Dr. Paul Dickinson is happy to be home in Lillooet for a one-month residency in family practice at Lillooet District Hospital and the Lillooet Medical Clinic.
Dickinson, 31, was raised here and is a graduate of Lillooet Secondary School.
Dr. Dickinson graduated from medical school in June 2014. At that point, he was officially a doctor. But, as he explains, “In order to be licensed to practise independently, you have to complete a residency program and write two more exams. So, for family practice, that’s a minimum of two years.” There are also additional third-year programs in emergency, anesthesiology and surgery.
He officially completes his residency on June 30, 2016 after completing his exams. The first exam in November is a practical exam where people act the role of patients and another doctor will be in the room marking him on his interview and management skills. The second exam in April is a four-hour written exam covering “everything you’ve learned.”
Enrolled, in UBC’s family practice program in Kamloops, Dickinson and his fellow doctors in the program are required to work for a minimum of two months in a rural community.
He expressed a preference for Lillooet, but the timing was wrong. Instead, he was assigned to Hope in February and March of next year.
He explains, “Lillooet wasn’t available during the time I was slotted for my elective, and I was very disappointed. I went to the university after I got my placement, which is going to be Hope, and I said I would really like some time in Lillooet, how do I go about setting that up? I was given UBC’s permission to speak to the doctors here and they graciously gave their permission.”
Inquiring minds want to know: Is he going to come back here full-time for his medical practice?
He says it’s “tough to say. Things are so open right now.” He and his wife Sam, a nurse, want to travel and see more of the province before their son, Jack, now 2, has to settle down in school. “The other reason is I want to see different sizes of communities and different styles of practice to see what I like. I do know I like working here and I’m definitely going to come back as a locum.”
From the time he first contemplated going to medical school, his dream was to go into family practice.
Today, he says he “absolutely” made the right choice.
“My very first day of clinical experience, I had a nurse who came in for her flu shot. She was in her 60s, she was retired, and so my very first flu shot, my hands were trembling. I’m sure I hurt her, but she was very nice. I had a lady with multiple sclerosis, and a lady who was pregnant and came in for her pre-natal, and a teenage girl who was asking about birth control,” he says, recalling the variety of patients he saw that first day. “And I remember thinking right off the bat that this was a totally different relationship being a doctor. Doctor-patient relationship are different than being a friend, different than being a family member You know more about some patients than their own family knows about them, yet the relationship is on such a different level. Every day I find something that tells me I’ve made the right choice.”
How does it feel to return to his hometown as a doctor?
“I think for me it’s actually been really nice,” he replies. “It’s shown me, #1, how I’ve grown as a doctor. I feel like I’ve come into a place where I can be professional and remember I’m there to do the job I’m there to do. We’re taught to be impartial and objective as physicians and that’s something you have to learn to do whether you know the patient or not. Coming home to people who knew me before I was a doctor, there’s been that initial awkwardness and then they just accept me and treat me like a doctor. I’m very grateful for that. The one thing I really like is that everybody here – the physicians, the nurses, the staff - has treated me like a resident.”
During his interview with the News, it was teasingly suggested that he acquired some of his interviewing skills working as a summer student reporter for the paper.
“That’s absolutely right,” he responded brightly. “It definitely helped me; I’ve had teachers say they like my interviewing skills. And I tell them I worked for the newspaper in Lillooet before I got into med school.”
In September, he will go back to Kamloops to study pediatrics at the start of his second year in the UBC residency program.
As a young husband and father, he’s determined to achieve a balance between work and family.
He acknowledges it can be very hard to “say no and work too much.
“Certainly being over-worked is the norm, but it depends. I found some rotations not so bad. In others, that was the way your teachers were trained, so that’s the way you’re expected to train. Maternity can be tricky because often you’re up all night but in the end, it’s a lot of fun bringing a baby into the world, so I think it balances out quite nicely. But it’s true the hours are long.”
And attitudes in the profession appear to be changing.
“I worked with one preceptor who told me a story about working in the 1970s and getting chewed out by the chief resident for spending his day off with his family rather than at the hospital. He’s glad to hear things have improved.”
His residency here confirmed for him how much he enjoys rural, small-town practice.
“I worked with an oncologist in Kelowna, and he asked me what I’m going to do. I said family practice. And he said ‘Good for you I could never do that.’ He’s dealing with very complicated cancer cases. He told me, ‘I know a lot about this one area, but the rest of it, it’s been 25 years since I dealt with it.’
“And it’s true. I look at the doctors here and without over-exaggerating, these guys are heroes to the residents. One minute they can deliver a baby and the next minute they can intubate a patient by putting a tube down their throat. Very few doctors can do that. Rural doctors are the last bastion of general practice.”
Dr. Dickinson concludes, “I’m really happy I was able to come back here. It’s one of the best starting opportunities I could have had.”