Justin Ross, MD, has been practising family medicine in Mistissini, Eeyou Istchee, for 10 years. Thanks to the Cree community’s hospitality and a high level of job satisfaction, he plans to stay at least another decade. With a population of 3,731, Mistissini (which means Big Rock) is Canada’s second largest Cree community, located 781 km from Montreal.
“I think the people who come here end up staying, the bulk of individuals being trainees, medical school students or residents,” says Dr. Ross. “The practice is amazing because of how welcoming this community is and how fulfilling this job is.”
History was a significant factor in Dr. Ross’s decision to set up practice and remain in an Indigenous region. “Aiding a historically, very marginalized population, as someone who comes from a background that is not Indigenous, you can see the levels of systemic racism that are at play in our society, and being able to come here and actually give what I feel is culturally safe care to the community is a huge motivator to be up here.”Ěý
Remote communities provide the opportunity to engage in what Dr. Ross considers the essence of family medicine: caring for patients across their lifespan. “The medicine is just so interesting because you really do feel like you’re a family doctor. You see people from when they were born, when they become a teenager, when they have their first child. It’s really cradle-to-the-grave family medicine.”
Another gratifying aspect of family medicine in remote locations is medical staff can become an integral part of the community, rather than simply being service providers. “There’s no anonymity here. When you leave the clinic, people see you and they know who you are and for me, that’s a very positive thing. Outside of the clinic walls, people see you and really buy into you as a member of the community, not just here to work, but here to also help.”
This level of social integration often leads to attendance at events such as funerals and baby showers. “I’ve attended all kinds of events here that I think if I was in Montreal, I might not have the opportunity to do so.”
Blending into an Indigenous community comes with its challenges, Dr. Ross notes. One of those challenges is reconciling historical circumstances. “Being raised in Quebec, you’re taught history from a point of view that is extremely biased, leaving out a lot of important details. And then coming here, seeing what the reality is, and learning from my patients and my colleagues about the centuries of abuse was a real eye-opener, and I just felt so humbled to be welcomed openly by the community.”
Over the years, medical care has been inconsistent in the region, making it difficult for the public to place their trust in physicians, a matter that poses a challenge to newly arriving doctors. “There are issues of abandonment by professionals. It took a couple of years for the community to view me as someone they trusted. I’ve tried to put myself out there and be available for my patients both in and outside of the clinic, and I think that’s something that if I was in the city, I wouldn’t necessarily be expected to do for my patients, because culturally it’s not the same.”
Now relatively entrenched in Cree society, Dr. Ross is in it for the long haul. “I don’t see myself really working anywhere else now, which is kind of crazy. I love this job so much and I don’t feel burnt out like many of my colleagues. I love being able to see my patients and see their journey beyond the clinic, within the community, and I feel both fulfilled and constantly stimulated, always learning.”
The absence of bureaucratic and political interference is another reason Dr. Ross has decided to stay, something that has resulted in increased interest from young family doctors. “The politics of family medicine are quite complicated presently in Quebec, and being up here is a bit removed from that.Ěý
