Recruitment and Retention

In 201920, the Recruitment and Retention (R+R) sector of RCCbc continued to build significantly on its efforts within the broader network. The core of the sector’s work involves valuing and upholding the culture of RCCbc by connecting with physicianshealth care providers and community partners, and supporting them with tools that improve quality of care and connection with colleagues.  

Members of the R+R sector, including the sector lead Dr. Alan Ruddiman, have actively participated in Rural Site Visits project this past year. These connections at a grassroots level have enhanced our understanding of the medical, social, physical and emotional contexts of rural healthcare service provision on the front lines, and insights gained through these community connections are helping to shape and enhance rural healthcare recruitment and retention efforts. 

Rural physicians from across BC are elected through Doctors of BC to its Representative Assembly (RA). Hearing from these physicians and gathering their perspective on issues facing our rural communities is important. Attending RA gatherings as an observer has allowed Dr. Ruddiman to appreciate challenges the broader profession is facing on matters impacting recruitment and retention while also networking and bringing rural perspectives learned back to RCCbc. In this environment, the R+R sector remains focused on continuing to support and enhance social accountability in advocating for equity of healthcare services and delivery of those services in our province. 

The Network of Rural Divisions – co-led by Drs. Brenda Huff and Josh Greggain – has contributed greatly to the efforts of connecting rural communities to one another, and creating a powerful voice and trusted space for information sharing driving innovation for rural physicians throughout the province. Similarly, the rural supports for Primary and Community Care Networks (PCN) engagement – led by Drs. Ray Markham, Alan Ruddiman and Ms. Kim Williams – has allowed for strong connectedness with strategic partners such as the General Physician Services Committee (GPSC), and has provided an opportunity to take a Partnership Pentagram Plus approach to both problem solving and to contemplating rural / regional / urban interconnectedness. 

The relationship of the R+R sector’s connections with our partners is being valued and recognized. Many frank and open dialogues occur with Locums for Rural BCHealthMatch BC, and the JSC locums sub-committee. These conversations allow all groups to shape recruitment efforts and policies and to rally additional resourceswhile seeking to ensure that rural BC gains equity and receives fairness in recruitment and retention efforts of appropriately trained and skilled physicians. 

During 2019-20, Dr. Ruddiman once again served on the Planning and Steering Committee for the Quality Forum – supported by the BC Patient Safety and Quality Council (BCPSQC). This relationship has led to a determined commitment between RCCbc and BCPSQC to think about how both groups can continue to collaborate using the Pentagram Partnership Plus model and to address the healthcare needs of community groups and industries in linked sectors whose activities take place in rural settings.  

Dr. Ruddiman continues to support the provincial Practice Ready Assessment BC (PRA-BC) program at the steering committee and subcommittee level. This group provides a strong influence and perspective in shaping and enhancing resources and policies required to welcome graduates of this program in becoming high functioning members of the rural team. These efforts continue to evolve, most recently with the support of Dr. Nancy Humber who is helping to shape assessment pathways for PRA-BC candidates with enhanced skills such as anesthesia, C-section or low-risk maternity careSimilarly feedback to the PRA-BC steering committee has required it to consider how best to evaluate candidates’ core proficiencies and confidence in providing emergency medicine. 

Physician resiliency and mentorship collaborations continue to be a focus within the Recruitment and Retention sector. Leaders Drs. Kirstie Overhill and Bob Bluman continue to develop, improve and expand on coaching and mentorship, with support for individuals and interprofessional teams through the Rural Education Action Plan (REAP) and UBC Rural Continuing Professional Development (RCPD) within a quality improvement framework.   

Drs. Brenda Huff and Josh Greggain are co-leading RCCbc’s Network of Rural Divisions initiative. Started nearly five years ago by Drs. Rebecca Lindley (Rural and Remote Division of Family Practice) and Ray Markham (Northern Interior Rural Division of Family Practice), the group brings together those Divisions of Family Practice with a significant rural footprint to discuss mutual significant/common issues that need to be addressed collectively. The group has grown considerably over time, engaging more and more Division voices at the table and facilitating collaboration and networking. This network convenes two face-to-face meetings a year, and several virtual meetings to maintain flow of communication.  

The Network of Rural Divisions includes those Divisions of Family Practice that serve rural patients and communities

Several of the Network’s conversations this year have addressed new and emerging issues, as well as challenges encountered in implementing Primary Care Networks into local communities (while not all rural communities within some divisions are large enough for a PCN, they are still looking to such networks for inspiration on how to develop full-scope of family practice within a community). These meetings allow the Divisions to share innovations and work towards achieving a shared understanding and a common voice. In the fall of 2019, the Network sent a letter outlining several key issues of concern for rural Divisions of Family Practice to the General Practice Services Committee (GPSC). This resulted in GPSC co-chairs Ted Patterson and Dr. Shelley Ross attending the Network’s October 2019 meeting to discuss the issues raised in the letter face-to-face. The Network hopes this positive step forward will lead to policy changes and stronger relationships between Divisions and GPSC.  

Over the past year, the Network of Rural Divisions created a private Facebook group to facilitate asynchronous conversations amongst group members. While there has not been much uptake for this resource, network leads Drs. Huff and Greggain will allow the group to attempt to find its audience.  

Members of the Network have expressed interest in restarting up the Rural Sounding Board as a place for the Ministry of Health to seek explicitly rural perspectives and/or input on rural policy documents. There has been discussion about starting up this resource in April 2020. 

Resiliency – Preparation for Adverse Patient Outcome

Through the 2019-20 year, Dr. Kirstie Overhill has supported the Rural Surgical and Obstetrical Networks (RSON) project to set up and integrate individual coaching for individual members of the rural surgical teams participating in the project. She has worked closely with UBC Rural CPD to build the infrastructure, content, and marketing to offer coaching through both the Clinical Coaching for Excellence Program (specifically for RSON participants) as well as the Coaching and Mentoring Program (CAMP) newly launched by UBC CPD.

In 2020, Dr. Overhill is retiring from UBC and will be handing over the Clinical Coaching for Excellence and CAMP roles to a successor. She is laying the foundation for a new project “Preparation for Adverse Patient Outcome” that would look at creating a conceptual lens to support people in understanding how to create and support both resilient individuals and highly functional teams as a collective offering  (rather than focusing on just individuals or teams as most programs do). Through this project, Dr. Overhill is also hoping to create capacity within UBC CPD to provide mentorship for rural community leaders.

Dr. Overhill is also interested in working with RCCbc’s TRC Calls to Action Working Group, led by Indigenous Physician Network lead Dr. Terri Aldred, to explore a CQI approach to addressing bias, with an eye towards supporting the development more tools to address bias and/or cultural safety training for healthcare providers.

Choices in Practice and Parenting

The Choices in Practice and Parenting initiative – led by Dr. Kirstie Overhill and supported by Program Coordinator Kassia Skolski – was tasked in 2019-20 with reviewing the current parental leave policies of the Joint Standing Committee on Rural Issues (JSC), collecting and reviewing available grey literature about parental benefits for physicians, and conducting an environmental survey to discover what resources (if any) are available to support physicians who take parental leave.  

Dr. Overhill and Kassia convened a committee, co-chaired by Dr. Alan Ruddimanthat held eight meetings throughout the 2019-20 period. An additional half-day in-person meeting was organized so that committee members could discuss the complex interconnectedness of parental leave policies on rural physician healthcare benefits, such as interruption of benefits from the Rural Retention Program and the Rural Continuing Medical Education Program – both of which are tied to the number of months of service provided by a rural physician living and working in an RSA community.  

The final report and recommendations from the Working Group was scheduled to be presented to the JSC in May 2020. However, the Working Group agreed unanimously that the focus for this committee’s members should be on addressing the needs of their communities during the Covid-19 pandemic. The JSC granted an extension to Fall 2020 for the submission of the Working Group’s findings. Dr. Overhill will be completing the final writing of this document over the summer.  

Dr. Pamela Kryskow worked closely with RCCbc and the Rural and Remote Division of Family Practice to host another successful Rural Locum Forum in May 2019 in Nanaimo. The event was well attended with a good mix of rural residents as well as experienced locums in attendance. Attendees engaged in interactive conversations about preparing to go on a locum, rural programs and compensation, as well as Real Time Virtual Support.  

As part of her work for RCCbc, Dr. Kryskow connected with the Doctors of BC Rural Issues Committee, the Joint Standing Committee on Rural Issues (JSC) sub-committee on locum issues to bring a rural locum voice to those tables. She reached out to Locums for Rural BC on behalf of RCCbc to explore ways to create stronger ties between the two organizations, Dr. Kryskow also moderated the provincial BC Rural Locums listserv on behalf of RCCbc and created additional RCCbc rural locum pages on the website.  

In Fall 2019, Dr. Kryskow stepped away from RCCbc to explore new projects. We thank her for her valuable contributions and wish her well on her new adventures.