program. The first two years of the program are spent learning through books, classrooms and labs. In the third and fourth year, learning is done on the job, by working with practicing physicians in hospital and clinic settings.
Once the MD program is complete, the student has become a doctor and can do a number of activities, including writing prescriptions. However, before obtaining their full license, the learner must complete a residency program in their desired specialty, which is practice under supervision. The length of residency depends on the specialty.
Patients in Neepawa are familiar with seeing students at various stages of their MD program. Between first year and second year, students participate in Rural Week, where students come and spend time in rural practices. Milligan explains, 鈥淎t that point, [the students] don鈥檛 know very much at all and they鈥檙e just there to give them a first exposure to rural medicine.鈥�
In addition to Rural Week, in the summer, the clinic will sometimes host first and second year MD students who want to do early exposures to rural medicine to get a better sense of the specialty.
In their third year, students begin spending their time working with patients. During third year, students spend four to six weeks going through every core specialty, such as family medicine, obstetrics, orthopaedics, internal medicine and psychiatry. The Beautiful Plains Clinic is one of the sites for the family medicine rotation. Other sites that commonly take students include Brandon, Dauphin, Portage, Winkler and Steinbach.
After third year, the students have done all of their core rotations and during their fourth year, they choose the rotations in which they want to spend more time. 鈥淭hose are called electives and we take fourth year elective students here too,鈥� said Milligan. A fourth year elective rotation with Dr. Poettcker first introduced Milligan to Neepawa. The elective rotations last two to four weeks. The program has been successful and Milligan said, 鈥淲e seem to be becoming increasingly popular. We are getting more requests to do electives with us and we鈥檙e actually having to turn some people down because we just can鈥檛 accommodate them鈥t鈥檚 a really good position to be in.鈥�
Recently, the clinic has begun taking more advanced learners. Within the last year, Neepawa has also begun taking on residents. These learners typically come in their second year and are within 12 months of being completely licensed and able to practice on their own. 鈥淭hey get a lot of autonomy,鈥� said Milligan, who mostly works with the residents.
When it comes to residents, Milligan explained that the clinic prioritizes physicians looking to practice in rural areas. 鈥淏ecause we鈥檙e a rural site, we take residents preferentially out of the Brandon residency program. Brandon has become a satellite residency program for the University of 水果视频. But there aren鈥檛 very many of them, there might be two a year,鈥� he said. The rest of the time, the clinic takes students out of Winnipeg. 鈥淲innipeg is looking for people to train their residents and we鈥檙e more than happy to accommodate that,鈥� said Milligan.
While in Neepawa, the students will stick with one doctor for their rotation. This doctor will be their main supervisor and they鈥檒l pick up extra call shifts with other doctors. This method gives some continuity and allows the learners to know what鈥檚 expected of them and the supervisors know what the student can and can鈥檛 do.
During the first week of December, the doctors in the clinic were working with a resident, a fourth year elective student and a third year core rotation student. Milligan explains, 鈥淭hat鈥檚 pretty much the max, except during Rural Week, when we have four to six at a time.鈥� He continued, 鈥淎t a site our size, if you start getting more than that, students start getting diluted experiences.鈥�
As students progress through their education and training, they work with more autonomy from their supervisor. However, the work is always reviewed by their supervisor.
Milligan explains that a medical student can鈥檛 see a patient without the doctor also seeing the patient, even if it鈥檚 something basic, like taking stitches out or checking blood pressure. Once the student graduates and becomes a resident, they are a doctor and don鈥檛 require as much supervision. A resident can see a patient by themselves and the attending doctor can review the case at the end of the day. Milligan explains, 鈥淚 review all of the notes [made by the resident] and I edit them, I will call the patient to clarify or talk to the resident鈥patients] can rest assured that we will talk about the case with the resident and review it.鈥� Milligan added, 鈥淚 think if anything, [the quality of care] has improved when you start teaching.鈥�
Because local doctors are working with learners at many different stages of their education, Milligan acknowledges that there can be challenges for patients. 鈥淚 think it might be confusing for the public because they see someone one time who is in Rural Week and doesn鈥檛 know anything and the next time, they see a second year resident and never see their attending or actual doctor and ask, 鈥楬ow come the last guy had to be supervised?鈥�,鈥� he said.
Milligan explained that patients have the option of only being seen by their regular doctor. 鈥淸A patient] can always say, 鈥業鈥檇 rather see my doctor鈥�. That鈥檚 perfectly fine, they鈥檙e never given any grief,鈥� he said.
While teaching takes extra time and effort for the community鈥檚 doctors, for Milligan, there are a number of benefits to taking on students. 鈥淔irst of all, it keeps me sharp, learning is a two way street. There hasn鈥檛 been a student who鈥檚 come who hasn鈥檛 taught me something,鈥� he said. Continual learning is an important part of medicine and he feels that teaching students helps to improve his knowledge base.
Taking on students also exposes rural physicians to the most current education. 鈥淭he students are fresh out of university with the latest information, the latest lectures, the latest studies. [Taking students] helps translate some of that knowledge out to the rural sites more effectively,鈥� he said.
The students are keen to work and tend to be very thorough as they build their knowledge base, which is a benefit to patients. Milligan said, 鈥淚 think it鈥檚 good for the patients to sometimes get a different perspective on things, it鈥檚 almost like a free second opinion.鈥� He added that more than once, after a receiving a physical performed by a learner, patients have commented that it鈥檚 been the most thorough exam they鈥檝e received.
Taking on students also creates a long-term benefit to the community, as a way to help with recruitment. Not only does it expose students to a community, it also creates an environment that鈥檚 attractive to many young doctors. Milligan notes that sites that do lots of teaching have lots of doctors.
Beyond all of that, Milligan enjoys sharing his knowledge with others, 鈥淚 like teaching, I like passing on what I know. It鈥檚 one of the things I enjoy.鈥�
Successfully teaching the next generation of doctors can鈥檛 just be done by the community鈥檚 doctors and Milligan praises the community鈥檚 residents. He explains, 鈥淔or the most part, the community has been very receptive to the students鈥� In general, a lot of the students have come back and said, 鈥楾he people of Neepawa are really great about having students,鈥�.鈥� This isn鈥檛 the case with all communities, explained Milligan, 鈥淪ome communities aren鈥檛 [welcoming to students], they come to learn and gain experience and want to do exams and procedures and every other patient said, 鈥業 only want to see my doctor.鈥� That鈥檚 frustrating for them, it鈥檚 hard on them. Here, the patients have been very open to having students, it鈥檚 been a very positive experience.鈥�
