Violetta Cohen

Email: viola.cohen@ubc.ca


 

SOME DAYS, AS SHE WRAPS UP THE LAST SIX MONTHS of her UBC family practice residency training, Dr. Emma Garson discovers nuggets of her family history from certain patients.

Dr. Garson was born in and grew up in Kamloops, a city of approximately 90,000 residents in BC’s Thompson-Okanagan region. After earning her medical degree from the Southern Medical Program (SMP) based at UBC Okanagan, Dr. Garson is now completing her two-year residency in her beloved hometown. She splits her time between practicing and learning at Aberdeen Medical Centre and Royal Inland Hospital.

“There’s not a ton of Garsons in town,” she says. Occasionally a new patient noticing her last name shares stories about her kin, including her father Bruce who passed away in 2013. “So I pick up my own family history just by practising here.”

A map showing Kamloops in BCDr. Garson didn’t come from a medical family. Her mother worked in IT at Thompson Rivers University, while her dad — a jack-of-all-trades — was a semi-pro hockey player, a cop and worked in the restaurant industry. Yet no one who knew Dr. Garson growing up in Kamloops would be particularly surprised that, by the end of this year, she’ll be a licensed physician.

“If you asked my mom she would definitely say I was a nurturing child,” laughs Dr. Garson. With friends growing up, “I would be like the mom of the group. I liked that role and I like looking after people.”

At 16 the idea of pursuing medicine began to tug at her. When her grandmother, who lived nearby, had a tumour removed, Dr. Garson moved in with her for nearly a month to help her recover. When her father’s health declined due to Alzheimer’s, she helped look after him as well.

For Dr. Garson, community has long been important. “I’ve never been one that’s needed to see the sights or travel around the world, or be in a big city,” she explains.

When exploring options for medical school, the SMP appealed to Dr. Garson because of its smaller classes and links to clinical training partners in the Kamloops region. The SMP, she says, delivered on her desire for a sense of community that she feared would be missing at a larger university.

Every year, UBC admits 288 new students to its undergraduate medical program. The bulk attend the university’s Vancouver campus, but the remainder — 32 students per region — attend satellite programs at the University of Victoria, the University of Northern British Columbia and UBCO. Established at UBCO in 2011, the SMP was designed to help medical students “meet the health-care challenges of tomorrow,” and serve the needs of communities throughout the Interior Health region.

“As a medical student in a smaller community,” explains Dr. Garson, “if you’re interested in being a surgeon in the future, there’s lots of opportunity to be a first assist. You might be driving the camera, so the surgeon can see what they’re doing, or retracting skin. You can really be part of the action.

“In the clinic in our community,” she continues, “I do minor procedures independently. I’ll do a skin biopsy on my own or an IUD insertion for contraceptive management. So I get to do some procedural things which I enjoy. It’s not necessarily everybody’s cup of tea. But certainly, at our site and just the smaller sites in general, there’s lots of opportunity to be hands-on.”

Emma with fellow Family Practice students in Kamloops

Now, as a family medicine resident close to achieving her dream of being a full-fledged physician, Dr. Garson currently rotates between the Aberdeen Clinic and Royal Inland Hospital. She’s getting a taste of many medical specialties including surgery, internal medicine, emergency medicine, psychiatry and obstetrics.

As she started transitioning from medical school to residency, Dr. Garson was more supervised at first. Now, doing full-care family practice at Aberdeen, she has more autonomy. “If I’m not confident about something, I can pick the brain of my preceptor [medical supervisor] and run my plans by her.”

By nature, Dr. Garson describes herself as someone with a generalist personality and as a “fixer.” Those traits dovetail nicely with family medicine, which demands competence in a variety of medical skill sets. Tailoring her future practice to the needs of Kamloops, she sees a strong possibility that she will focus on palliative care.

“I like doing longitudinal care. You get to know your patients well. You see them through the good, the bad and everything in between. To me, that’s a privilege.”

Recently married, Dr. Garson was so confident in her opportunities to practice medicine in her hometown after her SMP education that she and her husband bought a home. “There’s such a shortage of family doctors here in Kamloops and BC in general. So there’s value in me staying here.”

An avid golfer like her partner — there are seven courses in Kamloops — Dr. Garson looks forward to the work-life balance a medical career in Kamloops offers. Since buying her home, she’s been laying down a new floor and doing other renovations.

And, as a “fixer” at heart, she looks forward to a life-long career in Kamloops where she’ll also have the opportunity to repair the health of those in her community.

IT’S AN UNDERSTATEMENT TO SAY THAT TANELLE SMITH moved around a lot as a young girl. Born in Dawson Creek, BC, her father worked at various wood and pulp mills across North America. She racked up life in one town after another the way a snooker player racks up pool balls.

“I actually don’t remember them all,” says Smith, recounting her youth with chatty exuberance. “But it was really fun. I got used to introducing myself all the time and being a flexible person.”

Now a third-year student in the Southern Medical Program (SMP) based at UBC Okanagan, Smith credits her bouncy childhood with helping her cope with a shifting educational trek that eventually led her to UBCO.

THE PATH TO BECOMING A DOCTOR

Smith confesses she applied to UBC’s medical program on a whim, after discovering an interest in science during her undergrad. “I wanted to do something where I could directly help people.”

Every year, UBC admits 288 new students into its undergraduate medical program. The bulk attend the university’s Vancouver campus, but the remainder — 32 students per region — attend satellite programs at the University of Victoria, the University of Northern British Columbia and UBCO. Established at UBCO in 2011, the SMP was designed to help medical students “meet the health-care challenges of tomorrow,” and serve the needs of communities throughout the Interior Health region.

A map showing Dawson Creek and Kelowna, with a large distance between the twoThe SMP had a number of attractions for Smith; in addition to bringing her closer to family in Kelowna and Kamloops, the program offers a special focus on rural medicine. In the tiny towns and villages where Smith grew up, health care professionals didn’t always seem personally connected to community. But she wants to be a different, more integrated and community-involved doctor — the kind the SMP trains students to be.

As the first in her family to attend university — and with little exposure growing up around people in the medical profession — becoming a medical doctor initially didn’t seem like a plausible option. Fortunately, as Smith began to ponder that possibility during her undergrad, she found strong support from family members and university mentors.

Smith is a descendent of the Upper Nicola Indian Band — a community of the Syilx Nation — through her father and grandfather. Like many, Smith’s family was influenced by events such as the residential school system and the Sixties Scoop. Despite being proud of her heritage, this affected Smith’s confidence in her identity in academic institutions and the field of medicine, where historically there has been little room for Indigenous people and ways of knowing. But confidence in her Syilx-self further blossomed in 2019 after attending the University of Alberta’s SING program (Summer Internship for Indigenous Peoples in Genomics). During the week-long workshop, which focused on chronic wasting disease in animals, she interacted with elders, trappers, and, importantly, academics with backgrounds similar to hers.

“I suddenly felt free to be myself. I felt it was the first time I was surrounded by people who were Indigenous scientists. They were people like me getting PhDs and doing environmental science.”

At UBC in Vancouver — where all medical undergraduate students begin their studies before transitioning to the other campuses across the province — Smith spent her first semester in shared housing with three other Indigenous medical students. This arrangement was a source of strength and community, and — along with the non-Indigenous friends made in her program — helped ease her anxieties about possible reactions to her heritage.

Smith with a fellow Indigenous student from residence

Smith has particularly bonded with fellow SMP student Samantha, who roomed with her in Vancouver. Samantha is a member of the Metis Nation Alberta and a descendent of the Peayasis Band.

When she later moved to Kelowna in January 2020 to continue her studies in the SMP, Smith’s cultural confidence continued growing, since she was closer to family as well as her community of peers at the SMP site.

The health-care challenges currently affecting the world — specifically COVID-19 — have, for now, somewhat altered the learning experience for SMP students like Smith.

She’s impressed by how the Faculty of Medicine has adapted to the pandemic. Currently, lectures for first and second-year students are all online, but SMP students can still do some in-person clinical skills training, such as musculoskeletal exams, in a hospital setting. Some aspects of clinical skills training, like conducting psychiatry interviews, are done over Zoom.

The social resilience Smith built up from her semi-nomadic childhood has also proved handy during the pandemic. As vice-president of social events in the program, Smith and two classmates are in charge of arranging all social events. Despite COVID-19, the trio has found ways to keep students uplifted in a difficult time.

“I’ve driven around town dropping off supplies for games and snacks for classmates. Then we’ll get on Zoom together and play games like Mafia.” Smith also helped round up classmates at a pumpkin patch near Kelowna where — socially distanced — they scampered through a corn maze and pelted pumpkins with slingshots.

“That’s a great part of the SMP. It’s the community you get. There are only 32 of us so it’s pretty easy to get to know people.”

Smith and her father in Field, B.C.

Smith and her father in Field, B.C.

Now living with her father in Kelowna and closer to her extended Syilx family in Kamloops, Smith is learning more about her culture. She tracks deer in the mountains around Kamloops with her father and has learned to hunt grouse with a bird bow.

As for what kind of doctor she’ll be, Smith isn’t sure. But she was inspired after studying under Dr. Nadine Caron, Canada’s first female First Nations general surgeon and an assistant professor of surgery at UNBC’s Northern Medical Program in Prince George. Dr. Caron is a surgeon who frequently interacts with rural populations on a deep level. Smith says that before Dr. Caron, “medicine seemed cold and extricated from community to me. But she’s so open and goes out of her way to really reach people!”

Whichever path Smith chooses in the SMP, she intends to eventually serve Indigenous and other people in rural communities. “There’s a lot of opportunity to do so much there. Dr. Caron has taught me that you can integrate community with the practice of medicine. And I really value that.”