Med school tackles rural doctor shortage with crash course in community culture

Canada is often lauded for its universal health care system, but universal doesn't mean equal access. The reality is that seven million Canadians, particularly those in smaller communities, are without a family doctor — in Ontario alone the number is two million. 

The Northern Ontario School of Medicine University (NOSM) is working to change that with a curriculum that challenges how doctors get trained. The goal of the non-profit university is to teach them medicine, along with a few things that could influence where they choose to practice.

"We are actually addressing these problems through incredible education and training with a focus on family medicine and Indigenous health," said Dr. Sarina Verma, the school's dean.

"We think it's the template for success for all of Canada."

"The chronic doctor shortage in northern Ontario needs urgent attention," said Emily English, of the Ontario Medical Association. "The Northern Ontario School of Medicine is doing incredible work training future physicians and retaining their graduates to build practices in northern Ontario."

Originally a part of Laurentian and Lakehead Universities, NOSM became an independent entity in 2022 with campuses in Thunder Bay and Sudbury. It has a social accountability mandate to improve the health of people in the communities of northern Ontario. 

The program is expanding quickly, with the announcement in March that Ontario will open an additional 30 funded spots at NOSM for medical students and 41 extra spots for postgraduate students over the next five years.

"This expansion will increase access to family and specialty physicians and other health care professionals in every corner of the province to ensure that Ontarians can access the health care they need, when they need it, wherever they may live," Minister of Colleges and Universities Jill Dunlop said in a statement at the time.

NOSM actively recruits students from rural communities and 90 per cent of its student body comes from northern Ontario. The idea is that if students are already comfortable living in smaller centres, they're more likely to stay and practice there once they graduate.

So far, the theory has proven true. Each year NOSM enrolls around 80 students from more than 200 applicants, and 99 per cent of those admitted complete the program. Of the 902 doctors who have graduated since the school was founded, NOSM says about half have stayed in northern Ontario and the other half are scattered throughout smaller communities across Canada. 

"The distributed model like ours gets the learners, first of all, into an emergent program, which is four weeks in an Indigenous community," Verma said. "You live and work and breathe and understand what the context is, and then your training happens in communities. 

"We have learners who show up and within the first week they're actually assisting and delivering babies, actually doing surgeries as the first assist, they're on call in the emergency department," Verma added. "That's very different than having 14 other learners around you in a big hospital — you actually get to do a lot more, see a lot more, and be incredibly confident as a physician."

And 46 per cent of the graduates go into family medicine, which the school says is no accident.

Dr. Brenna Duffy is a graduate of NOSM who now works in one of the small communities Verma is talking about, at the Meno Ya Win Health Centre in Sioux Lookout, Ont., about 350 kilometres northwest of Thunder Bay. She agrees that the kind of medicine she practices here is unique.