‘Come check out the valley’: Annapolis Valley Family Residency Program showcases collaborative effort in training and recruiting new physicians to Nova Scotia communities

When you walk into Monica Cumby’s office and look at the wall, you quickly see why she’s dubbed the “den mother” of the Dalhousie Medical School’s Family Medicine Residency Program. 

Her walls are littered with photos of each year’s group of residents, and their family members, many of whom were born since moving to the Annapolis Valley. The valley program has the highest resident retention rate in Nova Scotia at 90 per cent of graduates staying in Nova Scotia. Seventy per cent of program graduates have chosen to stay in the valley to practise and build their lives.
 
So what’s the secret to the program’s success?

“When rural areas of the province are struggling to find professionals, especially physicians, we have many great things to offer: a beautiful part of the province, collaborative team-based practice opportunities (and) a community of physicians and specialists who are eager to work with residents and also committed to their success,” said Dr. Roop Conyers, a family physician at the Annapolis Collaborative Health Centre in Annapolis Royal, who organizes the valley’s program along with Cumby.

Two of the baby pictures on Cumby’s wall are from former Annapolis Valley resident, and now, family doctor working out of Berwick, Dr. Judith Puetz. These children, born during Puetz’s time in the valley, are now one and three years old. Dr. Puetz came to the Annapolis Family Residency Program from Ottawa because of her passion for rural medicine. She believes the valley’s proximity to major centres and employment prospects for her partner, Michael, helped her select this site for training. 

“The collegiality within my clinic is what I love most about my work life,” Dr. Puetz said. Although they moved to Nova Scotia five years ago, her family still has many provincial and national parks to explore and plenty of new memories to make in their new home, she added. 

Dr. Puetz is a great asset to the Annapolis Valley, said her preceptor, Dr. Christina Mercer. “She immediately fit in in our clinic and collaborated well with the team.” 

Engaged preceptors like Dr. Mercer are a major component of this program’s success.

“It allows us to have a part in shaping a new generation of physicians. We, as preceptors, learn from the residents as much as they learn from us, and having them in the clinic keeps us current and accountable for the care we provide,” Dr. Mercer said.  

Dr. Mercer’s current resident, Carly McLellan, is in her first year of the program, but already has her sights set on a career in the valley. Another former resident from the program, Dr. Corinne Dewar, is locuming in Berwick while waiting to officially join the practice in October. 

Dr. Puetz was part of the inaugural year of the Annapolis Valley Family Residency Program, a partnership between Dalhousie University and Nova Scotia Health Authority. She credits the program organizers with a great learning experience that had its first-year hiccups, but left her feeling very supported in her training. 

Training in a rural setting offered opportunities such as reporting directly to attending staff and less competition for specialty days, which for her meant that she and her classmates were often first-in-line for training in the operating room and emergency room, where they performed hands-on procedures. 

“I was particularly interested in the clinic-centered longitudinal aspect of the program – that we would follow our family practice patients a few days a week over the entire two years,” she said.

Dr. Puetz said she had “the good fortune of being offered a position to start in the clinic (where) I had trained. Having loved the residency experience there and feeling well supported by colleagues — other family physicians as well as specialists — I could not imagine joining elsewhere.”

Dr. Puetz and her family are now quite settled into their life in the valley. She works part-time at the Berwick Family Practice and has lots of time to spend with her growing family. 

While she misses easy access to international restaurants within walking distance, she suggests her rural life has easily made up for it. “I don’t have a long commute, get lots of outdoor time, and feel somewhat protected from the urban rat-race.” 

So where does she see herself in five years? Dr. Puetz said she intends to be doing exactly what she’s doing now – working in Berwick and spending time with her family.  

As for medical learners considering a rural Nova Scotia placement, Dr. Puetz has some advice: 

“If you enjoy the outdoors, want a safe place to raise children, and enjoy collaborating with other friendly and knowledgeable physicians, come check out the valley.”