Expression of Interest Form - Russell Binscarth, MB

Thank you for your interest in exploring a broad‑scope rural medical practice in our community. Our municipality serves approximately 2,600 residents locally, with a regional service population of about 7,000 that includes Waywayseecappo First Nation as well as Gambler First Nation.

Physicians in our community work collaboratively across family practice, emergency care, and selected facility‑based services. This Expression of Interest helps determine whether there is a good mutual fit. Completion does not represent a formal application or offer.

Full Name *

Preferred Name (if different)

E-mail Address *

Phone Number *

Current Location (City/Province/Country) *

Preferred Method of Contact: * Telephone
E-mail

Work Status in Canada * Canadian Citizen or Permanent Resident
Valid Work Permit
In Process/Other

Medical Degree & Institution (Country) : *

Year of Graduation: *

Residency Program & Location (Country) *

Certification(s): * CPSM (College of Physicians and Surgeons of Manitoba)
CCFP (Certification in the College of Family Physicians of Canada)
FRCPC (Fellow of the Royal College of Physicians of Canada)
FRCSC (Fellow of the Royal College of Surgeons of Canada)

Licensure Status with College of Physicians and Surgeons of Manitoba * Not Yet Eligible
Eligible to Apply (physicians currently licensed in another Canadian Jursidiction)
Eligible to Apply for Fast Track Licensing (currently licensed physician in USA, UK, AUS, IRL)
Application in Progress
Licensed

Previous experience in a rural or small community setting (less than 5,000) * Extensive Experience and Highly Comfortable/Confident
Moderate Experience and Comfortable
Some Experience and Somewhat Comfortable
Limited Experience with Developing Comfort
No Experience & Not Yet Comfortable

Comfort Level with Shared Clinic and ER/On-Call Rotation: * Would need clarification/support
Open to discussion
Comfortable

Relocation Plans: * Alone
With partner
With family (# of dependents)

Availability to begin practising in Manitoba * 12+ Months
6-12 Months
Immediately-within 6 months

* - denotes required field