Sustaining Pediatrics in Rural & Underserved Communities (SPRUCe)

More pediatricians are needed in rural British Columbia (BC), but recruitment and retention remain a challenge. For those who practice pediatrics in rural areas, the role can be relatively isolated and disconnected from other pediatricians and pediatric resources. Sustaining Pediatrics in Rural and Underserved Communities (SPRUCe) is a clinical network that connects community pediatric providers with interest in supporting and sustaining excellence in pediatric care in rural and remote communities across BC. The goal of SPRUCe is to support those providing rural pediatric care so that provider care gaps are filled, education and mentorship supports are available, and pediatric residents have a structured mechanism for exposure and contact with rural pediatrics.     

Achievements

Support for UBC Pediatric International Medical Graduate residents

One of the strategies implemented by SPRUCe has been to increase the number of international medical graduate (IMG) positions in Pediatrics, resulting in more Return of Service contract commitments in rural communities. However, the IMG match process is continually evolving, leading to significant stress for many pediatric residents. To address this, SPRUCe has facilitated collaboration between key stakeholders, including the Ministry of Health and UBC Pediatric Residency Program Directors, to improve communication and reduce stress levels. In addition, SPRUCe has hosted sessions connecting IMG pediatric residents with recent graduates who shared their experiences and is working to develop relationships with physicians in other medical specialties to match specialty IMGs with rural communities with support for successful integration.

Deepened partnership connections

Over the past year, SPRUCe has been pleased to see its relationships with important partners deepen and mature. These partners include the Joint Collaborative Committees, the UBC Department of Pediatrics, and the BC Pediatric Society Board. SPRUCe’s presence at various pediatric and rural health tables ensures that rural health and specialist issues are considered in discussions. Recently, SPRUCe had the opportunity to share its work at the Doctors of BC Rural Leaders and Clinicians Gathering, leading to important connections with specialists from other disciplines.

Explore the Numbers

39 Communities

Featured in an interactive map that identifies the names and locations of pediatricians in smaller communities across BC, allowing clinicians to easily identify a community pediatrician close to their patient’s home.

3 Newsletters

Featuring details about accredited continuing medical education sessions, evening sessions for residents about rural pediatric practice, and more. Newsletters are available on the website and are emailed to the SPRUCe network.

1 CME session

Organized and presented by SPRUCe was highly topical during the pediatric respiratory surge of 2022-2023.

Making a Difference

In February 2022, SPRUCe organized a session on Multisystem Inflammatory Syndrome in Children that had over 25 participants in attendance, following the COVID-19 surge that occurred in late 2021. The session was highly effective in discussing new and emerging clinical care in pediatrics. SPRUCe continued this success by organizing another session, HiFlow in Bronchiolitis, during the Pediatric Respiratory surge of the 2022-2023 winter, which had almost 40 participants, including interdisciplinary team members. The sessions allowed for insightful discussions and the sharing of knowledge among participants.

This was reflected in comments such as: “This was extremely timely and so relevant to those of us outside of the Vancouver area.”

SPRUCe has also received positive feedback and appreciation for the support in facilitating pediatric rural locums.

Plans for the Future

SPRUCe is taking proactive measures to address the shortage of pediatricians in rural British Columbia. To achieve this, the network has developed the following initiatives:

1. The implementation of the HOUSE Ped course in June 2023, which will be a two-day course in Prince George and a one-day course for RSA pediatricians in November 2023, immediately following the BC Pediatric Society Annual Conference in Vancouver. These courses will provide an opportunity to bring rural pediatricians from around the province together.

2. The Rural Pediatricians virtual meeting, which will be a series of two one-hour meetings in June 2023. These meetings will enable SPRUCe to ensure that the direction of the network aligns with the goals and priorities of rural pediatricians.

3. The network will conduct a repeat online survey of rural pediatricians in 2023. The survey will solicit feedback from rural pediatricians about burnout, locum coverage, recruitment, and some new issues.

4. Develop the role of the SPRUCe Resident representative role. This will help to ensure that pediatric residents have a structured mechanism for exposure and contact with rural pediatrics.

5. The network will evaluate pediatric rural outreach clinics. SPRUCe will develop a framework to support residents in ensuring they have valuable community and cultural experiences when they participate in rural pediatric outreach clinics. Facilitating Pediatric Residents’ exposure to rural medicine is one of SPRUCe’s aims, and it is critical for trainees to not only learn more about rural medicine but also to gain deeper appreciation for the experiences of rural citizens, particularly Indigenous people.