What emerged was a shared understanding that lasting solutions must be rooted in relationships, cultural safety, and the wisdom of communities themselves that acknowledge the importance of the local context.

Moderator:

• Becky Donelon, Executive Director, Health Workforce Strategy and Policy, Government of Alberta

Panelists:

• Dr. Lisa Bourque Bearskin (Associate Professor, Indigenous Health Nursing Research Chair, School of Nursing, University of Victoria) 

• Dr. Kendall Ho, Professor (Professor, Department of Emergency Medicine, University of British Columbia) 

• Jennifer Karach (Chief Nurse & Midwifery Officer, Government of Nunavut) 

• Nina Larsson (Director, Community, Culture and Innovation, Government of Northwest Territories) 

• Shallan MacKay (Manager, Recruitment Services, First Nations Health Authority) 

Presiding Elder and Closing Speaker:

• Dr. & Elder Roberta Price
  
  

Key Issues Persist

Alignment between Equity Gaps, Local Health Systems and Community Needs
Many rural and Indigenous communities express concerns that systems weren’t designed with them – or by them. Speakers emphasized that equity is lived, and it is shaped by who leads, who decides, and whether care is experienced as culturally safe. Community leadership helps build trust in health systems and create sustainable solutions.

Persistent Recruitment and Retention Challenges
For too long, recruitment in rural and remote regions has been treated as a transactional process rather than a long-term workforce strategy. As speakers noted, the familiar “post, appoint, repeat” model has never truly worked. It fails to reflect lived experience and offers little continuity or support. At the same time, retention continues to be undermined by systemic racism, burnout, limited career pathways, and environments that leave clinicians persistently stretched.

Systemic Racism, Burnout, Isolation, and Wellness Pressures
Individual wellness itself becomes a deciding factor in whether staff stay or leave. Clinicians in fly-in communities often work long stretches without leaving, creating intense pressure on their wellbeing. Isolation, (professional and personal), inflexible schedules, and lack of restorative spaces and longstanding systemic racism also contribute to turnover and decreased morale.

What’s Being Done

The good news is that a range of innovations are taking shape in rural and remote areas to strengthen health workforce recruitment and retention. There is a clear and growing emphasis on designing planning strategies that reflect local context and lived experience. Workshop participants widely agreed that these place‑based approaches offer greater potential for long‑term sustainability.

1. Centring Community Leadership and Cultural Safety
   Speakers noted that in rural and remote regions, especially within Indigenous communities, community leadership isn’t a “nice-to-have”; it fundamentally reshapes how health systems operate. When local voices shape decisions, care becomes more relevant, trusted, and equitable.
   • Indigenous leadership and intergenerational mentorship programs – including the Grandmothers Council (BC) and Graduate Nurse Residency Program (Nunavut) – are helping new practitioners enter the field with cultural grounding, consistent support, and guided transitions into practice.  
   • The “WISE Practices” framework describes evidence-based, distinction-based approaches that integrate traditional knowledge, education, and policy. The work is grounded in the United Nations Declaration on the Rights of Indigenous Peoples and the Declaration on the Rights of Indigenous Peoples Act, aiming to operationalize anti-racism and accountability in health professions. 
   • The Northwest Territories are publishing a Primary and Community Health Care Framework (expected May 2026), representing the most comprehensive, evidence-informed, and Indigenous-engaged system direction for primary and community health care in the Northwest Territories.

      

2. Building Relational Recruitment and Retention Pathways
   In addition to short-term fixes, leaders are also investing in long-term relationship-based workforce strategies:
   • First Nations Health Authority programs in BC like Raising the Canoe and Firekeepers create pathways for youth and graduates, blending skill building with cultural mentorship. 
   • In addition to ongoing recruitment efforts, Nunavut is addressing retention through their Roadmap to Strengthen the Nunavut Nurses Workforce. They’re investing in keeping the people they already have – creating better practice environments, improving professional development pathways, and strengthening leadership, and workplace culture.

      

3. Flexibility and Virtual Care: Modern Tools for Old Challenges
   Technology isn’t a silver bullet, but in rural and remote regions, it’s becoming more critical.
   • Virtual Community Health Nursing in Nunavut, for example, gives local nurses time to rest while clinicians elsewhere triage overnight calls.  
   • The Real-Time Virtual Support Network in BC – born during COVID‑19 – connects rural providers with specialists, provides clinical backup and decreases strain, while diverting 7 out of 10 people away from emergency visits and ensuring faster care for urgent cases.

      

4. Make Wellness a Core Workforce Strategy
   Speakers emphasized that wellness must be woven into system design – not added as an afterthought. Effective strategies to make remote work more sustainable include:
   • Job share arrangements that support work life balance for staff far from home.  
   • A “Bring a Family or Friend” approach allowing fly-in clinicians to bring someone with them to reduce isolation.  
   • Wellness spaces and fitness resources to support emotional and physical health. 

Progressing Forward

Through the conversations, stories, and shared experience, one message stood out: the future of rural and remote health care must be built with communities, not for them.

From Indigenous intergenerational mentorship and community-centered recruitment to flexible models of care and a renewed focus on wellness, the future of the rural and remote health workforce and the care they provide needs to be responsive to community needs.

The path forward needs to be collaborative and grounded in equity, anti-racism, cultural safety, and sustainable strengths and distinctions-based solutions that make sense in the local context.