Coming to Saskatchewan, you have to expect that you will be practicing in a rural community. For me, that is a town of about 2,500 people, although some towns are larger or smaller, and this does not include the people I see from nearby towns.
People are very happy to have a new doctor. My arrival was noted in the local paper at least twice. There were a lot of people who were very keen to welcome me to the town when I arrived, and asked how I was finding the place. They are also very anxious that they may be about to lose a doctor and in small towns, rumours run wild: I have been told a few times that I am leaving or have actually left, usually (I think) because I couldn't take the cold. I was told the town I am in has not had a Canadian-trained doctor for twenty years.
I was working in a hospital before I came here, so I have found the biggest difference with Family Practice is continuity of care. There is a good chance that you will see the wound you stitched up as those stitches come out; you will be the one providing regular antenatal care to the expectant mother; and the old fellow you admitted last night with an acute exacerbation of COPD will probably see you in a few weeks so you can discuss flu shots and maintenance therapy. This can be frustrating at times, but also very rewarding.
I enjoy the variety of the work I am seeing here: a combination of clinic, hospital (acute) and long-term care. While there are a lot of old folk, many of these people have adult children in the area, so you see them for colds and flu, health checks, and the like. There are a lot of sports to play in the area, and people often sustain injuries. While there is some variety, you can push things towards your area of interest, some doctors seem to do more skin excisions, injections, and so on, than others.
The hospital is nice, but I have always preferred working in regional facilities. It may be a cliche, but staff always seemed to have more time to get to know each other. Work relationships become social: we just attended a party with EMS, RCMP, Fire Brigade and hospital staff (which makes for an interesting and entertaining gathering). I found it very useful to have a nurse nearby to translate to Canadian English (and sometimes Ukrainian), as apparently my Australian accent is incomprehensible, however people are becoming more used to it. It is disconcerting when attempting an MMSE to have a patient's wife feeding him the answers in Ukrainian, but it didn't really seem to help.
I did not realise until I got here, how much I had gotten used to having facilities like ultrasound, CT, dialysis ... even a bladder scanner! This is not to say that these things are not available, but they are not hiding down in the basement. In some ways this is good: you have to think about what you are looking for and use clinical judgement before someone's brain is irradiated. At other times it is frustrating, as people must travel to another facility to get what is needed. Never forget that there are all sorts of specialists down the road (some a little further), but no more than a phone-call away. They will give advice for care, or be willing to see the patient in their ED. They are always willing to help and are not bothered by quick question phone calls.
Drugs: some are different, others are almost the same. Brand names are more commonly used here than back in Australia (maybe because I was in the public hospital system): people will come in asking for a medication they saw advertised on TV the other day. I am getting used to the pharmacists calling to clarify an order (although it is happening far less often). For example: trimethoprim isn't available here, so use co-trimoxazole instead; metoclopramide orders draw blank stares, athough it is available, but flucloxacillin is not (try cloxacillin). It really is worth checking Therapeutic Choices or something similar, to be sure you are using an appropriate/available drug (especially with antibiotics and different sensitivities). This is good preparation for the CAPE, anyway.
People here are more aware of their health. They ask about side-effects, and if they have them. Preventive medicine seems to be more prominent: people come for an annual physical, and when asked, tend to say yes to Pap or prostate exam, or whatever ... these things tended to be deferred back home. Maybe the prominence of medical advertising, and regular television shows plays a part in this.
Despite all these differences, there are still some things that remain the same. People everywhere are human: they worry about their health (some more, some less), and appreciate the help and support you can provide.
Good luck and I hope to see you soon.