OTTAWA — The new surgeon general of the Canadian Armed Forces says things are going to be different in the military health-care system.
Brigadier-General Scott Malcolm, originally from Richmond County, N.S., took the position on Dec. 13, 2023.
“We’ve got clinics, multiple clinics in Nova Scotia, we have our major clinic in Gagetown in New Brunswick, so they’re all going to be implicated in our functional realignment,” he said.
In recent remarks, Malcolm said there will also be staff changes at the national headquarters this year.
“The next level up in running a health system is running a health authority and I’m looking to realign our organization to create a Canadian Armed Forces health authority that’s going to be focused on the delivery of primary care on a national scale,” he said. “With the exception of Saskatchewan, none of the others … incorporate primary care into it, so there may be some lessons learned that I can share more broadly.”
At each military primary care clinic, Malcolm said there are multiple clinicians (doctors, nurses, lab technicians, nurse practitioners) and larger clinics like Halifax offer CT scans.
“In the current health human-resources crisis that we’re experiencing in Canada, and the concern around people’s access to primary care, we’re looking to share our model of care,” he said. “You don’t always have to see a family doctor. You can have access to these other competent clinicians who can meet your basic primary care needs.”
A graduate of Isle Madame District High in Arichat, N.S., in 1993, Malcolm earned a scholarship to Harvard University and graduated in 1997. He graduated from Dalhousie Medical School in 2001.
“While I was at Dal, I joined the military in June of 1999 through what they call the Medical Officer Training Plan,” he recalled.
Malcolm then completed his family medicine residency at the University of British Columbia in 2003. That same year, he was posted to Canadian Forces Base Petawawa, then a UN peacekeeping mission.
“I deployed immediately to Bosnia and I was there from September 2003 to March,” he said.
In January 2005, Malcolm was deployed to Sri Lanka following a catastrophic tsunami as part of the disaster response team. After that, he completed a tour in Afghanistan.
“It was my very first trip to Afghanistan — 7.5 months. That was during the war there, I was basically responsible for the delivery of primary care but in a war zone,” he said. “Also, for medical support to combat operations. I had a team of doctors, medical technicians and physician assistants.”
Malcolm’s second Afghan deployment was for a training mission.
“There I led a team of doctors that were looking to improve the residency training for Afghan military specialists,” he said.
Progressing in his career through a variety of postings around the country, in July 2020, Malcolm became deputy chief medical officer and was seconded to the Public Health Agency of Canada from November 2020 to March 2021 to help with the national deployment of COVID-19 vaccines.
“That allowed me to really apply all my accumulated experiences into helping Canadians in their time of greatest need,” he said. “I was our medical planner just before wave one of the pandemic. I was the lead medical planner on the repatriation of Canadians from Wuhan, China, off the cruise ship in Japan. Then I led the medical planning on our deployments into long-term care facilities in Quebec and Ontario.”
On June 25, 2021, Malcolm became brigadier-general and commander of Canadian Forces Health Services in Ottawa.
“That was a big step for me to get promoted and take over command,” he said, adding it is the “ultimate goal” of his career.
Part of his job is medical advisor to the chief of the Defence Staff, who is connected with other surgeons general across the world.
In cases like the Russian war on Ukraine, “we can bring some clinical advice around certain medical capabilities that we may require,” he said.
Another aspect of his job involves the military health-care system, Malcolm noted.
“Regular force members, full-time members of the military, are actually excluded from the Canada Health Act, meaning we’re not eligible for a provincial health care,” he said. “If you think of my role a little bit like a ministry of health … where we set the programs and the policies on the running of the health-care system.”
jakeboudrot@advocatemediainc.com