Sustaining Pediatrics in Rural & Underserved Communities (SPRUCe)

Sustaining Pediatrics in Rural and Underserved Communities (SPRUCe) is a network that connects community pediatric providers with an interest in supporting and sustaining excellence in pediatric care in rural and remote communities across British Columbia. 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 mechanism for exposure to rural pediatric practice and contact with rural pediatricians.

Pediatricians at the SPRUCe Social Event in November 2024.
Back row: Dr. Kayla Parker (Kamloops pediatrician and CHARLiE provider), Dr. Melissa Paquette (Kamloops pediatrician and CHARLiE co-lead), Dr. Laura Swaney (Cranbrook pediatrician and CHARLiE provider), Dr. Jenny Retallack (SPRUCe co-lead and CHARLiE provider), Dr. Breanna Clive (Kamloops pediatrician), Dr. Kirsten Miller (SPRUCe co-lead and CHARLiE provider). Front row: Dr. Laura Sauve (UBC Pediatrics Assistant Department Head – Clinical Partnerships).

Achievements

Launched a Rural Pediatrics Special Interest Group

In 2024, the SPRUCe initiative broadened the discussion of rural pediatrics beyond British Columbia (BC). The SPRUCe co-leads started the Canadian Paediatric Society (CPS) Rural Pediatrics Special Interest Group (SIG). SIGs provide a method for pediatricians with shared goals and/or clinical practices to connect. Some SIGs eventually become CPS Sections, which guarantees time on the annual conference agenda for topics of interest to Section members. Following this, a small group of Rural Pediatrics SIG members from across Canada met in person at the June 2024 CPS conference to discuss goals. Topics raised included establishing connections, sharing resources and learnings, advocacy, and contributing to the development of CPS position statements and guidelines (by providing the rural perspective).

The Rural Pediatrics SIG then collaborated with the CPS Social Pediatrics Section to develop a session for the 2025 conference. “Keeping care close to home: How to optimize care for children in rural and remote areas in Canada”, will be presented by a Nunavut pediatrician and by Real-Time Virtual Support (RTVS) CHARLiE pathway co-lead Dr. Melissa Paquette. Dr. Paquette will highlight how RTVS supports rural providers and enables rural pediatric patients to receive specialist care right in their home communities. Over 240 Canadian pediatricians have joined the Rural Pediatrics SIG.

Fostering Connections Within BC's Rural Pediatrics Community

Fostering connections between BC’s rural pediatricians is one of SPRUCe’s most important priorities. Feeling connected to colleagues leads to reduced feelings of burnout. In 2024, SPRUCe continued to offer virtual opportunities for rural pediatricians to come together, hosting 5 CME sessions and 2 focused meetings with RSA pediatricians.

In addition, SPRUCe hosted a social gathering at the BC Pediatrics Society annual conference in November 2024. This event brought together pediatricians from RSA communities, residents and program directors from the UBC Pediatrics training program, the Assistant Department Head for UBC Pediatrics and RTVS CHARLiE providers. Informal feedback from this event was extremely positive. Specifically, one pediatrician who is the sole pediatrician in her community and another who is one of only two pediatricians in her community both expressed their gratitude for the event. The event provided residents in training with a rare opportunity to engage with rural pediatricians in person, and provided an opportunity for these pediatricians to be seen as role models and mentors, just like the pediatricians the residents work with regularly at BC Children’s Hospital.

In 2025, the SPRUCe team are looking forward to establishing connections with other rural general specialty groups, starting with RCCbc’s General Rural Internal Medicine (GRIM) Network.

Strengthening Supports for Rural Pediatricians and Residents

During 2024, SPRUCe strengthened connections with the UBC Pediatrics residency program and with BC Children’s Hospital. SPRUCe co-lead Dr. Jenny Retallack is now a member of the BC Children’s Hospital Steering Committee regarding Equitable Access to Pediatric Care. Both co-leads have met with Dr. Laura Sauve, Department of Pediatrics Assistant Department Head – Clinical Partnerships, on several occasions. Through these relationships, the aim is to convey the current state of pediatric specialty services in rural BC and the significant impact that pediatric workforce challenges have on rural communities.

SPRUCe has supported sessions for International Medical Graduate (IMG) pediatric residents. As these residents transition into practice, SPRUCe will continue to support them by connecting them with previous IMG pediatricians currently in practice and with other potential rural mentors. SPRUCe is in the process of planning another HOUSE Pediatrics course with 8 spots reserved for IMG pediatric residents. Having a positive and close relationship with the pediatric residency program directors allows us to gently push the program to tailor the training of IMG and rurally interested pediatric residents so they graduate feeling confident and ready for rural practice.

Explore the numbers

5 CME Sessions

During 2024, SPRUCe hosted 5 accredited virtual CME sessions.

173 Total learners

A total of 173 attendees joined SPRUCe CME sessions in 2024.

5 Resident focused events

SPRUCe hosted 5 sessions specifically for Pediatric Residents in 2024 (Reflections on Residency; Positions, Locums and Outreach opportunities in Rural BC; Introduction to SPRUCe and Rural Pediatrics; Rural and Remote Elective opportunities; SPRUCe social event).

>25% Vacancy rate

In 2024, there was a >25% vacancy rate for pediatric positions in RSA communities in BC.

Making a Difference

At the SPRUCe social event in November 2024, a pediatrician who practices as the sole pediatrician in a rural community expressed gratitude to SPRUCe for hosting the in-person event, and for providing regular virtual opportunities for rural pediatricians to connect. Throughout the evening, she spent time meeting with pediatric residents and building new connections. Another pediatrician, who practices as one of two pediatricians in a rural community, also expressed gratitude to SPRUCe. Joining the SPRUCe events has been a positive experience for her. Lastly, pediatricians from BC Children’s Hospital who joined the event were effusive in their positive feedback about how great it was to meet some of the rural pediatricians from across BC whom they had heard about or spoken to by phone, but had never met in person before.

Plans for the Future

In 2025, the SPRUCe team will continue facilitating connections between rural pediatricians in BC. Planned activities for the year ahead include:

A repeat of the SPRUCe Social Event at the 2025 BC Pediatric Society Conference
Considering an assessment of ‘connectedness’ between BC rural pediatricians
Collaboration with RCCbc’s new GRIM initiative
A HOUSE Pediatrics course for IMG residents & residents going to RSA communities (scheduled for November 2025)
Initiating discussions around a ‘rural pediatrics’ training program for new pediatricians (1-2 per year x 2-3 months)
Scheduling Compassionate Leadership training for SPRUCe/rural pediatricians