There were two other factors that related to my ultimate choice of residency. One was that all four of my best Christian friends in my medical will class were going into Family Practice. The other was that there was a certain amount of excitement around Family Practice. I used the word discipline with respect to it in the previous paragraph. Some would equate discipline with specialty and might still not see Family Practice as a specialty. This goes back to the time when this branch of medicine was known as General Practice, which it still is too many. It was seen as the branch of medicine that individuals went into if they did not get into a specialty. Even if they did choose this area of medicine, it was, and to some extent, still is by some, seen as inferior to being a specialist. However, in Canada, the College of Family Physicians had been formed and had been successful in creating a separate residency program under the rubric of Family Medicine, not General Practice. Those involved believed that being a good and successful Family Practitioner involved specialized training.
So it was that my three friends and myself, plus a couple of other fellows that I knew reasonably well, found ourselves part of the group of 12 residents in the Family Practice Residency Training Program run out of the St. Boniface Hospital in July 1976, my year of graduation from medical school.
I was never disappointed with this choice and with the program. I think it was a well set up and run by Family Physicians for Family Physicians.
There was one other aspect of career choice that was involved which I will mention at this time. My concerns for community had led me to believe that these would be more easily realized in the smaller setting of a rural practice than in a city such as Winnipeg. In the larger centres, it seemed to me that the lines around what might constitute your community of practice would be quite blurred. I had already also come to the understanding that the challenges and variety of rural practice generally outweighed that in urban centres. My two summers of working up north as a primary care clinician with nurse practitioners had already made me quite comfortable with those prospects.
Indeed, I was also aware of a couple of other factors that, to my mind, detracted from the greater possibilities of a rule practice if one stayed in the city. One was that it would be too easy to quickly refer any problem to a specialist without working at resolving it yourself first. The other was that there was already a somewhat established practice of specialists really limiting what family physicians could do in hospital settings, particularly when it came to emergency and obstetrical work, as well as anything to do with anesthesia and surgery. Much in these areas has been done by general physicians over the years, and those of us who wanted to do general or family practice, wanted to hold onto as much of that as we could. We realized we needed extra training in those areas, particularly if we were going rural, and that was already being offered, particularly when it came to emergency medicine, obstetrics and anesthesia.
In Family Medicine, we also had elective periods offered. I was interested in neurology and knew that there was a lot to learn in the field of endocrinology, so chose those two areas for two of my three electives. I also knew that I had difficulty with cardiology and that there was a lot to learn in that area, so I faced my anxieties about that area by getting right into it for my third elective. I did not do any extra obstetrics or anesthesia. However, I had already taken an elective in Plastic Surgery as a clerk, or fourth-year medical student, which I enjoyed and stood me in good stead during my years in family practice.
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