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Making a Big Impact in a Small Community

There are only 17 medical schools in Canada, which makes getting into one that much more challenging. When Dr. Ashley Bernotas applied to McMaster University’s School of Medicine in Hamilton, Ontario, she was one of almost 5,000 qualified applicants. Only 194 were accepted. After learning that she had not been accepted to McMaster, Dr. Bernotas considered Caribbean medical schools and chose AUA because of its “reputation, the strength of its MD program, and the convenience and safety of Antigua.”

During Clinical Sciences, Dr. Bernotas actively selected rotations in various locations knowing each one would offer a distinct experience in serving different communities. “I felt very privileged to have opportunities that were diverse not only in location and socioeconomic demographics, but also in healthcare accessibility and patient population,” she says. “I got to see different parts of the country from a unique perspective.” Ultimately, she chose family medicine as her specialty because of the range of patients she would be able to treat.   

Last year, Dr. Bernotas became one of four residents in a new residency program at the 300-bed Champlain Valley Physicians Hospital (CVPH). It’s located about 25 minutes south of the Canadian border in Plattsburgh, New York, in the Champlain Valley, which includes parts of Upstate New York, Vermont, and Quebec. During the interview process, CVPH administrators made it clear to Dr. Bernotas that the program had never existed before and that a lack of primary care physicians in the region was its driving force.

This shortage is due to an aging population and the pending retirement of physicians. It is estimated an additional 100 primary care providers will be needed by 2018. With 20,000 residents, Plattsburgh is the largest municipality in the Champlain Valley, while the rural surrounding areas have 140,000 residents combined. Primary care is in especially short supply in these towns.

Dr. Bernotas was intrigued. As a natural leader and problem-solver, she had often thought about directing a residency program herself someday. This was a ground-floor opportunity and a chance to learn a great deal. “When you’re in a program’s first class you get to learn a lot about what works and what doesn’t, what the pitfalls and the benefits are,” she says.   

Despite working 12-hour shifts and having little free time, Dr. Bernotas has always been able to make herself at home wherever she is. “I’m the kind of person who can have a conversation with anybody and make friends easily,” she says. Plattsburgh’s size makes this particularly easy and the town seems to agree with her. She’s able to get to know her patients really well because the community is so close-knit.

“You don’t get continuity of care to this degree at a lot of other places. Doctors at CVPH deliver babies and end up caring for them through childhood, adolescence, and adulthood.”

After residency, she plans to go into private practice but wants to maintain her relationship with CVPH, ideally, as faculty. The bonds she’s formed with her patients, colleagues, and mentors and the clinical experience she’s gained there have made her feel like a full-fledged member of the hospital and the Plattsburgh community. “Practicing medicine was always my dream but actually being able do it at this level has far exceeded my expectations.”