Melissa Bouwsema is one of Ornge’s Fellows for this current session. She shares how she got to her current position, how much it has helped her and what she is looking forward to achieving with Ornge before she transitions to physician life.
 
Justyn: When did you join Ornge? 
Melissa: July 2023
 
What is your current role with Ornge? 
I’m one of this year’s Prehospital and Retrieval Medicine fellows.
 
Can you describe your academic background/where you are on your educational journey? 
If my math is correct, I’m currently in grade 26… which feels like too many years of school when you count them all. I started with a Bachelor of Kinesiology at the University of Alberta, followed by medical school at the University of Calgary Cumming School of Medicine (class of the Goats for those who know the medical menagerie). I then moved to Kingston for an Emergency Medicine residency at Queen’s University, where I also completed a focused year in Resuscitation and Reanimation Medicine. What’s next is to be decided, but some of my friends have threatened to stage an intervention if I do another fellowship after this one… it’s probably time to transition into attending physician life instead of accumulating more student loans.
  
What made you want to join the fellowship program? 
My parents met in the paramedic program at NAIT, and I grew up hearing about their work days, so I think just I naturally became interested in prehospital / out-of-hospital medicine. I love caring for critically ill and injured patients, and I work best in a team, so the fellowship felt like a great way to expand my repertoire. 
 
Can you describe a typical day as a Fellow? 
The fellowship heavily focuses on clinical work, so most of my time is spent working with the medical crews. Shifts start at 7 a.m. or 7 p.m... When everyone is in, the crew begins checking over the asset and bags, ensuring we’re ready for the day's first call. From there, the flow of the day really depends on how busy we are — on some shifts, we have a bit of downtime for informal education / case discussions/exercise / just catching our breaths. On other days I’m lucky to inhale a protein bar and a bottle of water between calls. The shift ends 12 hours later or whenever we get back to base from the last call. I don’t make firm plans for after work on the days I have a shift because that feels like asking to get back to base late (just like I won’t say a particular word that starts with the letter “q” when I’m in the Emergency Department … if you know, you know). 
 
What has the fellowship experience been like for you? 
I’m learning a lot! There’s so much nuance to delivering patient care outside the (relatively) controlled hospital environment. As a physician, I’m now trying to master skills I historically relied on my nursing or respiratory therapy colleagues to perform. It’s really humbling, but the paramedics I’ve worked with have been really patient teachers as I navigate the steep learning curve. 
 
How much has the fellowship helped you in your career? 
 It’s still early days, so it’s hard to forecast that. I haven’t settled on plans for after this year — I’m just trying to keep my eyes out for opportunities as they present themselves and enjoy the year because this position is a bit of a dream realized for me. Regardless of where my career goes next, I’m confident I’ll be a better physician with the skills I will come away with and for the experience of working in this totally new context. 
 
What are some things you hope to gain from your tenure? 
I’m really happy to be learning skills that will enable me to be a better team member back in the hospital setting. In future resuscitations, I will have a much more intimate understanding of what I’m asking of my team when I’m leading a case. 
 
Separate from my learning goals, I hope to contribute to the evolution of the fellowship, as it’s becoming more established since it was first piloted in 2021. I’m still getting to know the organization and where the opportunities to contribute are, but I aim to be a “value-add” and a learner over the year. 
 
What part of the fellowship program has stood out to you the most? 
I pursued the fellowship for what I imagine are similar reasons to everyone who works in Prehospital and Retrieval Medicine. Scene calls and transporting critically ill patients pose a very unique clinical challenge. In the Emergency Department, I care for undifferentiated patients, but meeting patients before they reach the hospital or managing their care as they move between healthcare facilities means working to assess and treat them with even less information than I usually have.
 
On top of that is the twist of sometimes doing medicine in an environment you can’t control or predict — the pilots have an impressive ability to land in locations I wouldn’t have thought possible (like a collection of rocks trying to be an island), where the paramedics then develop an extrication plan like it’s easy (I would say it’s not, scene management is another skill I’m trying to learn). 
 
Also, who wouldn’t like to learn how to climb in and out of a hovering helicopter without hurting yourself? 
 
What advice would you give those hoping to join the 2024 fellowship program? 
Come with a growth mindset and humility!




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