78 Supporting rural paediatricians in British Columbia: Could a rural paediatrics clinical network make a difference?

British Columbia (BC) is a geographically expansive province with an uneven distribution of population and resources. The number of paediatricians in rural communities is small and they face a unique reality compared to their urban counterparts. In 2020, a clinical network (Sustaining Pediatrics in Rural and Underserved Communities – SPRUCe) was introduced to provide support and connection for rural paediatricians in BC.

The rural paediatricians were surveyed shortly after the launch of the network, in June 2021, and again in July 2023 in order to evaluate the impact of the network.

In British Columbia, communities are designated as rural through the Rural Practice Subsidiary Agreement (RSA). In 2021, there were 12 RSA communities served by 32 paediatricians, while in 2023 there were 14 RSA communities served by 38 paediatricians. Surveys were sent to paediatricians in RSA communities for whom the study coordinators had email contacts in the spring of 2021 and in the summer of 2023. Anonymized survey results were collected, tabulated and compared.

In 2021, surveys were sent to 28 paediatricians with a 96% response rate, while in 2023 surveys were sent to 36 paediatricians with a 69% response rate. Comparing the responses, in 2023 a lower proportion of respondents endorsed being concerned about recruitment (81% in 2021 and 68% in 2023). Similarly, a lower proportion disagreed that effective strategies were in place for paediatrician recruitment to their communities (62% in 2021 and 40% in 2023). In 2023, a higher proportion of respondents agreed that they had methods to engage and interact with other rural paediatricians across the province (30% in 2021 and 52% in 2023). Unfortunately, no improvements were noted in the proportion of respondents who endorsed workload challenges, feelings of burnout or limitations in their ability to secure locum coverage. Rural paediatrician involvement medical learner education of medical learners remained static at 80%.

Strategies to support rural paediatricians in BC are needed to address concerns about workload, burnout, and lack of locum coverage. SPRUCe, a clinical network to support rural paediatrics, provides an example of a potential strategy which may be having a positive impact. The short timeframe between administered surveys and small group of respondents makes demonstrating change challenging, but it is encouraging that decreased recruitment concerns and increased feelings of connectedness among rural paediatricians were noted.