Establishing a distributed campus: making sense of disruptions to a doctor community

Abstract

Medical Education 2010: 44 : 256–262 Context In August 2004, the Northern Medical Program (NMP), a distributed campus of the Faculty of Medicine at the University of British Columbia, Canada, admitted its first students. Situated at the University of Northern British Columbia in Prince George, the NMP created new opportunities, challenges, stresses and changes for the approximately 180 local specialists and family doctors. This study examines the initial impacts of the NMP on doctors practising in its host community. Methods Qualitative interview methods were used. A purposive sample was drawn from: (i) doctors who had involvement with the NMP, and (ii) doctors who were not involved with the NMP. Data were collected from May to September 2007 using a semi‐structured interview guide. Interviews were audiotaped, transcribed and checked by participants. Analysis involved identifying, coding and categorising key emergent themes until saturation. Results Prior to the implementation of the NMP, doctors in Prince George had formed cohesive networks, in the face of adverse conditions, that functioned effectively as a form of social capital. The introduction of new doctors and resources through the NMP disrupted this sense of community cohesiveness. Over time, however, the NMP has created new mechanisms by which doctors interact and develop partnerships. Discussion The study confirms the value of a social capital framework for understanding a medical community’s adaptation to change. At this early point, it appears the NMP has created new mechanisms by which doctors can interact and develop the partnerships and relationships necessary to renew a sense of community cohesion.

Students Who Stay: Stories of Northern Medical Program Graduates and Place Integration.

“…In fact, several participants used the term 'collegiality' when they described the interactions they observed during their training in the NMP. As has been previously reported (Hanlon, Ryser, et al, 2010;, the establishment of the NMP has had a largely positive impact on the established medical community within northern BC: the continued growth and increased diversity of the medical community in Prince George are attributed in large part to the establishment of the NMP. A strong sense of 'collegiality' was cited as one of the most important reasons for wanting to practice in the North.…”

“…Their findings suggest that positive educational experiences in rural settings improve the likelihood that medical students develop ties to that rural setting (Curran & Rourke, 2004), regardless of whether they were raised in a rural region (Dunbabin & Levitt, 2003), or whether their overall medical training took place at a rural-focused institution (Rourke, 2005). As discussed in the Study Context section of this chapter, the NMP, based in Prince George, BC, was established with exactly that goal in mind: i.e., that training more physicians closer to their homes, and providing newcomers to the North with positive rural-based training experiences, would eventually increase the chances that they would become local physicians upon graduation (Kondro, 2006;Snadden & Casiro, 2008;Hanlon, Ryser, Crain, Halseth, & Snadden, 2010).…”

“…Even local physicians, who understand better than anyone the challenges and rewards of practicing medicine in northern BC, may assume that NMP graduates intend to remain in the North (Lovato, Bates, Hanlon, & Snadden, 2009;Hanlon, Ryser, et al, 2010).…”

“…Researchers have begun to explore the impact of new medical students on the workload of local physicians (Hanlon, Ryser, et al, 2010) …”

“…Prince George is a relatively collegial and kind city to work in, so that generally you can Several groups have reported that, prior to the establishment of the NMP, the Prince George medical community was a cohesive group of physicians (Hanlon, Ryser et al, 2010;Toomey, Hanlon, Bates, Poole, & Lovato, 2011), united by their "common goals, routines of social interaction, and various expressions of trust and cooperation" (Hanlon, Ryser et al, 2010, p. 260). However, for some local physicians, the opening of the NMP has changed their perceptions of community cohesion (Hanlon, Ryser et al, 2010).…”