History of Teaching & Learning Medicine

History of Teaching & Learning Medicine

The History of Teaching and Learning Medicine in the Lake of the Woods Area

By Dr. Sherry Reed-Walkiewicz

Learners pursuing careers in medicine have been coming to Kenora in formal student placements for savvy mentorship and top notch clinical experience for decades and for well over a hundred years in the apprentice-like tradition of the vocation. A younger doctor working with experienced ones has always been the pathway for layered learning.

The earliest documented residing “medicine men” in the Lake of the Woods area were members of various First Nations. They were traditional healers and spiritual leaders. These medicine elders passed their knowledge along to the next generation of healers who were identified by spiritual guidance or were chosen for aptitude.

According to Marcel Dubroy in “A History of the General Practitioner 1879-1957”, the first permanent European doctor in Kenora (then known as Rat Portage) was Dr. Thomas Hanson in 1879. He was English born but Canadian trained. He made his way to the Lake of the Woods area via Brandon, Manitoba at the age of 32. It appears that he stayed for most of his career and attracted similar aged and younger colleagues including Dr. W.J. Gunne in 1879 or 1880, Dr. Scovil in 1882 and Drs. F.W. Cane and A.S. Macdonnel around 1885 to hang their practice shingles.

A pioneer citizen, teacher and physician named Dr. William John Beatty (1866-1939) came to Keewatin in 1897 after graduating medicine from Trinity University in 1896. He bought the Beatty Block, added a wing and eventually opened the first Keewatin Hospital. In 1903 The population boom of the turn of the century led to the Sisters of Providence of Montreal to open St. Joseph`s Hospital. It wasn`t a teaching hospital affiliated with any School of Medicine but it was the training ground for hospital medicine experience for the next 50-60 years and attracted a steady stream of young physicians who came from all over the world. In 1968 the Kenora General Hospital (formerly called the Royal Jubilee Hospital) and St. Joe`s amalgamated and the Lake of the Woods District Hospital was officially opened in 1974. It started hosting medical learners by the end of the 1970s, according to local memory.

The wave of physicians who came to town during the 50s, 60s and 70s eventually became the first area doctors to preceptor student placements from university programs starting in the late 70s and early 80s. Dr. Allan (Al) Torrie came to Kenora in 1951, followed by contemporaries Dr. Barrie Leckie, Dr. Peter Delamere, Dr Earl Bryngelson and Dr. Playfair, just to name a few. Dr. James (Jim) Beveridge explained that the physicians during that era were largely company employees who practiced in one of 4 practices. There was the Flower Mill Practice in Keewatin; the Pulp Mill Practice in Kenora; the CP Rail Practice and the Indian Practice in the Lake of the Woods Clinic on Matheson Street. Comprehensive, multispecialty office, hospital and emergency medicine was just what everyone did and the job ended when the last patient was tended to. It would have been a rich environment for any fortunate student, resident or young rookie doctor to have been a part of. Listening to some of Jim`s side stories of notorious behavior by his senior colleagues was beyond fascinating, but that`s a story for another article. In 1972 Dr. John Augustine of Thunder Bay was the first founding Chair of The Northwestern Ontario Medical Program (NOMP). It was a partnership struck between the Thunder Bay and Northwestern Medical societies and McMaster University to coordinate one month long undergraduate “horizontal elective” exposure to rural medicine with the goal of increasing student comfort for rural practice and to increase recruitment and retention upon training completion. Dr. Torrie embraced the model and co-ordinated the first placements here for not only McMaster University students but also for students from the University of Manitoba and Dundee University in Scotland where he had connections.

Dr. Peter Harland came to Kenora in 1978 and assumed the role of local coordinator for the NOMP placements in Kenora between 1980 and 2000. He recalls working with the then NOMP Chair, Dr. Peter Neelands and the sole secretary for the program, Delores McGirr. ‘Kenora accepted about 30 students per year and no more than 2-3 during any month. The torch to continue providing exposure focused opportunities for learning was passed and shared more or less equally by all of the present physicians who would round up students to get involved in interesting cases and procedures as they presented. There was no pressure or expectations of the students. The more enthusiastic they were and available, the more they learned and benefited from their time here.’

Notable mention for fondly remembered and enthusiastic mentors that have inspired many a student during the 80s and 90s include, Dr. William (Bill) Cameron, Dr. Rudy Ramchandar, Dr. Jim Beveridge , Dr. Ron Loewen , Dr. Peter Harland, Dr. Waldy Loewen, Dr. Alfred Molle, Dr. William (Bill) Kyle, and Dr. Ronald Lass.

Ronald`s daughter, Dr. Rowena Lass came in 1982 and joined Dr. Beveridge`s practice. She was the first female physician to set up practice in Kenora and to break through the gender bias that so many still held at that time. Dr. Lass can be credited for successfully acting as a positive role model for the growing demand of female medical students who wanted to see how to balance life work issues as a female physician in a rural location.

In 1991 NOMP took a quantum leap forward expanding into postgraduate studies for family medicine. Core rotations, not just elective blocks were now being decentralized from the medical resident`s home academic centers and the impact was positive. Several of the active practice physicians in Kenora today and many teaching faculty here are the product of this initiative in the 1990s and early 2000s. Specialty core rotations and electives, not just Family Medicine are also regularly offered here now.

In 2005 NOMP disbanded with the official opening of the Northern Ontario School of Medicine (NOSM).

The apprentice-like tradition of teaching the art and science of medicine obviously began long before the Northern Ontario School of Medicine (NOSM) officially opened its doors in 2005 but the school`s activity and demand for curriculum quality preceptor based community learning was certainly a propelling force in the development of the local Lake of the Woods Health Science Campus (LWHSC). Academic interest and excitement appealed to a small leadership core and teacher recruitment expanded. The growing faculty saw the need to organize themselves into a LEG (Local Education Group) when the call for applications was made. The LWHSC LEG was officially recognized on November 28, 2012 by the Board of Directors of the Northern Ontario Academic Medicine Association (NOAMA). This was an important milestone because it secured equitable compensation for teaching and start-up funding on par with academic centers across Ontario. Academic deliverables expected from the Kenora campus would match that of other teaching centers and could be met because resources were now available for program development, faculty recruitment, leadership development and research activity. Kenora and Keewatin now annually hosts 6 third year NOSM students for their entire 8 months Comprehensive Clinical Clerkship. In addition, our community provides active teaching and supervision for another 136 weeks per year on average for other medical learners at all training levels and in many specialty areas. The LWHSC presently has a compliment of 34 active faculty.

This brief history doesn’t do justice in recognizing all of the early pioneers of Kenora`s medical teaching tradition and the persistent trail blazing that went on at all levels to make it work and work well. Lots of things have changed over the years in how medical learning occurs in teaching settings around Kenora but having medical learners here has always been about one thing: improving the health of people in Northwestern Ontario. Doctors understand that in order to keep the furthest reaches of Northwestern Ontario populated by well trained health care providers they need to have had some or all of their training done here and to have had positive experiences that will want them coming back. That same goal of rural training doctors for rural community practice remains alive today. According to the latest statistics from NOSM, the strategy is working. Retention is high. White coats of the past – job well done!

(Special thanks for the fact finding contributions and personal stories shared by Dr. Jim Beveridge and Dr. Peter Harland in my research for this article)
November 2014