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Physician assessor gives back to health-care community

SIPPA welcomes international physicians while serving rural Saskatchewan.

WEYBURN — On a cool October morning Dr. Nana Yaw Amo Broni finished an overnight shift at the Weyburn Hospital and went to the clinic, where he saw patients until almost noon, before heading home for sleep and time with his children, and then returning for another night at the hospital.

Besides seeing patients, his tasks at the clinic include assessing the work of a candidate in the Saskatchewan International Physician Practice Assessment (SIPPA) program.

Despite his demanding schedule, Amo Broni took on the extra job of SIPPA assessor as another way to give back to the program that helped establish his career in Canada.

Amo Broni was a physician in Ghana for four years before he and his wife came to Canada in 2016. He worked as a health care aid in Edmonton until 2018, when he was admitted to Saskatchewan’s program for ensuring doctors trained outside of Canada are ready to practice here.

After 12 weeks of clinical assessment in Saskatoon and Rosthern, he was assigned to Weyburn where he remained under supervision for the first two years of a three-year return-of-service agreement. The work satisfied him and he has stayed on in the community.

His wife, Beatrice Adamtey, is an optometrist, who did Masters degrees in Â鶹´«Ã½AV Africa and Edmonton. She is currently in Boston, taking a program to obtain a license to practice in North America. While she studies in the U.S., her mother lives with Amo Broni and cares for their two daughters, ages two and three. The help is welcome during the difficult time apart.

“It's what we have to do, right?” Amo Broni said. “People are making sacrifices for various things in their lives all the time… (It’s the) the mindset you need, especially if you want to achieve something great,” he said.

SIPPA, which is a program of the University of Saskatchewan’s College of Medicine, provides the pathway for international medical graduates (IMGs) like Amo Broni to bring their expertise to Saskatchewan at a time when an estimated 6,000 residents do not have family doctors.

The lack is felt especially in rural and remote parts of the province, where SIPPA graduates are serving the need: 75 percent of new family doctors going into rural Saskatchewan each year came through the program.

“I think people forget that medicine, at its heart, is an apprenticeship,” Barton said, noting that for thousands of years, accomplished physicians have stood shoulder to shoulder with learners, mentoring, coaching and assessing them.

 

“That’s a lovely model to bring people, who have trained elsewhere, into. It certainly isn’t … sink or swim at all. It’s a lot of structured support to help them succeed,” Barton said.

The program was among the first of its kind when it began in 2011, making Saskatchewan a Canadian leader in preparing IMGs for licensure.

Witt has led SIPPA since 2014, and his leadership strength is widely recognized – he has chaired the National Assessment Collaboration on Practice Ready Assessment for the Medical Council of Canada since 2018; was Medical Director for Saskatchewan Air Ambulance for seven years; and was the pandemic chief of staff for Saskatoon during the initial response to COVID in 2020. 

He was named the 2023 Physician Leader of the Year by the Saskatchewan Medical Association. 

The College of Medicine’s dean, Dr. Preston Smith (MD), is proud of Witt’s commitment to the province and the college. 

“Nationally, he is one of the leading experts in practice-ready assessments and there's probably lots of jurisdictions in Canada that would like to steal him. He's really good at what he does,” Smith said. 

Vice-Dean Education, Dr. Kent Stobart (MD) agrees. “(Dr. Witt) is truly a servant leader. He gets involved with things, he knows trainees, he visits communities, and teaches stuff to the course. He would never ask anything of anybody else if he wasn't willing to do it himself.” 

As SIPPA director, Witt’s focus is on optimizing the physicians’ experience and striving to keep them in rural Saskatchewan where they are urgently needed: heavy workloads, frequent on-call shifts and isolation negatively affect retention rates. 

SIPPA is valued and supported by the Saskatchewan Ministry of Health, the Saskatchewan Medical Association (SMA) and the College of Physicians and Surgeons of Saskatchewan (CPSS).

Kim Statler, a director in the ministry’s Medical Services Branch, said SIPPA, “does an excellent job of providing a stream of candidates to work in some of our smaller centres where it’s difficult to recruit to... They’re really integral to those sites where we need to maintain emergency room coverage and ensure that we have appropriate access to family physician services.”

Each year, SIPPA receives dozens of applications from experienced physicians who don’t need a full residency program, but whose experience is not quite sufficient to go straight into practice in Canada. SIPPA brings them up to speed.

For example, recognizing that international candidates may not have had much recent emergency-room experience, the ministry and the SMA fund emergency related training to prepare them to, “hit the ground running,” Statler said.

That training previously was available to candidates once they had already begun their three-year service but SIPPA responded to candidate feedback to provide it earlier in the process, said Julie Yu, of the SMA.

The partners also provide funding for coaching and mentorship for candidates in their first two years.

“(It’s) someone to talk to when you're kind of isolated, you're the new kid in town, you still don't have a full license, you're under supervision, all these things, so (they need) to have their organization there for them in a meaningful way,” Witt said.

Most SIPPA candidates often already live in Canada’s largest cities, and many are already Canadian citizens. Because it usually takes years before they are accepted into a practise ready assessment program, their families have established lives in those places: SIPPA candidates often leave their families during the five-week orientation and three-month field assessment. Families are most likely to arrive after that, when physicians begin their three-year assignments.

SIPPA has worked to shorten that separation by providing four weeks of the orientation online.

“Anything we can do to ease that or minimize that time makes sense,” Witt said.

Yu notes that SIPPA and its partners, “look at problems and we work together on finding solutions and ways to improve.”

The SMA also offers a winter driving course for physicians who are not accustomed to ice and snow. In rural Saskatchewan, where physicians often travel between communities, a snow storm can turn a one-hour drive into two hours and advance practice in controlling a skid can prevent a life-threatening situation, Yu said.

Last year, the ministry also increased funding to expand the program to 45 positions per year from 36. When the full complement is achieved, SIPPA will have about 150 candidates in various stages of the program practising in rural Saskatchewan.

It takes some time to prepare a medical community to receive the welcome, extra physicians, Stobart said.

“You can't just place them in the community. You have to develop the community. You have to have the doctors in the community to develop them to support the program as well,” he said.

In another recent development, in January 2023, SIPPA expanded its responsibility for supervision of all candidates who successfully complete the 12-week clinical field assessment. Previously, that role was carried out by the CPSS and SIPPA had no further formal involvement with the candidates whom they had recruited and worked closely with, Witt explained.

“It seemed like we did this fantastic job with them, and then we just dropped them. They wanted that ongoing connection, they called with questions and whatnot, so the opportunity to support them as they transition into practice and for their first several years of practice in rural Saskatchewan was fantastic,” he said.

SIPPA is now a continuum that starts with candidate selection, moves into orientation, to clinical field assessment and now, into supervision for their first two years. SIPPA continues to report to CPSS.

“We were very grateful to the ministry for providing that funding as well as the close collaboration with the College of Physicians and Surgeons (for SIPPA to) take the lead with supervision with this group of physicians,” Witt said.

The Saskatchewan Health Authority (SHA) has the important role of identifying the rural communities in greatest need of the SIPPA candidates, most of whom will enter into a contractual relationship with SHA.

— Submitted by USask Media Relations

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