National Rural Critical Care Course: rural docs teaching rural docs
Suzanne Kingsmill, BA, MSc
Shawville, Que.
Can J Rural Med vol 2 (2):143
© 1997 Society of Rural Physicians of Canada
The Society of Rural Physicians of Canada (SRPC) offered its second and greatly expanded national Rural Critical Care (RCC) Course at the annual rural medicine conference in Banff in April 1997. It covered 8 hands-on topics including insertion of chest tubes, paracentesis and peritoneal lavage, pediatric crises, transport, electrocardiography, radiology, central and arterial lines, ventilators and rapid sequence induction.
The SRPC's goal is to make the RCC course a truly national course for rural physicians designed and taught by rural physicians who have been there and know the problems faced by rural docs in the field, problems that all too often are not recognized or understood by urban specialists.
Rural doctors with a special interest and expertise in their topic know what it's like when the fog rolls in or the roads close in a snowstorm, and they have learned to cope with problems and improvise in emergencies that their urban coutnerparts would never face. Urban specialists cannot know the depth of the need to learn these techniques and the enormous stress placed on a rural doctor forced to make choices that specialists are often not aware must be made; specialists often do not understand that transport isn't an option or that rural doctors are capable of safely practising techniques their urban counterparts cannot do.
Using rural doctors as teachers -- rural doctors who have used the techinques in field conditions and who understand the rural medical life with all its subtleties and nuances and all its larger- than-life emergencies -- makes for a truly hands-on experience in the RCC course. Participants at this year's course often found themselves swapping information and tips, and there were vigorous discussions and lots of give and take between the rural doctors giving the course and the rural docs taking it.
According to course coordinator and SRPC President Keith MacLellan, the RCC course has been developed from scratch because no course existed that specifically addressed the special needs of rural physicians. MacLellan notes in the RCC course manual1 that many hospitals now require doctors to show proof of certification in a wide array of "LS" courses, which places an impossible burden on rural doctors who usually practise in small groups. Rural doctors can't all take ATLS, ACLS or all the other LS courses because they can't take the time or the expense to get away. A multidisciplinary RCC course to cover issues relevant to rural doctors could solve this maintenance of competence problem. The goal of the course is to give rural doctors a practical base for further learning, depending upon the needs of their communities.[1] Judging by the enthusiasm of this year's participants, the SRPC's national Rural Critical Care Course is a successful first step and has all the potential of evolving into a permanent, national-level CME course (see also the announcement about a related issue, combined CME/locum service, on page 111 ).
Reference
- Society of Rural Physicians of Canada.Rural critical care manual. Mount Forest (ON): The Society; 1997. 101 pp.
