For Dr. Kris Srivatsa, working with his colleagues in the intensive care unit is like spending time with family. That might be hard to imagine – it’s a stressful place, where he and his coworkers provide care to the sickest patients in the hospital.

But the tight-knit team shares a kinship that gets them through the tough days. “Everyone from the nurses to the respiratory therapists to the housekeeping staff – we all take care of each other, we’re a little ICU family,” says Dr. Srivatsa, an internal medicine specialist who has worked at Colchester East Hants Health Centre in Truro since 2009.

The team eats lunch together (they even plan special themed meals) and enjoy just hanging out and supporting one another – something Dr. Srivatsa rarely experienced during his residency training in the U.S. “It is so different from when I worked in the States, which was always go, go, go.”

Dr. Srivatsa’s path to practising in Canada was not straightforward. Born and raised in Mumbai, India, he studied medicine there after high school. After graduating, he worked for a year in an underserviced rural community – something most Indian medical graduates must do before applying for residency. “It was a great experience – very bare bones, but I learned so much,” he said.

He then headed to the United States to obtain a masters degree in Public Health focusing on occupational and environmental health at the University of Alabama at Birmingham. He went on to complete residency training in internal medicine, also in Birmingham, before attending fellowship training in infectious diseases in Detroit.

In 2009, with his training almost complete and his U.S. visa set to expire, he decided to look for a job in Canada. Almost immediately he connected with a physician recruiter in Elmsdale and learned about an opportunity in Truro. “I connected with the group there and we had a phone interview. It sounded like a good fit.”

The recruiter warned him the paperwork would take at least six months to finalize. However, since Dr. Srivatsa had already applied for a Canadian work permit, he cleared the process in just two months. “It all happened so smoothly,” he said.

In May 2009, he took off, driving to his new life in Nova Scotia. “It was just me and my cat in the car. I drove with a little bit of trepidation. I’d never been to Atlantic Canada before. The highways in the States are so busy, so coming into New Brunswick I was like, ‘Where is everybody?’”

Despite the jitters of starting fresh in a new place, he relished the opportunity to work in a rural area again. “Working in a regional hospital like Truro is different than working in a tertiary centre like in Halifax,” said Dr. Srivatsa, who is now head of the Department of Internal Medicine for the Northern Zone. “In Halifax, patients will often get to see separate sub-specialists directly. Here, we internists do it all – we see patients with cardiac issues, renal failure, complex pulmonary diseases, vascular diseases such as stroke, and common infectious diseases. We still have our own sub-specialty niches, but our skills are broad.”

He says this gives medical learners more hands-on experience when they come for rotations in Truro. He recalls working with a first-year med student during Rural Week in 2016. “He loved the experience and came back for an elective in his fourth year. He’s now doing a general internal medicine residency at Dal. It’s so satisfying to see him go from being a green medical student to a senior resident running the show. I hope to have him as a colleague in Truro one day.”

Dr. Srivatsa leaned on his background in infectious diseases during the pandemic, helping lead the hospital’s COVID-19 response. The centre treated the first Nova Scotian critically ill with the disease. “He recovered,” Dr. Srivatsa said. “There’s nothing like the satisfaction when someone turns the corner and moves out of the ICU. It’s what motivates us.”

These days, the challenge his team faces is providing care to the growing number of people who receive treatment in hospital but don’t have a family doctor for follow-up care once they go home. “We just don’t have the staff to do as much outpatient care as we’d like to [because] we’re so consumed with inpatients. It means that people who should be seen earlier have their conditions worsen and they end up in hospital. It’s a vicious cycle.”

“I feel we’re not providing the service our community deserves,” he said. “Things got so bogged down during the pandemic and we’re still playing catch-up.”

Beyond his work at the hospital, Dr. Srivatsa also runs a monthly internal medicine clinic at the health centre on Millbrook First Nation. “I see many parallels with my own culture,” he said of the community. “We are both very family oriented. I’m so grateful to be able to provide care for them. Their health centre takes a holistic approach and it’s a well-oiled machine – it’s how it should be everywhere.”

Retaining and recruiting more international physicians is key to improving Nova Scotia’s health-care issues, but it’s not an easy fix. Dr. Srivatsa knows that because he trained in the U.S., his situation is different than that of other internationally trained medical graduates (IMGs), who face barriers practising medicine in Canada. “It’s a huge learning curve,” he said. “They need support and mentorship.” Even providing a stipend so IMGs can afford to take time off to study for their exams could make a big difference, he says.

Most importantly, new recruits and their families need to feel welcomed by their communities. “I’m fortunate to have a close-knit group of friends through my partner, who is an artist and gallerist. We travel, have dinners and movie nights together.”

Building strong relationships both at work and home can help retain physicians long term. “People are becoming more xenophobic in Canada – it has crept up from the U.S.,” said Dr. Srivatsa. “But there’s still a lot of positivity. I’m an example of a successful immigration. I brought something to my community and made it my home. I appreciate the opportunities given to me to thrive and be successful. My community welcomes people from all walks of life. I wouldn’t want to live anywhere else.”