We are thrilled to welcome Dr. Samuel Bulford, a Consultant (Attending) Emergency Physician from Sydney, Australia. Dr. Bulford will be joining the Ornge Fellowship for an immersive full-time clinical experience. He shares his experience, learning goals, and excitement for the role.
 
What is your role with Ornge?
 
I am a Prehospital and Retrieval Medicine Fellow with ORNGE.
 
What is your professional background and experience?
 
I am a Consultant (Attending) Emergency Physician from Sydney, Australia. Most recently, I have spent 18 months working as a Pre-hospital and Retrieval Medicine Physician for Sydney's Aeromedical Retrieval Service. Prior to this, I completed my Emergency Medicine training at the quaternary Liverpool Hospital in Sydney, Australia. This training program included one year's training in ICU/Anaesthetic medicine, and time as a mixed Paediatric and Neonatal Registrar. Prior to moving to Australia in 2017, I completed my undergraduate degree and two year residency program at University College London.
 
Elsewhere, I am a clinical academic for both the University of Notre Dame Medical School as well as the University of Tasmania School of Paramedicine. In these roles, I focus on creating and delivering mixed cohort, immersive educational interventions based around shared clinical reasoning between the two professions. This is very important to me indeed, as I truly believe the two clinical tribes have much to learn from each other. Honestly, the best parts of my medical practice are those I have learned from paramedics.
 
What attracted you to apply for the Ornge Fellowship and how do you think it will contribute to your career development?
 
Building on my experience in Sydney, the ORNGE Fellowship is the next step in my journey to become a rounded and excellent Pre-hospital and Retrieval Medicine Physician. There is no better way to learn than spending time with an experienced and high performing service, and for this reason, I am very excited to work with ORNGE.
 
There are similarities between ORNGE and the Sydney Service: the case mix, the geographical patient distribution and the transport assets. However, the way ORNGE operates and delivers pre-hospital care is unique and deliberate, and built on years of experience. I am therefore excited to absorb myself within this excellent system, and take learnings from ORNGE to my next challenge as a Pre-Hospital and Retrieval Physician.
 
Beyond this, I love traveling and exploring, and so the chance to live and work in Toronto, and travel around Canada, is also one not to be missed.
 
What are you hoping to learn during your Fellowship with Ornge?
 
I am particularly interested in safe systems and macro-risk. I hope therefore to learn how risk is balanced within the complex, vast, dynamic and excellent pre-hospital system in Ontario, and to understand my place within that both as a physician delivering care on the ground, and as a physician coordinating care across the province. Given the increasing and emerging role of physicians in pre-hospital care around the globe, this learning opportunity is fantastic.
 
I also hope to learn about ORNGE's place in the provision of care to remote communities, as this is such a valuable and important part of any pre-hospital service's role beyond the perhaps more obvious urban case mix.
 
Given the unique challenges of air and land critical care transport, what are you most excited about, and what do you anticipate will be the most challenging aspect of the role?
 
Critical care transport is a fascinating specialty. Clinicians need to be deeply collaborative and without ego, whilst unambiguously clinically confident and able to make nuanced and critical decisions efficiently, safely and deliberately. I am truly thrilled to get to do this with ORNGE, learning from some of the best pre-hospital Clinicians in the world and absorbing learning from a proud and accomplished team of Critical Care Paramedics.
 
As for challenges - learning a new system, set of protocols and abbreviations can be a challenge, but I am sure things will feel second nature soon enough. Maybe the cold? In Sydney, we shiver when temperatures fall down to 15C!
 
What aspect of collaborating with transport medicine physicians in the Operations Control Centre (OCC) are you most looking forward to?
 
The OCC role is one of the aspects that most attracted me to the Fellowship with ORNGE. It is an opportunity to combine clinical acumen, in particular of a patient's likely clinical trajectory, with knowledge of the wider System and Service, whilst balancing many other logistical, environmental, technical and non-technical factors in order to safely deliver excellent and equitable care across the province. It is rare in medicine to use clinical skill and experience in this way but is certainly an emerging feature of many pre-hospital care services. In addition, it is another opportunity to help less served areas deliver safe and excellent care.
 


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