Training Future Public Health Physicians

Friday April 11th, 2025 Jason Lind

When Dr. Lloyd Douglas considered a career in medicine, public health was not on his radar. After training as general practitioner at the University of the West Indies in Jamaica, he knew that he wanted to focus on something broader than individual patients.

“The idea of population health and doing work to promote and protect health at the population level was quite appealing,” he says. Today, Dr. Douglas works as a Public Health Physician seconded from the Thunder Bay District Health Unit to the Sioux Lookout First Nations Health Authority.

As a public health physician, he works with organizations and communities to develop a public health system for the Sioux Lookout area First Nations. Dr. Douglas provides public health education and contributes to health promotion, emergency preparedness, public health surveillance and more. A typical day may include work on all or none of the above.

Having completed his residency in Public Health and Preventive Medicine (PHPM) at NOSM University in 2021, Dr. Douglas says the program prepared him for some of the realities of working as a public health professional serving First Nations communities and organizations.

PHPM is a five-year residency program that includes “direct patient care, graduate studies, and training in population-level care at public health agencies,” says Dr. Emily Groot, Program Director. Focusing on disease prevention and health promotion at the population level, PHPM specialists support equitable health outcomes for all members of society.

In addition to technical expertise in public health, Dr. Douglas says that having soft skills and knowledge about building relationships are critical to the work of public health physicians. He is working with the program to incorporate more applied training opportunities for residents. “Residency should be a true apprenticeship,” says Dr. Douglas.

He has first-hand experience of this through his work with First Nations and remote Northern communities. “It’s about understanding the complexities of the population that lives in two worlds and being an ally,” Dr. Douglas says. “Every resident at NOSM University should spend some time in the Far North. That’s the best way to learn.”

PHPM residents train across Northern Ontario and outside the region to get a broad range of experiences. With just 10 residents, the small program provides a tight-knit learning community with two streams: a PHPM-Family Medicine stream in Sudbury and a PHPM stream in Sault Ste. Marie. This provides residents with a variety of experiences and learning opportunities.

Dr. Lyall Pacey is a third-year PHPM resident currently based in Thunder Bay. He also serves as the chief resident for the PHPM program. “Part of why I chose NOSM University was the opportunity for clinical training,” he says.

“I wanted to work where my clinical and public health training could converge and have some rural and remote perspectives. NOSM University gave me one of the best opportunities for that.” He has trained in Sioux Lookout, Moose Factory, James Bay and other remote and fly-in communities and describes these experiences as the best part of the program.

“The training I’ve enjoyed the most has been our experiential learning experiences,” he added.” Touring mines, meeting occupational medicine physicians, and simulated emergency management training have provided invaluable learning.

The NOSM U PHPM program also supports scholarly work in public health. Recently, NOSM University residents Dr. Oscar Pico Espinosa won the CAME Rising Star Certificate of Excellence award and Dr. Kasunka Kankanam Gamage received a 2024 NAPCRG Distinguished Trainee Research Award.

PHPM is a dynamic and continually changing specialty as it involves working with multiple aspects of the medical profession. “You might provide direct patient care while also working on health policy. One day, you might be managing an outbreak, and the next you might work on a report summarizing health issues in your region. You interact with a broad range of other public health professionals like epidemiologists, public health nurses, public health inspectors, data analysts, health promoters, and policy analysts,” Dr. Groot says.

Individuals with an interest in the specialty are encouraged to connect with Medical Officers of Health and other PHPM specialists. Actively seeking out insights and information from these professionals will provide valuable knowledge and a deeper understanding of the field.

Dr. Douglas encourages people to be true to themselves overall. “Understand what type of medicine you want to practise. Understand the challenges that you are going to face, the type of life involved and see if it is a fit,” he suggests.

Learn more about the PHPM program on the NOSM University website.

Gallery, In the Spotlight

Expanding global impact: NOSM University professors advance medical education

Tuesday April 8th, 2025 Jason Lind

In late 2024, Dr. Jack Haggarty, psychiatrist and NOSM University Professor, travelled to the University of Global Health Equity (UGHE) in Rwanda in his role as clinical supervisor and educator. This marked his second time supporting UGHE undergraduate clerkship rotation in psychiatry, reinforcing an evolving partnership between two institutions that share a commitment to health equity in underserved communities. Dr. Haggarty was among 10 international physicians providing two weeks of clinical supervision to UGHE medical students in Butaro, Rwanda.

Founded in 2015, UGHE was created through a collaboration between Partners in Health and the Rwandan government, with a shared vision to advance health equity and medical education in rural communities. Its main campus is in Butaro, a mountainous region near the Uganda border, and its programs extend to other rural areas of Rwanda.

Partners in Health founder Dr. Paul Farmer, a global health visionary, dedicated his life to building sustainable, high-functioning medical services and education in underserved regions including Haiti, Peru, Russia and Rwanda. His principles of equity and access continue to shape UGHE’s work today.

Dr. Haggarty sees UGHE as a ‘concept model’ similar to NOSM University, as both universities strive to improve health equity, medical access and education in rural communities.

Developing Partnerships

The partnership between NOSM University and UGHE began in 2021 with Dr. Emily Groot, Program Director, Public Health and Preventive Medicine at NOSM University. She was looking for opportunities for residents interested in global public health to gain a wider variety of experiences.

“I was really interested in developing a partnership with an institution that is newer than NOSM University but has thought through a lot of the same challenges we face,” she says. “It provides an opportunity for us to learn from another institution that is embracing a similar social accountability mandate.”

The partnership between NOSM University and UGHE was a natural fit—both universities serve rural communities and train health professionals to deliver equitable access to care in underserved areas.

Dr. Haggarty sees parallels between the rural communities of Rwanda and those across Northern Ontario, such as Indigenous and Francophone populations, which similarly present opportunities to learn from low-resource settings.

During his recent visit to Rwanda, Dr. Haggarty worked with local social workers, psychologists, and psychiatrists to train 36 UGHE medical students in core psychiatric skills such as mental status exams, pharmacology, and mood disorder treatment. He also supervised students during rotations at Rwanda’s only psychiatry hospital, which serves the country’s 13 million people. Following his initial visit in 2023, student interest in psychiatry grew significantly, leading to discussions about developing a postgraduate psychiatry program at UGHE.

“One of the reasons I’ve been asked to continue to engage with UGHE is because the NOSM University experience has been so parallel,” he says.

Dr. Tara Baron, pediatrician and Associate Dean of Continuing Education and Professional Development (CEPD), has also played a key role in fostering this relationship. She first visited UGHE in 2022, 2023, and again in January 2025 while bringing a medical resident with her. These experiences provide pediatric residents with invaluable exposure to healthcare systems outside North America, allowing them to develop teaching skills while adapting to different medical environments.

“For the residents, this is an opportunity to understand medicine in a global context, work with minimal resources, and learn alongside talented UGHE students,” says Dr. Baron. “It’s an extraordinary opportunity for growth.”

Dr. Baron also sees parallels between UGHE and NOSM University in terms of challenges and learning opportunities, including learning to provide care in limited resource environments and ensuring that there is space for medical students to have hands-on learning.

Looking Forward

UGHE main campus sign The physicians enjoyed their experience teaching and learning from UGHE and hope to deepen the partnership with NOSM University going forward.

Dr. Haggarty is looking forward to continuing working with UGHE and the Boston-based Partners in Health to develop more programs. “It was a privilege to be invited. We’re looking forward to working on a postgraduate development plan for psychiatry,” he says.

Dr. Baron, who has been at NOSM University since its inception, describes the experience of working with the UGHE students as “extraordinary” and is working to bring two UGHE pediatric residents to Northern Ontario for an elective.

“They are bright, motivated students who are so keen to learn. It has also been a privilege to watch UGHE develop their own clinical teaching capacity over the past three visits, to the point that eventually visiting faculty will no longer be needed,” she says.

“Our residents get the opportunity to go there, so we wanted to be able to be reciprocal and give their students the opportunity to come and see what pediatrics in Canada is like,” she says.

In May 2024, UGHE professor Dr. Ursin Bayisenge presented at NOSM University’s annual faculty development conference, Northern Constellations and Connections. Faculty members who have engaged with UGHE believe that formalizing this partnership could bring lasting benefits to both universities.

Gallery, In the Spotlight

Spotlight on Public Health

Monday April 7th, 2025 Jason Lind

April 7- 11 is recognized as Global Public Health Week and Canadian Public Health Week.

This annual week highlights the work of public health professionals and the role of public health in improving health outcomes and health equity. The theme for Global Public Health Week 2025 is “Redefining Equity: Decolonizing Public Health for a Healthier World.”

Public health plays a vital role in the health and well-being of rural and Northern Ontario communities. “We look at what major changes we can make at a societal level that’ll help keep people healthy and prevent illness,” said Dr. John Tuinema, Associate Medical Officer of Health and Director of Health Protection for Algoma Public Health.

Dr. Tuinema completed NOSM University’s Public Health and Preventive Medicine (PHPM) residency program in 2021 in the midst of the global COVID-19 pandemic. This resulted in a unique learning experience as it involved working around the clock to contain the outbreak and keep people informed.

While the global COVID-19 pandemic put a spotlight on the work of public health officials, Dr. Tuinema says the work of public health is often invisible as a large part of it involves disease prevention. It is the prevention aspect that attracted him to the profession. The combination of medical expertise, big-picture thinking and social sciences skills required drew him in.

“The moment I read about a career in Public Health, I knew exactly what I wanted to do,” he said.

Dr. Tuinema encourages anyone curious about a career in public health to explore the field by connecting with local public health professionals, speaking with PHPM program directors at institutions like NOSM University, or completing electives with by public health agencies.

A career in public health offers a unique opportunity to create lasting, systemic change that improves lives on a large scale. Public health professionals address social determinants of health—such as housing, education and food security—especially for Northern, rural and Indigenous communities. By focusing on disease prevention, health promotion and policy development, they help build healthier communities.

“Even if you aren’t planning to become a public health physician, understanding public health principles can benefit any medical practice. There are ways to learn from public health for all medical specialties,” he said. “Public health involves thinking beyond individual patient sand working towards a healthier society as a whole.”