Nfld. & Labrador

Doctor gets $50K incentive to work in N.L. but says job offer withdrawn

A doctor from Newfoundland says the cancellation of a job offer he received as a resident terminated his goal of working in his home province, and cost taxpayers $50,000 for a government bursary he was told he doesn't have to repay.

​Eastern Health says 'very successful' bursary program rarely leaves medical residents without N.L. positions

Dr. Christopher Nicholas says he and his wife were devastated when his job offer with St. Clare's Mercy Hospital in St. John's was taken off the table. (Submitted)

A doctor from Newfoundland says the cancellation of a job offer he received as a resident terminated his goal of working in his home province, and cost taxpayers $50,000 for a government bursary he was told he doesn't have to repay.

"My wife and I, we were devastated," said Dr. Christopher Nicholas, 33, who is now working as an interventional radiologist in Buffalo, N.Y.

Nicholas was offered a position at St. Clare's Mercy Hospital in St. John's during the middle of his residency in 2013. 

But that job was later rescinded for what he calls a "miscommunication."

 That's taxpayer money that was essentially just burned.- Dr. Christopher Nicholas

Nicholas said he met with Dr. Larry Alteen, the vice-president of medical services at Eastern Health, to talk about the medical resident bursary he had received.

"[Alteen] said that, 'No, you don't have to repay it, because it wasn't you who defaulted on your contract. It was us who pulled your contract,'" Nicholas said.

"So that, for me, was a relief … but that's taxpayer money that was essentially just burned."

Dr. Larry Alteen, pictured here in file footage, is the vice-president of medical services at Eastern Health. (CBC)

CBC News approached Eastern Health and the doctors named in this story, but the health authority said they can't comment specifically on Nicholas's case, citing privacy regulations.

However, Dr. Doug Drover, the health authority's chief of staff for medical services, spoke in general terms about the bursaries, which are meant to attract and retain physicians in this province.

"The condition is that they commit to come back [to Newfoundland and Labrador] and provide 36 months of service ... and if they complete successfully their training program and are willing to come back, then we try to find them employment," he said.

It is extremely rare when we've given a bursary to somebody that we don't have a position for them.- Dr. Doug Drover

The one-time government bursaries, which range from $50,000 to $90,000, are supposed to help with residents' living expenses during their training.

Drover calls it "a very successful program." 

"It is extremely rare when we've given a bursary to somebody that we don't have a position for them," Drover said.

"It's unfortunate. We try not to do that, but in that case … it's sort of on us, so we do not go after that bursary."

Dr. Doug Drover, the chief of staff for medical services with Eastern Health, says it's extremely rare for a resident to be given a bursary without a position being available. (CBC)

He said it's not a waste of taxpayers' money because the intent at the time was good.

"We've only had two [bursary situations like this], and we've provided bursaries every year for over two decades. So other than a couple of people, we're at 100 per cent," he said.

Getting the job offer

Nicholas was enrolled at Memorial University's Faculty of Medicine, and part of his residency took place at St. Clare's. There, he found his passion: interventional radiology. 

It's a sub-specialty that uses medical imaging to make diagnoses and to perform minimally invasive procedures.

"It was cutting edge; it was a perfect mix between using imaging technology and seeing patients and performing procedures on patients," Nicholas said. 

"I really just fell in love with the discipline."

Nicholas says interventional radiology is a sub-specialty, sometimes called pinhole surgery, that uses medical imaging to make diagnoses and to perform minimally invasive procedures. (Dr. Jon & Dr. Chris/YouTube)

In late 2013, he was offered a job at St. Clare's. He later secured a fellowship at the University of British Columbia, and applied for the bursary. 

Nicholas was endorsed at the time by Dr. Rick Bhatia, the clinical chief of diagnostic imaging at Eastern Health.

"He is a great resident who will obtain skills we would find very valuable," Bhatia wrote in an email. 

"This application would receive my strongest support."

Nicholas says he was offered a position with the radiology department at St. Clare's Mercy Hospital in St. John's in 2013 that was contingent on him going away for a year to do training in interventional radiology. (CBC)

In 2016, Nicholas was approved for the $50,000 bursary, which he says went straight to the debt he had accrued over his 14 years of post-secondary education.

He and his wife Becki had planned to stay in St. John's well beyond those three years in the bursary contract. The couple had bought a house in 2011 that they renovated over the course of his residency.

"We consciously made the choice to keep our house while we went away for that year [of training] to Vancouver, knowing that we would be coming right back," he said.

Extracurricular activities

During his fellowship at UBC, Nicholas said he realized it might be his only chance to fulfil his childhood dream of getting his pilot's licence.

"There's no helicopter flight schools on the island, so I thought, 'While I'm away in Vancouver, this could be my only opportunity to really actually get a good crack at it,'" he said.

"I figured, at the end of my fellowship, maybe I could delay my start date [before] I came home, just to finish flight school."

Around Christmas 2016, he approached Dr. Adrian Major, who was his mentor and main contact to the radiologist group at St. Clare's, to see if he could push his start date back by a month.

Nicholas says it was a childhood dream to get his helicopter pilot's licence. (Christopher Nicholas/Facebook)

"My thought process at the time of the request was that, 'Hey, it can't hurt to ask,'" Nicholas said.

As weeks went by, he started hearing "through the grapevine" that his job was in jeopardy.

Nicholas said he also heard that his bosses took issue with his social media presence. While in Vancouver, Nicholas and his wife had started a YouTube channel together, documenting their weekend adventures.

Nicholas withdrew his request for the delayed start, and apologized for asking for it in the first place.

Major responded via email, saying he was concerned about how Nicholas could be focused on interventional radiology and yet still have time to pursue a pilot's licence.

While I believe extracurricular activities can well round an individual, your activities appear to outweigh your commitment to your primary profession.- Email from Dr. Adrian Major to Dr. Christopher Nicholas

"We need a dependable, trustworthy colleague in our profession, which requires long hours and more demands from referring physicians," he wrote. 

"While I believe extracurricular activities can well round an individual, your activities appear to outweigh your commitment to your primary profession."

Another doctor from the department also emailed Nicholas: "Just pay some attention on the job when you start working here."

'The needs are not what they used to be'

There were more emails exchanged and a Skype meeting, followed by a group conference call.

"They basically said that there was no job. And they specifically said, 'The needs are not what they used to be … The reasons for your dismissal have been outlined in our previous emails,'" Nicholas said, which left him confused.

He said he felt as though the reasons behind the move were "based on me getting a helicopter licence, me subjectively having too many extracurricular activities, and ultimately their perception that I was not dedicated to interventional radiology."

Dr. Adrian Major, pictured here from a government announcement in 2012, is the divisional chief of diagnostic imaging at St. Clare's Mercy Hospital in St. John's. (N.L. government)

A month later, Nicholas wrote an email to the radiologist group at St. Clare's.

"I truly feel misunderstanding and miscommunication have contributed to this situation," he wrote.

Major later replied via email: "You have no written contract with the St. Clare's group of radiologists."

Major added there was no need for a third interventional radiologist at that time.

"I know this is difficult for you but it is best for you to utilize your time in pursuing job opportunities elsewhere in this province or Canada," he wrote.

'There needs to be some accountability'

A year has passed since the incident turned Nicholas's life upside down. But Nicholas says he feels as though he's won the lottery with his new permanent position in Buffalo.

"I feel like I was ostracized for having a social media presence in my previous role as a resident in Memorial, and now I'm working for a company who values that social media presence," Nicholas said.

"We started a YouTube channel … a totally novel concept, where we take the viewers on YouTube into our procedures [and] we teach the public what interventional radiology is."

Nicholas says he and Becki now have roots in the city — and they're happy.

But he's speaking out so this situation doesn't happen to others.

"I think there needs to be a change in the system," he said. "There needs to be some accountability."

Nicholas says he isn't optimistic that he will ever bring the medical expertise he learned in Newfoundland back to his home province.

"We really gave Newfoundland the fighting chance. We did everything in our power to get back there. And after you get treated that way, it's very difficult to come back. You just don't feel welcome."

About the Author

Jen White

CBC News

Jen White is a journalist with CBC News in St. John's.

With files from Anthony Germain