When a child arrived at Dease Lake’s emergency department short of breath, the X-ray showed white on one side of the chest. But what was it? Fluid in the lungs? Pneumonia? Fluid around the lungs?  

Before acquiring ultrasound training, Dr. Breanne Abbott would have had to use her best clinical judgement with starting treatment often leaving the clinical certainty of a diagnosis to higher level of care after a patient is medevaced. Using point-of-care ultrasound (PoCUS), the answer was immediate: a giant pleural effusion with underlying pneumonia. Treatment could begin right away.  

“It really feels magical sometimes,” says Dr. Abbott, who has practiced in Dease Lake for the past ten years. “You put the probe on and you’re like, ‘Oh, I know exactly what it is.’”  

Dease Lake, a Rural Practice Subsidiary Agreement (RSA) A community, sits seven to eight hours from the nearest diagnostic ultrasound services in Terrace or Whitehorse. Many basic emergency labs take seven to ten days to return. There is no CT scanner. For physicians practicing here, diagnostic uncertainty is a daily reality.  

Consider a patient with a swollen leg and suspected deep vein thrombosis. The standard protocol: start blood thinners and send them on a multi-day journey for a five-minute ultrasound scan. Now, Dr. Abbott and her colleagues can check immediately with PoCUS.  

“It’s been a game changer for our group,” she says.  

Dr. Abbott and a team of physicians in Dease Lake have been seeking ultrasound training for years but found it nearly impossible to access. Leaving Dease Lake for courses meant finding locum coverage—already scarce—and traveling significant distances. The traditional model of having rural physicians leave community for training simply wasn’t working.  

At the Rural Continuing Medical Education (RCME) Leaders Gathering event in November 2023, held in partnership with UBC Rural Continuing Professional Development (CPD), physicians and partners came together to support the ongoing development of rural medical education across the province. During this gathering, she mentioned this challenge. The response from partners and healthcare leaders was immediate: “We can bring education to you.”  

Over an 18-month period, Dr. Abbott, her physician colleagues, the Dease Lake Stikine Regional Health Centre administrative team, the UBC Rural Continuing Professional Development (RCPD) team, and the RCME Community Program collaborated to organize point-of-care ultrasound (PoCUS) training through RCPD’s Hands-On Ultrasound Education (HOUSE) course.

The UBC RCPD HOUSE Course equips rural health professionals with the skills and confidence to integrate PoCUS into their clinical practice. The program brings accredited training directly to rural communities, working with local physician leads to tailor the agenda to community needs and maximize hands-on learning time.

The partnership between the HOUSE and Dease Lake teams was crucial to overcoming the logistical challenges of hosting the course. These included arranging travel for expert instructors making the long journey north, shipping ultrasound equipment from multiple BC communities, coordinating physician schedules to allow course participation, and organizing three days of catered meals. The catering, prepared in Smithers, required HOUSE instructor, Dr. Stefanie Falz Mclellan to transport frozen meals on a seven-hour drive to Dease Lake, a trip during which cell service is lost about 90 minutes in.

The course was made possible through the collaborative efforts and funding support from the RCME Community Program, Northern Health Authority, SPIFI Grant, UBC RCPD, Closer to Home Bursary through the Rural Education Action Plan, and Dease Lake’s RCME Physician Lead Dr. Breanne Abbott.

“I’m surprised it worked, to be perfectly honest,” Dr. Abbott admits. “There was uncertainty around whether the finances would come together. But it did.”  

This past summer, a comprehensive three-day Hands-on Ultrasound Education (HOUSE) course came to Dease Lake. Seven physicians trained together, learning gallbladder assessments, cardiac views, lung ultrasound, obstetrics, trauma, nerve blocks, and procedures.  

The on-site model offers distinct advantages over sending individual physicians to external courses. Training the entire team together creates a collaborative learning environment where physicians can support each other’s ongoing development. “We are all learning this together, and we can continue to support each other,” Dr. Abbott explains. “Next time someone can’t see something clearly, we can help each other troubleshoot.”  

Rather than following generic curriculum, the course was tailored exactly to what Dease Lake physicians encounter: respiratory emergencies, potential DVTs, trauma cases, and obstetric assessments. And practically speaking, finding locums to cover individual physician absences would be impossible. Training the team together was the only realistic path.  

The impact extends beyond the three-day course. Dr. Abbott enrolled in a year-long ultrasound fellowship to become an even stronger resource for her community. 

For patients presenting with shortness of breath who have both chronic lung disease and heart failure, ultrasound provides definitive answers about whether this is fluid overload or a lung disease exacerbation. The treatments are opposite, and clinical presentation is often identical.  

“Going through each training session, you could see the confidence building,” Dr. Abbott recalls. “People were realizing I can do this. I can see their gallbladder. Next time I see a patient, I can check for that. There were many moments of physicians knowing they could now do things they didn’t know how to do before.”  

The transformation was palpable. Physicians who had never performed point-of-care ultrasound were now making definitive diagnoses at the bedside, changing treatment plans in real-time, and avoiding unnecessary patient transfers. 

Dr. Abbott emphasizes the critical importance of RCME funding: “Without that funding, I don’t think our whole team would have access to training, and it improves patient care.”  

The Dease Lake team has used RCME funds to bring multiple courses to their community: The CARE Course twice, the BREATHE Airway course, ACLS and PALS training and now HOUSE. Each course builds capacity that would be nearly impossible to develop through traditional models of sending physicians away for training.  

However, she notes an equity concern: all RSA A communities receive the same RCME allocation, regardless of remoteness.  

Dr. Abbott’s message to other remote communities: “If you’re feeling like, ‘I’d love to have ultrasound training, but how am I supposed to get it?’ It’s worth making the effort to plan for this. The team over at UBC Rural CPD made it easy to collaborate.  

The Dease Lake model proves that with adequate funding, creative partnerships and committed local champions, medical education can reach even BC’s most remote corners, transforming the quality of care entire communities receive.  

After 11-12 years of practice, Dr. Abbott remains passionate about her work. “I feel so lucky that I love my job. Every day I’m using ultrasound—in clinic, in emerge, on my OB shifts when I’m down south. It improves patient care every time I’m using it.”  

The success in Dease Lake demonstrates what’s possible when healthcare providers, educational institutions and funding programs work together to overcome geographic barriers. It challenges the assumption that physicians in remote locations must always travel to access professional development and instead bring resources to where they’re needed most. 

The RCME Community Program is a partnership between UBC Rural CPD, Northern Health Authority, Rural Education Action Plan (REAP), and health authorities across BC, generously supported by the Joint Standing Committee on Rural Issues (JSC), a joint committee of Doctors of BC and BC Ministry of Health.

For more information about bringing medical education to your community, contact the RCME Community Program at [email protected].