Dr. Nicole Cardinal understands the challenges and rewards of working on a rural reserve. Originally from the Saddle Lake Cree Nation, in Alberta, Canada, she made the decision return home after university to practice medicine.
“I think it is twice as hard to attract someone to come to [the reserve] to be a physician,” says Dr. Cardinal, explaining there are a number of issues that are difficult for outsiders to understand. According to Dr. Cardinal, historical trauma, high rates of depression and drug abuse, the use of traditional medicine and other cultural sensitivities are just the beginning.
“You have to be flexible in running your clinic,” she explains. “Some days I will get three people and other days everybody will show up. The weather determines that, what’s going on in the community, if there’s a death; [all] that determines how well my clinic is going to run.”
Dr. Cardinal says follow- up for her patients is very difficult to get.
“So, if you are very strict on how you practice medicine – you do this every three months, every six months … It doesn’t work that way here. You catch people when they’re here. I might not see them for a year or six months, so I do all that I can to help them at that time.”
"You have to be ready to accept what gets put on your doorstep,” continues Cardinal. “If you’re the kind of person who likes to follow those rigid guidelines it does not work for my population.”
While working on a rural reserve is not without its challenges, for Dr. Cardinal, it remains a great place to life and work.
She says that, “a lot of people have misconceptions about reserves, that they’re scary places to be, that we’re not good facilities to be working in. But our facility here is a great example of what things can look like: we have lab, we have an ultrasound tech, we have a dentist, a pharmacy, and nurses.”
“The reason that we’re here is that we enjoy being here,” concludes Dr. Cardinal. “We like the community and we like the work that we do.”
This is part of an interview with RPAP during a 2016 Medical Skills Weekend Event. The Alberta Rural Physician Action Plan supports Alberta's rural practitioners, their families and communities in improving the quality of rural health care by offering comprehensive, integrated initiatives to enhance rural medical services, education, attraction, recruitment, and retention. For more information, please visit