Andrea Wong had never worked in a rural community before her six month clinical placement on Manitoulin Island. Her fourth year placement saw her working at community pharmacies, a hospital, and a family health team on the island.
“I grew up in the KW area, so working in a rural environment seemed a little intimidating,” says Wong. “But there’s so much you can find there that you don’t get in a city, and there’s such a strong sense of community. The opportunity to really get to know your patients was fantastic.”
About a six hour drive north of Toronto, Manitoulin Island is located in Lake Huron and is the largest freshwater lake island in the world. The island has a population of approximately 13,000, about 40% of whom are indigenous Canadians, spread out over almost 3000 square kilometres. Access to healthcare services on the island is limited, and Wong was often the only pharmacy representative on the teams she worked with.
“When the Regional Clinical Coordinator for area, Kaitlin Bynkoski, explained the Manitoulin placement, I was excited to hear I’d be the only pharmacy representative on the team,” Wong remembers. “Nervous, for sure, but I thought it’d be a good challenge that would force me to practice to the full extent of my scope.”
Wong was the first Waterloo Pharmacy student to ever complete a clinical rotation on Manitoulin. She spent her first weeks on placement figuring out what her role would be.
“Since they only have a full-time pharmacist in two days a month, a lot of the roles pharmacists would traditionally play were taken up by other professionals,” she explains. “At first it was hard to figure out my place in the team. But through trial and error we came up with systems that would best utilize my skills and knowledge.”
For example, at the family health team Wong started off completing medication reviews with all patients with appointments. But that wasn’t always the most efficient as some patients with simpler medication regimens didn’t require pharmacist support. Instead, Wong decided to review electronic medical records to identify patients who would benefit from a review, like those who had been on the same medication for some time or were taking many different medications.
“Over time the patients and other healthcare providers were impressed with the services a pharmacist can provide,” says Wong. “I felt like I was truly making a difference. It took some time to adjust to the fact that there was no pharmacist to double check my work, but the physicians and nurses were so supportive.”
Medication reviews were just one of Wong’s many duties. At the hospital, she conducted systems-level policy reviews of quality assurance processes. She also contributed to an insulin pen project, switching diabetic patients over to insulin pens, and ran presentations on topics like COPD.
“By the end of the placement they began to think of me as an expert on medication. Even when I couldn’t find the answers to questions immediately - on hospital rounds or on the community pharmacy floor – I was always able to direct myself and find the information we needed.”
Experiencing life on the island was another plus for Wong.
“My philosophy was to say yes to everything. I got invited to make maple syrup, go fishing, try mushroom picking. I also joined community cultural events – these were fun, and involved lots of hands on crafts, listening, and knowledge sharing through storytelling.”
She’d recommend the experience to any pharmacy student eager for a chance to develop independence and push the boundaries of their knowledge.
“After 6 months, my preceptors were so impressed with the difference a pharmacy student can make. My time on Manitoulin helped me feel like I’m ready to go out there and practice. Maybe even in a rural environment like the Island.”