Medical society requests more training places in NB for emergency physicians

More emergency physicians need to be trained in New Brunswick to maintain emergency services in the province, according to the New Brunswick Medical Society.

Health Minister Dorothy Shephard’s plan to reinvigorate the health care system recognizes the problem that has plagued the province for years – a staff shortage – but details are lacking on how recruiting efforts will change.

The plan released last month also mentions the use of “innovative education and training models” to address the shortage, but offers few concrete steps.

But the medical society has identified at least one movement it says is part of the solution: to create more emergency medicine residency positions.

“Recruiting and retaining the appropriate number of emergency physicians in the province is critical to the operation of our emergency rooms,” said Dr. Mark MacMillan, president of the medical society, in an interview.

“The company has always been in favor of improving medical learning in the province because we know that if you train here you are more likely to stay here and work here in the future.

Currently, New Brunswick has two residency positions open each year for graduates of medical schools who wish to obtain certification in emergency medicine through the program at Dalhousie University in Saint John.

The medical society is also keen to see a three-year College of Family Physicians of Canada certification program expanded, a step that could help emergency departments in less urban areas.

This year, shortages of nurses and doctors, highlighted by the COVID-19 pandemic, have forced Horizon Health to cut the hours of some emergency departments. The reduced service continues at Sackville Memorial and Oromocto Public hospitals.

Not enough emergency room doctors prompted Oromocto to cut

Internal emails from senior management at Horizon Health, obtained through right to know requests, indicate shortage of emergency room physicians in the Fredericton area has resulted in reduced hospital emergency hours Oromocto audience during the summer.

As of June 22, Oromocto’s emergency room began to close at 4 p.m., instead of 10 p.m., because doctors were needed to keep the emergency operational at Fredericton’s Dr. Everett Chalmers Regional Hospital, according to emails from Dr Édouard Hendriks, the former vice-president. of medical, academic and research affairs at Horizon.

On June 22, the Oromocto Public Hospital began to reduce its opening hours by closing at 4 p.m. instead of 10 p.m. (Joe McDonald / CBC News)

In the meantime, Oromocto’s emergency room was transformed into an “emergency care center”, since only family doctors were available to work there and were not qualified to treat patients requiring emergency care. , according to Hendriks’ correspondence of June 15.

Hendriks did not respond to a CBC News interview request.

Emails sent by family physicians in response to senior management highlighted several concerns about their ability and willingness to staff the emergency room.

“Family practitioners working in the community often no longer have the skills to manage trauma, MI, fractures, chest drains and intubations,” Fredericton physician Kari Van Middlesworth wrote to Hendriks.

“It’s not safe for patients and patients don’t sort themselves properly. When patients present to the emergency room, they are often inaccurate in their assessment of the severity of their problem.”

Medical society wants to raise standards in emergencies

The medical society’s call for more residency positions follows the advice of the section of the society representing emergency physicians.

“We believe we have the need and the capacity to increase residency training capabilities here in New Brunswick, which we believe will help us fill our emergency department positions with qualified emergency physicians and enhance the emergency medicine level across the province, ”the section heads said in a statement to CBC News.

The medical company also wants Horizon and Vitalité to promote greater collaboration between rural and regional hospitals, since many emergency rooms do not have certified doctors in emergency medicine.

According to the Physician Registry, most emergency physicians practicing in New Brunswick hospitals are located at the two Moncton hospitals, the Saint John Regional Hospital and the Chalmers Hospital in Fredericton.

Emergency physicians who are members of the New Brunswick Medical Society say the province has the need and the capacity to train more physicians in emergency medicine. (SRC)

The Upper River Valley Hospital, Oromocto Hospital and Miramichi Regional Hospital each have an emergency physician, according to the registry.

In total, there are 71 licensed doctors in emergency medicine in the province, including three with temporary licenses. More than half, 37, are in the Saint John area.

The medical company also wants regional health authorities to move towards requiring this type of certification when hiring new people in emergency rooms, especially when it comes to hospitals. in urban centers.

“Requiring this type of certification could pose problems for some departments that are struggling to recruit their vacancies,” said Anthony Knight, CEO of the medical company. “But the long-term goal of enabling and establishing these criteria would benefit these departments in the future.”

Saint John’s Integrated Family Medicine and Emergency Program assists emergency room staff across the province, and residents often work in rural hospitals like the Sussex Health Center, Charlotte County Hospital and the Upper River Valley Hospital in Waterville, said Dr Rob. Dunfield, a third year resident of Saint John.

“We are in our training, but we play an important role in the care of patients,” said Dunfield. “We have less of a problem with the staffing of positions in these hospitals in the emergency departments thanks to this program. “

Health Minister Dorothy Shephard announced her health plan on November 16, but details were lacking on the increase in staff in emergency departments and elsewhere in the system. (Hadeel Ibrahim / CBC)

Opening up more training opportunities for resident physicians would require collaboration between the medical schools, hospitals and medical schools that issue the certification, as well as financial commitments from the province, MacMillan said.

Shepard has made no commitment to increase the number of medical education opportunities.

“We are discussing frequently to try to understand how we can improve the number of students that we have, which is possible, and we will definitely continue to have these discussions,” she told reporters after announcing her plan. health care. .

The Department of Health has also discussed with medical schools how to shorten training and is considering recognizing medical certifications from other countries, Shepard said.

It is not uncommon for New Brunswick medical graduates to make residencies in another province. This year, more than 60 percent of medical graduates left to complete their residency elsewhere, according to the province.

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