Sun Country Health Region is involved with a number of different ways to recruit doctors at the provincial level, regional level, and they depend on the communities across their region as well. Recruitment is an extremely challenging and complicated topic.
Historically doctors had been in charge of finding their own replacement. They would remain in an area until someone else had arrived to take over the practice. Yet, as it became more difficult to find human resources the act of recruitment has fallen onto others. Included in this challenge is the fact that many doctors newly out of the College of Medicine want a Monday to Friday, 9 a.m. to 5 p.m. job. This is something they can have in Saskatoon and Regina where there is emergency personnel at the hospitals. They do not want the on-call lifestyle, which comes with living in a smaller centre.
Alain Lenferna, VP Medical with Sun Country, explains current recruitment efforts.
Locally the Moose Mountain Health Care Recruitment Committee (MMHCRC) may come into talks with a doctor. From here they would then approach Sun Country to help with possible immigration paperwork or a site visit; but, as soon as this community brings the name of a physician to the health region Sun Country automatically attaches the name of the doctor to the community. This name is not shared with anyone else unless MMHCRC were to say that the physician has decided against moving to this community; so, if you can find a position elsewhere that they might be happy then permission is given to share that doctor's name with other communities.
Lenferna stressed that the names of physicians are absolutely not shared if a community has found a doctor on their own and will only tell other communities if MMHCRC were to give permission.
Regionally, Sun Country is continually finding doctors and in this instance they are given a questionnaire to fill out. The questionnaire includes questions such as what are your interests, what do you like to do, do you have any special interests or special skills for practicing? For example, someone who is an obstetrician would be more likely to go to an area where they can utilize this skill.
Once the questionnaire is complete and the doctor is found to be a general practitioner their name is spread out to a number of communities, which correlate to the doctor's interests or personality according to the questionnaire.
"At this point in time that's every community," Dr. Lenferna explained.
From here the communities must let Sun Country know if they are interested in this particular physician. Multiple communities might say they are interested and from here interviews with the community foundations such as MMHCRC are set up. The community group then must decide if they would like to offer a position in their community. The doctor, therefore, may end up with multiple offers and chooses where they think they would like to be.
"We've tried to match the communities to the physician and we've tried to leave the choice to the physician to say this is the community I want to go to," Dr. Lenferna stated.
This is in fact related to retention of physicians in a community as well, because if they choose where they want to be there is a better chance of them staying as opposed to Sun Country directing where they should go. Thus, the choice is left with the physicians and Sun Country simply facilitates a dialogue between a doctor and the community.
Another way that Sun Country is attempting to recruit and retain physicians is to offer a bursary to youth in the region who are interested in pursuing this field of study. Often youth who grow up in rural areas would like to return, so to provide an incentive such as a bursary is one way to ensure they will be back.
"We want to start growing them from that end and they'll have basically a four year commitment," Marga Cugnet, President and CEO of Sun Country, said.
These young doctors write down the communities they would like to go to following their schooling. The health region then does their best to get them back into these communities; but, the bursary is accepted by the student on the condition that if they are unable to fill their requirements there they may possibly be sent elsewhere in the region. Sun Country hopes to get them into their area of choice, however, because this again correlates to retention of them following the four year commitment.
For recruitment on the provincial level there are two main avenues being pursued. One includes the organization called SaskDocs. This group is active in finding physicians offshore who would be good candidates for passing the Saskatchewan International Physician Practice Assessment Program (SIPPA), which is the assessment program all offshore doctors must pass in order to practice in Saskatchewan.
Initially in the case of SaskDocs a list of priority communities were developed, which only included Weyburn and Estevan within Sun Country. Bound by their agreement with SaskDocs, Sun Country was unable to release the name of the doctor anywhere else. They were required to send the physicians found by SaskDocs to either of these centres; however, they have since lobbied to have the Arcola, Carlyle, Redvers grouping placed on the priority list. Sun Country has also lobbied to have Oxbow put onto the list as priority and Kipling has recently been added.
Through this recruitment process the physicians are presented with all of the priority communities according to the SaskDocs list throughout Saskatchewan, thus, physicians are able to look at all positions in Saskatchewan and choose which community they want throughout the province. Changes have begun with this process though.
Through this process the College of Medicine determines if the individual would be licensable. If yes, then that name is sent back to SaskDocs. SaskDocs then looks at what the physician is looking for, which they determine to be found in a couple of different health regions; but, they further look to see which region is priority at that time. A physician is then sent to Sun Country where they help the physician come into contact with different communities.
"That's how we ended up with six of those candidates at the end of the day," Dr. Lenferna explained.
There are three times a year that physicians can enter SIPPA, each only with 30 seats available for all of Saskatchewan. Therefore, 90 seats can be filled per year; but, this doesn't mean Saskatchewan gets 90 doctors a year because if the physician cannot pass SIPPA they are sent home. Also, as a health region they are guaranteed two spots, with the chance to have more seats as relying on a first come first serve basis.
They felt fortunate to gain four extra seats for the current round of SIPPA. Sun Country has six potential physicians for completing SIPPA. These physicians have already agreed to go to a particular community. There is currently one in the process that is intending to come to Arcola, two for Weyburn, one for Kipling, one for Oxbow, and one for Estevan.
SIPPA next runs in May and they currently have two candidates slated to begin this assessment.
The other recruitment effort on part of the province is looking at physicians already licensable in Canada as they have already gone through immigration. Previously there were only seven countries that Saskatchewan would license from in an attempt to meet national credentialing; but, this has now opened up to all countries, therefore, doctors who had immigrated earlier and were not from these licensable countries are now being sought out. Saskatchewan is the first of the other provinces to open up licensing to this group.
They still need to go through an assessment process after the College of Medicine says they're licensable. Many of these physicians are now coming from other provinces in order to become a doctor again and practice. This group, however, is feared to leave once licensed and have completed their required two years as they have come from living in Calgary or Toronto for possibly the past ten years. With a license from Saskatchewan they are then able to be licensed across Canada.
While Sun Country and the province works to obtain doctors they are also bound by the ethical rules of recruitment.
"We don't want to particularly go and recruit in a country that can't afford to lose their physicians. And South Africa at this point in time is one of those countries. Will we turn down a South African physician who presents themselves? No, because they've already made that decision. But, we're not going to go and try and recruit them," Dr. Lenferna explained.
Cugnet added that this mimics the ethical rules within the country. "We won't go into the north or try and recruit from another region, but if they approach us of course [we will welcome them] because we know then that they're not happy so that we might as well keep them [in Saskatchewan]."
"We don't go poaching our neighbours," Dr Lenferna stated.
Ultimately Sun Country wants to have nine doctors to spread between Arcola, Carlyle, and Redvers. With the addition of the one currently in SIPPA it was thought there would be four in the area; but, the doctor in Redvers is now leaving which means there will only be three here again and an experienced Nurse Practitioner.
The dynamics the health region is dealing with continually changes as do the rules to recruiting; but one of the most important parts of the process is retention of physicians by communities, which will be the subject of our continued health care series next week.
