Rural, Remote and Northern Practice

A large part of my working life has been spent in places where the nearest specialist was a flight away. It shaped how I practise, and it is relevant to what kind of student I would be.

Where

Community pharmacy across British Columbia, Alberta, Saskatchewan, Manitoba and the Northwest Territories, including manager roles in remote and northern communities — among them Inuvik, above the Arctic Circle.

What changes when the referral is not available

You become the referral. In a city, a complicated medication question ends with "ask your doctor next week." In a community of a few thousand with a rotating locum, next week may not exist. You learn to hold more, more carefully, and to know precisely where the edge of your competence is — because there is nobody standing just behind it.

Continuity is unavoidable. You see the same people for years. You see the consequences of your own advice. You meet them in the grocery store. That is uncomfortable and it is also the best possible teacher about boundaries, confidentiality, and what a professional relationship looks like when it cannot be compartmentalised.

Scarcity forces triage. With limited resources you learn to distinguish the problem that will resolve itself from the one that will not, quickly and without drama.

Culture is not an add-on. In northern and Indigenous communities, care that ignores how a person understands health, healing and family does not work — not as an ethical failing, but as a practical one. It simply does not land.

What I would bring to an urban clinic

Comfort with ambiguity, and with being the person who has to decide. A high tolerance for logistical friction. And a reflex to ask who is not getting access, which is the question that first pulled me toward compassionate-access work and eventually toward this degree.

What I would not bring

Any claim to speak for those communities, or to have understood them from the inside. I worked there. I was not from there, and the difference matters.

Education, not medical advice.