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Since 2013, Dr. Robert Tremblay has practised family medicine in Chisasibi, a remote Cree community in Northern Quebec, home to more than 5,000 people. As a resident, he is a full-time member of a team of physicians with mixed contracts where some colleagues work a scheduled number of days per year.

It was serendipity that led Dr. Tremblay north, following his graduation from McGill University. This came after working during residency with a physician who had worked in Chisasibi and enjoyed her time there. With “infinite options” coming out of medical school, he targeted family medicine for the flexibility it offered and the freedom to work anywhere.

After a two-month stay in Chisasibi, he asked his wife to visit the community and the two of them made the decision to settle there with their newborn baby. They are now a family of five, embracing the outdoor activities of the remote Hudson’s Bay region.

“Chisasibi is a small community that is really like a large family,” Dr. Tremblay says, adding that the closer connections create deeper communal bonds than what you’d find in urban centres. “People here care about you, even if they don’t know you well,” he says.

Providing care in a remote community hasn’t been without its challenges. In Chisasibi, the Indigenous Cree population is reliant upon support systems compromised by an inequitable system. Not only is equal access to care a challenge, but there are also inequities of housing, food (a head of lettuce may cost $10) and other basic needs on a day-to-day basis.

“The remoteness also makes accessing specialist care difficult,” he says. “Montreal is a 14-hour drive away, which limits my ability to serve patients who have urgent care needs.”

As a cultural outsider, Dr. Tremblay understands the need for patience and understanding while living within the surrounding Cree community. Unwrapping the influences of intergenerational trauma and learning the nuances of their history take time and effort.

“I’ve built trust in the community by just being present, taking part in activities and staying non-judgmental,” he says. “My role isn’t to judge, it’s to diagnose and treat.”

Dr. Tremblay notes the risk of burnout in his community is just as high as in larger cities, even if some of the root causes differ.

“You always think you have to work all the time,” he explains. “System planners realize burnout is happening, but organizations keep pushing ahead even as we raise red flags.” He has seen the impact of the pandemic on new practitioners and believes there needs to be greater emphasis on teaching them how to maintain a healthy work-life balance.

Dr. Tremblay developed a keen interest in investing for the future when he met an MD Management Limited (MD) Advisor* in medical school. “We were learning a lot about the human body, but very little about managing a business, a practice or finances,” he says.

His desire to learn more about proper investment and give back to the students he teaches brought him to the MD Physician Council. He hopes to help put increased resources toward the growth and knowledge of the next generation of doctors and sees in MD the perfect opportunity for an organization to step in and fill that knowledge gap.

For Dr. Tremblay, this gap is particularly challenging outside of urban centres. “Doctors who live in remote communities still need the same advice and guidance. Services should be more flexible to serve people in these areas to provide equitable access to financial opportunities.”