Reminiscing on residency: Dr. Kerubo Workman on what it’s really like being a rural Ontario physician

In 2013, Dr. Kerubo Workman’s husband bought her a textbook for Christmas. She was working as a nurse and had completed training as a physician assistant. With the gift, her husband encouraged her to study for the board exam, hoping she would pursue her dream of attending medical school and, one day, become a physician.“At the time, I had two children, and I contemplated it, but it didn’t seem possible,” she says. By the time the acceptance letters from medical schools began arriving, she was pregnant with her daughter and put her medical pursuits on pause. In 2016—just six months after giving birth—she accepted an offer to the Saba University of Medicine. “My family was so supportive of me. Besides my children and husband, I remember my sister telling me, ‘Your 30s are an opportunity to change your life,’ which encouraged me to take that next step.” As a mature student in medical school, Dr. Workman faced the added challenge of raising a family and managing a household, compounded by the long hours required during residency in Windsor, Ont. But life experience brought an added depth to her training and a clearer understanding of who she was and how she worked best: “I started early everyday, before the other residents, and finished my patient visits in the morning. That allowed me to approach the rest of the day with a clear head.”After graduating in 2022, Dr. Workman stepped in to run a medical practice in Wallaceburg, a town in Chatham-Kent, Ont., a largely rural municipality of about 100,000 people, roughly three hours southwest of Toronto.As the only Black woman practicing family medicine in the region at the time, Dr. Workman sought to provide culturally sensitive care and advocated for health equality in the region—work she continues today. Last May, she was recognized for her work in her community when the Black Physicians’ Association of Ontario nominated her for the Trailblazer: Rural Medicine Award, an award that recognizes a healthcare professional that has made groundbreaking contributions to medicine in a rural community.The community that Dr. Workman lives and practices in has a storied past with Black Canadians: it became a stop on the Underground Railroad, and in 1841, the Dawn Settlement, a community of free Black people was established near Dresden, Ont., a town in the region. Despite that, the population of Black residents in the region had dropped to a mere 2.5% by 2021.“As a Black female, I’ve had patients make racist remarks and I’ve had to dismiss them from my practice,” she says. One of the most striking memories she recalls was an older gentleman in the community who refused to receive care from a Black doctor. “I overheard him speaking to the receptionist, saying ‘My doctor better be a white man,’” she says.Her experience isn’t isolated: in 2018, the Journal of the Association of American Medical Colleges surveyed 46 Black physicians working in Ontario. More than 70% reported experiencing racism, including discrimination from colleagues and supervisors. The most overt incidents, however, came from patients, with multiple doctors saying patients had refused care because the physician was Black. The findings challenged the long-held notion that racism is rare in Canadian healthcare.Beyond the everyday challenges of racism, Dr. Workman provides care in rural Ontario—communities that have been disproportionately impacted by the province’s healthcare crisis. According to 2023 data from the Rural Ontario Municipal Association, rural Ontarians are losing primary care providers at a rate of 12% per year, four times faster than people in urban centres. The report also found that in both 2022 and 2023, there were more than 600 temporary emergency department closures throughout rural Ontario. In Wallaceburg, those closures are felt: “We’re chronically under-resourced. Sometimes, patients don’t receive the care they need, because services are limited, and the closest specialists are in London or Windsor, over an hour away. It makes it challenging to meet our community’s needs,” Dr. Workman says. And the community’s needs are significant. According to the Municipality’s 2025 Well-Being Status Report, Chatham-Kent has nearly double the rate of premature deaths compared to the rest of the province. The report also found that 14.8% of respondents smoke daily, compared with 10% provincially, and that one-in-five households struggle with food insecurity.“Can you afford food is something that I ask my patients multiple times a month,” says Dr. Workman. She also says that the clinic recently lost its smoking cessation program, despite evidence that it had been effective in the community. Poverty also makes travel to and from specialist appointments—and even the short treks to the doctor’s office—challenging for some residents. That’s why Dr. Workman offers home visits, particularly for patients requiring palliative care. That part of her work took on new meaning after her father, who lived in Montreal, was diagnosed with cancer. By the time of his diagnosis, the disease had already spread to his bones. A year after his death, on Jan. 26, 2025, she reflected on some of the regrets she still carries. “I should have visited more,” she says. “I felt a sense of responsibility for my patients, so I found it difficult to drive to Montreal to visit.”She had previously considered ending her own home visits, given that it’s a practice rare among physicians at her own clinic, and one that takes time away from being physically present in the clinic itself. But navigating her father’s illness gave her new insight into how patients experience palliative care. “My dad used to say, 'The doctor doesn’t do anything, he just comes here and talks’,” she says. “But I saw how much that one physician made a huge difference for him. He was in pain, and those home visits meant that he didn’t have to get dressed, sit in a car or be wheeled into a hospital or doctor’s office.”The experience also reshaped her understanding of medicine itself. “Medicine gives you such an intimate and unique window into people’s lives,” she says. “You gain a deep understanding of the human spirit.”And despite the struggles she initially felt in Chatham-Kent—from a provincial healthcare system that feels like it’s failing its most vulnerable residents, to racism from some patients—she has also witnessed how rural communities show up for their own.After her father-in-law, a longtime community member, died in October, patients brought cards, shared stories and delivered baked goods (butter tarts were the most popular).“It gave me a deeper connection with patients I’d known for years,” she says. “It felt like their way of saying, ‘We see your pain’.”1. What is the biggest thing that residency taught you about being a doctor?One of the physicians I worked with had a saying: your patient will have physical symptoms that you see, but the mental health component, their genetics, their environment and life experiences are all underneath. It taught me to look at the context, and provide individualized care to my patients. What might work for one person, may not work for another. I don't have that context when I'm giving them the diagnosis, so I make sure that the environment is appropriate, I go over the knowledge that they have, and then when I'm delivering bad news, I make sure that I'm sensitive to them. This makes you more effective as their physician. 2. What is something you've learned further down in your career?To be consistent in how you do things. With palliative patients, for example, meet at the same time every week. Ask the questions that may seem repetitive weekly, which will help you catch the small details and trends over time. It helps you catch the changes. I don’t want my patients to be diagnosed late, like my father, so I ask them every time if they’ve done their tests and remind them how it can help. One physician taught me that if all of your patients love you, you’re not doing good medicine. Remember that medicine and treatment are collaborative. You’re coming up with a plan with the patients and you’re giving them advice to guide them and help them navigate their health. Respect their autonomy, but give them the advice that is best for them. 3. What is your number one tip for residentsQuestion everything. In medicine, people have a fear of not looking bright. As physicians, we’re expected to be the experts, and you’ll feel that pressure once you begin working. Residency is a time where that’s not expected of you, so use that to your advantage: ask questions. When you’re given an answer that doesn’t sit well with you, ask again. People (other physicians and other people in medicine) will want to help you because they know you’re in training.

Reminiscing on residency: Dr. Kerubo Workman on what it’s really like being a rural Ontario physician

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