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Letter to the editor: Doctor shortage. 'The health of people is deteriorating due to a minimal or utter lack of care'

'A basic human right for healthcare in Canada is being neglected and seemingly controlled by a regulatory body that seems more concerned about its own self-interests and not the public it should be accountable to'

Editor's note: Mr. Hicks writes in response to the BayToday story Northern Ontario School of Medicine consults Northerners as it evolves into NOSM University


Dr Verma was kind enough to come to our area and discuss a difficult topic on Tuesday, November 9th and that should be commended.  I suspect that being the Dean, President and CEO of a medical school is an extremely difficult and nuanced role to have.

With that said, I was quite disheartened to hear a number of her comments as detailed in your article.

Here is some information as detailed in the above article

  • Northern Ontario is short somewhere between 300 to 400 physicians.
  • NOSM receives 2000 to 2400 applications annually and they fill 64 slots with those applications
  • That is a little over 3% of the applicants.  That means it will take five to seven years to resolve the physician shortage and that is if population numbers are static

During those five to seven years, the health of people is deteriorating due to a minimal or utter lack of care.  This in turn puts greater stress on an already strained healthcare system.

What Dr Verma revealed is that NOSM could resolve the shortage with one year's worth of applicants. They do not, however, for various reasons.  

One of those reasons might be that it's an opportunity to ensure only the best applicants get selected.  

My response to that is...really?

Out of two thousand applicants, only sixty-four are of acceptable quality in that given year? 

What is the delta of acceptability between Successful NOSM Applicant #64 and Unsuccessful NOSM Applicant #65?  In turn, what is the delta of acceptability between Successful NOSM Applicant #64 and Unsuccessful NOSM Applicant #100?  I would suspect that the differences between the number of the applicants that are successful and not successful are quite small and absolutely do not mean that the person cannot be a doctor. 

It's simply a matter of, "Sorry.  We're full.  Try again next year!"

As Dr Verma admitted, some applicants have to apply nine times before getting into NOSM.  

Nine times...

By stating that publicly, Dr Verma is clearly unaware of just how ridiculous the process sounds.  That someone can be unacceptable eight times and then acceptable on the ninth means the following...

i)  This person has no business applying to med school this many times because they clearly are not acceptable as a physician and the acceptance process has failed multiple times at making that clear to the person hoping to enroll

ii) OR the acceptance process is so inefficient, out-of-touch, and convoluted that they are literally turning away people who COULD be a physician and these applicants simply need to keep entering into the "Med School Lottery" and hope they get lucky.

The admissions process is clearly inadequate and it needs to improve dramatically in both terms of efficiency and efficacy.

Dr Verma also went on to say “We’ve been changing our admissions criteria so that really, if you are not from northern Ontario and you don’t intend to stay in northern Ontario, your chances are low. Eighty-nine per cent of our students last year came from rural or northern Ontario."

It should be one-hundred percent. 

IF and only if NOSM cannot fill their slots with applicants from northern Ontario who also intend to practice in northern Ontario, then NOSM recruits outside of northern Ontario and those applicants all commit to a minimum of five years practicing medicine in northern Ontario upon graduating.  Why that isn't a requirement for every successful enrollment is beyond me.

To be clear, a portion of this is out of the control of Dr Verma and her team.  Enrollment numbers are not decided by the medical schools.  Enrollment numbers are decided by the College of Physicians and Surgeons of Ontario and their reasons are their own. 

What ARE those reasons?

I don't know.

But what I DO know is this.

  • The College of Physicians and Surgeons of Ontario has a good understanding of the current need for physicians in Ontario and they have known this for years if not decades.
  • The College of Physicians and Surgeons of Ontario, while knowing about the physician shortage crisis continues to set limits on enrollment that ensures the crisis will continue.
  • Limiting the value of some products and services can inflate the value of those products and services.
  • Inflating the value of a product or service can in turn increase the importance of that product or service.

Why would the College of Physicians and Surgeons of Ontario be allowed to put themselves in a position where they get to dictate the availability and value of the physicians that they regulate and chronically fail to display they understand the needs of the population that they are there to support?

That's a great question to ask an MP or MPP.  It's also a headline that should be at the top of every newspaper and news website every day until our provincial government figures out that a basic human right for healthcare in Canada is being neglected and seemingly controlled by a regulatory body that seems more concerned about its own self-interests and not the public it should be accountable to.

Also...northern Ontario doesn't need a "better marketing plan".  We need to stop trying to compete with southern Ontario.  We simply cannot offer everything that they can.  Northern Ontario isn't a "hidden jewel".  We're right here.  We always have been and we always will be.  We need to be done with trying to lure people north.  People either get tired of living south of here or they don't.  We desperately need to evolve in northern Ontario but hoping for more people to come north and realize that it's great up here is not the way forward.

The actual truth is that it's NOT great up here; not without some effort. Putting in effort and a significant amount of realigning of personal expectations and objectives can make it great but northern Ontario isn't for everyone and that's without accounting for unpredictable weather and sub-zero temperatures.

Yes, we have lakes and trees up here in abundance.  They also have lakes and trees in Toronto.  Toronto also has restaurants and places of interest and entertainment that are open on Mondays and past 8 P.M.  Northern Ontario?  Not so much.  

Let's stop hoping that people will realize how amazing it is up here.

Let's just be amazing.  

The people we want and need will notice; they'll figure it out and come north.


Steve Hicks

Chair of the Sundridge & District Medical Center Committee

Councillor - Municipality of Sundridge