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.’”
The Challenge
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.
The Solution
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.”
What followed was 18 months of collaborative planning between Dr. Abbott, her physician colleagues, UBC Rural Continuing Professional Development, and the RCME Community Program to host a hands-on ultrasound training course in July 2025. The logistics were complex—coordinating expert instructors willing to make the long journey north, shipping pallets of ultrasound equipment to a community over 470 kilometers from Smithers, organizing three days of catered meals. All while requiring food pickup in Smithers and the subsequent seven-hour drive north—and ensuring adequate coverage so physicians can participate.
Funding came from multiple sources: RCME Community Program funds saved over two years, the Specialist, Sub-specialty, Indigenous and Funding for Innovation (SPIFI) grant, and the Closer to Home CME Funding.
“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.”
Why It Works
This past summer, a comprehensive three-day Point-of-Care Ultrasound (POCUS) 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.
“We are all learning this together, and we can continue to support each other. Next time someone can't see something clearly, we can help each other troubleshoot.”
Real Impact
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 realize 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.
The Funding Question
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 POCUS. 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.
“The cost of bringing a course to Dease Lake compared to communities one or two hours outside of Smithers is different. A physician in a less remote location could leave for a day and do an ACLS course. We can't do that from here. We won't get a locum. Having training on-site feels imperative for our group.”
A Model for Other Communities
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.
Looking ahead
The RCME Community Program is a partnership between UBC Rural CPD, 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 rcme@rccbc.ca.
