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How a rural Nova Scotia village found a new doctor amid widespread shortage

A housing shortage, large patient rosters, and a lack of support are some challenges for recruiters looking to attract doctors to rural areas of Nova Scotia.

That challenge is underscored by a doctor shortage that’s left more than 100,000 Nova Scotians without a family doctor.

Despite those challenges, Sacred Heart Community Health Centre in Cheticamp has managed to keep doctors for long periods of time and even recruit new ones to the rural area.

Dr. Marcel Aucoin was a family physician in Cheticamp for 26 years. He retired last month, but not before recruiting his own replacement doctor — the daughter of one of his colleagues.

“It was an easy fix, let’s say, for our situation,” he said.

Support systems help

Aucoin said doctors in Cheticamp discussed his succession plan for nearly five years to fill the gap that he would leave behind.

“When you have one physician trying to move into an area where there’s a lack of support, it decreases the chances of that physician remaining because the demands are just too much,” Aucoin said.

“It’s much easier to recruit someone with roots from the area, with family support, with friends, with a whole social support system in place already.”

Mindy LeBlanc is the physician recruitment consultant for the northern zone of Nova Scotia.

She says retiring doctors who find their own local replacement is a rarity.

“We do see it, but it doesn’t happen as often as we would like,” she said.

She says there are several challenges when recruiting doctors to rural areas of the province — including securing housing and finding doctors willing to step into an established solo practice with large patient rosters.

“Sometimes that can be a bit frightening or intimidating to newcomer physicians,” she said.

Looking to attract young doctors

Aucoin says one reason the small village has managed to retain doctors is due to a supportive environment.

“We have a good team, a good system in place, we support each other. And it’s inviting to a number of residents and med students that come in,” he said.

One of those visiting medical school students was Dr. Michel Chiasson.

He started at the hospital about 20 years ago after doing a rotation with Aucoin.

Dr. Michel Chiasson has been a doctor at Sacred Heart Community Health Centre in Cheticamp for just over 20 years. (Medical Affairs at Nova Scotia Health)

He saw the benefits of a rural family practice and decided to settle in Cheticamp and build a life there.

He has family ties to the area and he says those roots helps with retention.

“There’s no mystery that that recipe seems to work — growing your own physicians,” he said.

Chiasson hopes med school admissions consider a wide representation of applicants from both rural and urban areas.

“That will increase the chances of physicians coming back to rural areas,” he said.

Med school initiatives

Dalhousie Medical School will be adding five seats for rural Nova Scotian applicants starting in September. (Matthew Moore/CBC News)

Dalhousie University has created initiatives to train medical students in rural areas.

In 2019, the university introduced a family medicine experience where all first-year med students spend six half-days with a family physician. Students spend one week observing a rural physician in a popular unit called rural week.

A new partnership between Dalhousie Medical School and Cape Breton University starting this September will see CBU sponsor five seats for rural Nova Scotian applicants in hopes to alleviate family physician shortages in rural areas.

The university also introduced a clerkship program in which four medical students spend their entire third year of medical school training under physicians in Cape Breton.

The program has since expanded to Nova Scotia’s South Shore.

A spokesperson for Dalhousie says the clerkship program strengthens student ties with the community and gives them a better feel for practising in a rural environment — with the hope they will one day come back and work there.

LeBlanc says doctor recruiters work with community navigators to help find accommodations or help spouses find jobs.

While Aucoin isn’t sure there’s a magic formula for doctor retention, he says recruiting students who express interest in returning to their home community is ideal.

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