According to a new study, the key to keeping doctors in the North may be to train them there.
The Northern Ontario School of Medicine (NOSM) opened its doors in 2005 as a medical school geared towards preparing students to practice in rural settings. NOSM has two campuses: one at Laurentian University in Sudbury, and the other at Lakehead University in Thunder Bay.
The NOSM has been tracking where its students choose to practice medicine since 2011, the first year its graduates began to practice independently after graduating and completing their residencies.
Since then, 94 percent of NOSM graduates who completed both their degree and their residency at NOSM stayed in Northern Ontario. In all, 160 NOSM graduates now practice medicine in the North, alongside 90 NOSM registered dietitians who now also work in northern rural communities.
“We are very excited that NOSM’s model is proving successful in improving access to healthcare for the people and communities of Northern Ontario,” said Dr. Roger Strasser, NOSM Dean, in a statement.
NOSM students are drawn to the lifestyle in rural communities, and many successful applicants are originally from rural hometowns. The selection process also favours admissions for indigenous and francophone students by using mini-interviews with community members, including patients and First Nations elders, instead of using the Medical College Admission Test (MCAT), a test that has not been validated for this demographic.
But rural doctors also face unique challenges, sometimes being the only doctor in town, or sometimes with just a few peers nearby. Even so, their patients still have diverse needs, and advanced equipment and health care services may not be close at hand, which can make them inaccessible, especially during emergencies. A rural doctor might be called on for anything from assisting in a surgery, to delivering a baby, to providing palliative care.
This can be daunting for graduates who have no familiarity or experience practicing in rural settings, which is something the NOSM aims to change by providing specific training opportunities that come more easily by being based in northern locations.
The strong ties to the community and exposure to rural work environments during their degrees are important for keeping graduates practicing in rural communities in the long haul, after financial incentives stop but the challenges of working in remote locations keep coming.
“There is still much work to be done. Northern Ontario communities continue to face a broad range of health challenges, with some communities continuing to struggle with maintaining medical services,” says Strasser. “We are eager to continue our work together to advance the health of the people of Northern Ontario.”