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Northern Ontario School of Medicine consults Northerners as it evolves into NOSM University

On solving doctor shortages: 'I think the job of the municipality has been forgotten. They need to be part of our solution.'

North Bay is not alone when it comes to facing doctor shortages — it is a challenge faced by countless communities across Northern Ontario.

The Northern Ontario School of Medicine (NOSM) was created in 2002 to “reverse a chronic shortage of physicians with a mandate to improve the health of Northern Ontarians, with a focus on rural, remote, Indigenous and Francophone populations.”

NOSM estimates a minimum of 313 full time equivalent physicians are currently needed across the North, “of this group we need 126 family physicians — 86 of these in rural communities.”

That number does not reflect anticipated retirements over the next five years.

NOSM numbers indicate North Bay is currently in need of 26 physicians including seven family doctors and 19 specialists.

Temiskaming Shores requires six physicians — three family doctors and three specialists to fill the gap in that community.  

Dr. Sarita Verma, Dean, President and CEO of NOSM is currently touring the North as part of a consultation process with northern communities, having started in Thunder Bay in early September leading up to a stop in North Bay Monday night.

She is consulting with local citizens, medical professionals and municipal politicians as NOSM transitions into NOSM University in what will be Canada’s first-standalone medical university.

Dr. Verma told those who joined the event both in person and virtually that on June 3 of this year, the Ontario Government introduced legislation to establish the Northern Ontario School of Medicine as an independent, degree-granting institution.

The consultation tour gives the Dean an opportunity to visit communities and hear first hand the struggles and challenges of receiving access to quality health care, and gather ideas as to how the university should look moving forward as they tackle the issues of health care delivery. 

Part of the process includes receiving feedback from the Francophone, Indigenous and rural communities.

“I think the first thing is that they don’t feel that the training that is one-size-fits-all training,  is necessarily customized to their needs,” Verma said.  

The school receives anywhere from 2,000 to 2,400 applications annually to fill just 64 positions, with some applying as many as nine times before being accepted.

“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. Seventeen per cent, that is a record in Canada, were Indigenous and 25 per cent were Francophone,” shared Verma.

“Outside of Quebec there is no bigger number than NOSM so we’re doing really well for a little school.”

There is one obvious solution to the doctor shortage.

“The solution is for the northern university to graduate substantially more physicians. Some of the other solutions are things like bringing people from southern Ontario to be able to have the chance to do what we call electives,” shared Verma.

“Many physicians come here when they’re learning and they fall in love with Northern Ontario. They discover that there actually are so many positive benefits. The other thing is to actually be able to bring physicians here on locum. (Defined as a doctor who substitutes for other doctors while they take leave, patient overflow or are on vacation.) So, you can fill some of the short gaps with people who come to do 2- to 6-week locums and then when they’re here, you really have to convince them that it is a wonderful place to live and work.”

Third-year medical student Chelsea Schelhaas spent her first two years training in Thunder Bay and has been in North Bay since August and will stay until April before returning to Thunder Bay for her fourth year.

“Patients who don’t have a doctor are very frustrated. I work with a lot of patients that are sent to a hospital list and having that continuity of care not there is really frustrating,” said Schelhaas.

“So I think to have a family doctor is a privilege in Northern Ontario and something that shouldn’t be a privilege it should be a right.”

“So if we can increase the number of physicians that will improve patient care, it is going to improve continuity of care and patients are going to benefit,” she went on to say. 

Victor Xiao is also a third year medical student from Thunder Bay.

“I think the transition to NOSM University is an opportunity to reorganize the building blocks of the school,” said Xiao.

“I’m from Thunder Bay so after I graduate, I plan on setting up there.

Verma says municipalities need to get involved.

“I think the job of the municipality has been forgotten. They need to be part of our solution,” stated Verma.

And that could be as simple as rolling out the welcome mat.

“If you come here and have a terrible experience, then you will never come back. But if they come here and have a wonderful experience, they get welcomed by the community, they get a chance to meet people in the community. It is part of a marketing program I think that communities need to do.”

The solution is not just limited to physicians.

“We can do a lot of work with community outreach workers. There are a lot of people looking for work now and they could be counsellors with one year of training, they could be addictions experts with one or two years of training. There is a lot of work we can do together,” said Verma.

“There are programs right now that do addictions training but they’re not degrees in medicine. So, maybe there are solutions and we’ve been thinking about a lot of these. As a university we can branch out to a lot of this kind of stuff.”  

Like anything else, there is a process.

“It won’t happen right away. It takes at least 24 months to get permission from the government to open any new programs but we’re already thinking outside the box. We’re already innovating. We’re already looking at what are the gaps that a doctor or a nurse can’t fill,” Verma explained.

“There are nurse practitioners but we can also expand our physician assistant program. They are actually about to become a regulated health professional. And physician assistants can do a lot of things as long as they have a supervisor nearby.”

It takes a number of people with different skill sets to complete the team.

There is a great need for specialists in the area of psychiatry, general internal medicine, pediatrics, emergency medicine and anesthesia.

“The University, once proclaimed into force, will maintain its mandate to advocate for equitable health care, especially for underserved rural, Indigenous and Francophone communities in Northern Ontario.”

NOSM currently has 123 faculty members (physicians or health-care providers) working in North Bay with five self-identifying as Francophone and two self-identifying as Indigenous.

Thirteen faculty members are in West Nipissing with seven self-identifying as Francophone and self-identifying one as Indigenous.

Teaching occurs at hospitals, in family health teams and clinics. 

With more stops still to come on the tour, the hope is to use the time between December 20 and January 3 to digest and sort the feedback collected.  

“Most of it will be used to develop, what I think is evolving in my head is a regional campus framework of a network of smaller campuses so that people don’t feel so disconnected from NOSM,” shared Verma who calls the feedback she’s been getting on tour “inspiring.”

“I think people really care.”

It has been suggested that Northern Ontario needs a better marketing plan.

“I think Northern Ontario is the hidden jewel and I wish that we could just find a way to become more known out there.”