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Where are they now? Charter Class Alumna thrives in rural Francophone practice

Reflecting back, Dr. Lyndsay Berardi says her mother’s experience with breast cancer ignited her ambition to become a family physician. At the time, Lyndsay was a Francophone teenager in Kirkland Lake. Her mother’s diagnosis marked the beginning of many trips to Sudbury for cancer treatment, and for Lyndsay, it would chart the course of her career in medicine.

“Even though I was relatively young, I was acutely aware of some of the inequities in accessing health care; having to drive three-and-a-half hours to go to Sudbury for my mother’s oncology appointments and there were times when I wouldn’t see her for six weeks because she was having radiation treatments,” Lyndsay says.

“At that point I was more and more drawn to the idea of pursuing medicine as a career. I went to university and studied biochemistry with the full intention of applying for medical school. This was around the same time that NOSM was starting up and everyone in Northern Ontario was really excited to be gaining a new medical school,” she says. 

“Getting into the new medical school became my ultimate goal. I went through university telling myself ‘I’m going to be a member of the charter class.’ The goal was to get into medicine so that I could help people like my mom by ensuring they have access to health care, and that they can receive health care in a compassionate, culturally appropriate manner from somebody who was really invested in their care.”

To this day, Lyndsay says helping her patients navigate the intricacies of the health-care system is a service she works hard to provide for her patients. 

“The system is complicated for physicians to navigate, let alone patients who are unwell and afraid. That’s what I saw happen to my mom and I was adamant that I wanted to be part of the solution.” 

She joined the charter class at NOSM in 2005. In class she met her husband Dr. Philip Berardi, fellow NOSM charter class Alumnus from Sault Ste. Marie, who is now a Hematopathologist at the Ottawa Hospital campus and an Assistant professor at the University of Ottawa. They now have three children and live in Orleans between Rockland and the Ottawa Hospital. 

Lyndsay’s family medicine practice is in Rockland, a rural Francophone community of approximately 10,000 located about 45 minutes east of Ottawa. She says she was drawn to the small French community because it reminds her of Francophone Northern Ontario. In Rockland she practices entirely in French “which is something I’m very proud and happy to be able to do,” she says. 

“Our intention was always to go back to Northern Ontario, but with the level of Phil’s specialty, jobs for him were mainly in large tertiary centers, which is why we decided on Ottawa. That’s also how I discovered Rockland, where I’ve been working as a family doctor since I graduated residency in 2011.”

She credits NOSM’s strong Francophone advocacy, curriculum and inclusiveness for supporting her as a Francophone medical student which allowed her to study medicine in French. 

“If it wasn’t for NOSM, I don’t know that I would’ve been able to acquire the Francophone community experiences, medical skills and terminology required to continue to practice 100 per cent in French. I would’ve likely ended up practicing in English,” Lyndsay says. 

“Having been born and raised in Kirkland Lake to a Francophone family meant that retaining the French language was really important to me. At NOSM, French health care was always stressed and equally valued, and all efforts were made to allow me to learn and practice in French.”

“All of the medical French terms are not commonly used French words, so there was definitely a learning curve over the past ten years while I practiced only with French physicians and patients,” she says. “I don’t think I would have ever felt comfortable had NOSM not provided me with the opportunity to learn medicine in French.”

She says cultural sensitivity is a core strength of the MD Program at NOSM, as is NOSM’s approach to clinical skills.

“During my MD program at NOSM, I had the opportunity to focus on the clinical skills right from the start. That is what makes the school successful. I now teach residents in their second year of residency from places like University of Toronto who have only read about the skills that NOSM students have performed several times.”

“For example, by the time I got to residency I had performed several lumbar punctures compared to others who said they’d only read about them many times. That’s the beauty of NOSM, and rural medicine. It’s a very hands-on approach to learning medicine,” Lyndsay says. “There’s no hierarchy of residents either that you have to wade through in order to get the opportunity to try.”  

“Being able to work in a rural community and provide care and in French are two things that are important to me. I hope that although we were unable to return to Northern Ontario, people recognize the value of being able to provide Francophone care in a rural community.”

“I feel indebted to NOSM. The program changed my life, it’s where I met my husband, it’s where I was supported through training because medical school and residency are not easy. I am so thankful and appreciative to the faculty in Sudbury, for the time they took to teach me. If it weren’t for their many hours dedicated to my learning and to the success of the School, we wouldn’t be in the position we are right now in our lives. I feel that sense of gratitude every day and every time I have a student or a resident work with me. I’m so grateful to NOSM for that.”

 

Putting social accountability into everyday practice

Dr. Ella Goodman, graduate of the Northern Ontario School of Medicine’s (NOSM) Charter Class of 2011, constantly puts social accountability into practice. For the past nine years she’s provided care to highly vulnerable populations at the Norwest Community Health Centre in the south-east area of Thunder Bay.

“We have a large number of low-income families, unattached patients without family doctors, a large Syrian refugee community, a large urban-Indigenous population and a lot of underserved people in general. We’re always working to better understand everyone’s needs, to better provide health care and access to the health services they deserve,” says Ella. 

New virtual care options being offered over the past year helped some patients feel more comfortable accessing services.

“In COVID times, we’re trying as much as possible to keep our services going and to adapt, so we’ve been offering a blend of in-person and virtual appointments. There have been real benefits in accommodating virtual appointments for our clients. Many who work and those with transportation issues, used to struggle with appointment times. Now, they enjoy not having to take time off or take the bus to get here and wait in the crowded waiting room for a ten-minute appointment. Virtual appointments are much more accessible for those who have access to the technology.” 

Also, Ella credits the health team at the centre for making unique, thoughtful advances in socially accountable care. “Community health workers here have stepped up with different programming, for example, providing boxes of toiletries, food and common household items to some of our populations that may have a hard time accessing these things during COVID.”

She says her education at NOSM prepared her well for the cultural sensitivities and other realities of practice that exist not only here in one of the most challenged neighbourhoods in Thunder Bay, but in many communities across Ontario.  

“There’s definitely a fear that a lot of individuals feel when they have not had equitable care in the past. NOSM prepared me for the realities of trying to break down those barriers and having a strong sense of cultural awareness,” she says.  “I try to build an alliance, where the patient feels safe to come and receive care, and a lot of that comes down to meeting the individual where they’re at in their health-care journey. NOSM definitely prepared me for that.” 

Ella says NOSM’s focus on culture in education gave her a deeper understanding that culture is unique and helped her apply strategies to deliver better care. She says the nuances of those lessons directly apply to her practice.

“At NOSM, I learned the core concepts of not making assumptions, being open to learning more about a culture, and not being afraid to ask questions. It’s important in practice, and I think it was really helpful to learn early on.”

“I’m always humbled by our patients and always learning in my encounters with them, for example, we didn’t previously have mirrors in our clinical exam rooms and a lot of our patients wear the hijab. It’s helpful to them to have a mirror when putting it on and important because they can’t leave the room without it. Lessons like these are always popping up, and they humble you—I think they require the right approach in asking questions and being willing to learn.”

There are two things that keep Ella going as a busy young physician who is balancing her own young family, and as a hospitalist and preceptor working in a pandemic, “the population we serve, and the wonderfully supportive environment at the centre. I feel like I’m doing meaningful medicine on a daily basis.”

In light of her own lessons learned, she strives to teach NOSM medical students the key values of “just doing the best that we can to help those who we can, and the importance of being able to help provide a safe environment where all individuals can access quality care.”

 

2021: A year dedicated to climate and social justice

So far, 2021 has started out as a political hot potato, both for our American neighbours and our own rising number of COVID-19 cases across Ontario. Yet, here in Northern Ontario, with vaccinations on the horizon, this new year brings some promise of the end (but not the eradication) of COVID-19 as a pandemic. It is the anticipation of in-person reconnection with loved ones, and hopefully, the resumption of academic and business work. We are taking stock and planning new courses of action to better ourselves and to better serve our communities. This year our resolution might be to re-evaluate the meaning of ‘normal’ and whether we should go forward having learned some valuable lessons from 2020.

On average, each of us makes two New Year’s resolutions. From Thunder Bay to Sudbury, Toronto to Vancouver, there are interesting similarities. The two very common resolutions tend to be weight loss and exercise, and quitting alcohol or cigarettes. There is a common desire to become better people and to achieve a higher purpose. On the first day of the year people take their values more seriously. I love new beginnings. It’s a great way to throw away anything that may have been pulling you down, get over mistakes you’ve made, and start something with a fresh head and a heavy dose of positivity. So, here are five big ideas on how I want to take NOSM forward in 2021.

1.    Be an advocate for social justice

Justice is the concept of fairness. Social justice is fairness as it manifests in society. That includes fairness in health care, employment, housing, and more. Discrimination and social justice are not compatible. Social justice depends on four essential goals: human rights, access, participation, and equity. Social justice can’t be achieved without these four principles. Do not be afraid to engage in conversations with loved ones, coworkers, and friends. Microaggressions which can appear in the form of racist jokes or statements, perpetuate and normalize biases and prejudices. Remember that not saying anything or laughing along implies that you agree. Remember that all forms of oppression are connected. You cannot fight against one form of injustice and not fight against others. I think that is obvious from the political turmoil we are observing. Now, more than ever, I am so glad we live in a country that tries to address the inequities of our society.

2.    Undertake curricular reform

Medical schools strive to embody innovation, and seasoned ones are seeking compliance with current principles of adult learning, the needs of society, the changing nature of health care and how current students learn best. This year we will ask: What should prompt a medical school to change a curriculum (whether it be reform of the full curriculum, or limited to a specific course)? How should such change be conducted? What kinds of paradigms may inform such a change? What constitutes a success in curricular reform? And how can curricular reform be evaluated within a reasonable timeframe? A new curriculum designed for the future and which includes equity, environmental change, digital and virtual medicine and more out-of-the-classroom teaching will be explored this year.

3.    Embrace a new culture of kindness, respect and professionalism

In the pandemic, we have experienced high levels of stress. Now more than ever, a positive space is important for our physical and mental wellbeing. As Aesop once said, “no act of kindness, however small, is ever wasted.” This year, as we start to re-enter a world lifted from physical distancing, I encourage you to practice random acts of kindness. Kindness is contagious and leads to more collaborative and cooperative behaviours in others. We are adding the Code of Respect to our NOSM resources and endorsing the Okanagan Charter to integrate wellness into all aspects of education and work. Our medical school will work to embody kindness in everything we do. We ask you to respect each other and to be the true professionals that the health system demands.

4.    Deal with climate change

The world’s best scientists tell us that to undo the most extreme scenarios of climate change, 2021 must be the year for coordinated, comprehensive climate action. But we’ve got a lot of work to do before then. The good news is that the global momentum around climate change is building toward a crescendo. The number of Canadians who are now either “alarmed” or “concerned” about climate change has doubled in the past five years. Hundreds of thousands of people from all walks of life, including students, teachers, communities of faith, and health-care professionals, are taking to the streets to demand climate action. This year, I hope that NOSM’s Task Force on Climate Change is going to lead us in addressing climate change in our curriculum, policies and infrastructure.

5.    Get excited, be passionate, and have new, dangerous ideas

“An idea that is not dangerous is unworthy of being called an idea at all,” Oscar Wilde. Now don’t take me literally. I am not advocating illegal or perilous actions. I believe that to bring forth creativity, innovation can only occur with the catalyst of a new idea. In other words, let’s not cling to the ‘way it has always been done’. NOSM is still a young school and should not be so easily held back by tradition or risk aversion. Innovation does not come by following the mainstream or the status quo. Innovation is about creating change, discovery, and examining new ideas – it thoughtfully considers out-of-the-box or upside-down thinking and implements methods that might at first seem uncomfortable, unconventional, or even wild. This year, I hope to bring people together from all areas of NOSM and offer them the freedom and flexibility to share and discuss the “dangerous” ideas in a safe environment.

Of course, the big catalyst for change in 2021 that will be remembered and will have the most impact is the V word: Vaccination. Everyone, please get vaccinated as soon as the opportunity is provided.

Please continue to follow my journey on Twitter @ddsv3.  I welcome input on this blog and other issues you want to bring to my attention by email to dean@nosm.ca.


Mark your calendar for the next Whole School Webinar

We will be holding one of our regular whole school webinars on Tuesday, January 26, 2021 at 8:00 a.m. Updates on COVID-19 and other important school issues will be presented.


Vaccinators Needed 

NOSM and Ornge (Ontario Air Ambulance Corporation) are partnering to deliver the vaccination roll-out in remote First Nations in Northern Ontario. Plans are underway to begin deploying vaccination teams by mid-February. Please volunteer to join the vaccination roll-out. We will be seeking volunteers to join the air transport vaccination teams, including: senior medical students, residents, clinical faculty, and alumni. Those with experience providing care in Indigenous communities are encouraged to apply.  NOSM will also soon be seeking volunteers to assist with the vaccination roll-out in partnership with the public health units across the region to assist with vaccinations to the population at large.

*Check your NOSM email for more details that will be sent over the next few weeks.


Dr. Hirvi awarded CAME Certificate of Merit

Congratulations Dr. Ed Hirvi, recipient of the 2021 Certificate of Merit Award from the Canadian Association for Medical Education (CAME). Dr. Hirvi is the NOSM Section Co-Chair, Family Medicine. The award recognizes faculty members committed to medical education in Canadian medical schools. We are so grateful for all you do at NOSM!


Register for the Women’s Health Symposium

Join us for the first virtual Northeastern Women’s Health Symposium on January 22 & April 16, 2021. Topics will include on management of dysmenorrhea & Endometriosis, non-invasive prenatal testing, cervical cancer screening during a Pandemic, abnormal uterine bleeding, and vulvar health. The conference is targeted to family physicians, specialists, medical learners and allied health professionals with an interest in women’s health. Register here.


Register for Northern Lights 2021

“Daring Leadership in Difficult Times,” is the theme for Northern Lights 2021: Pan Northern Leadership Forum with two of Canada’s top physician leaders, Drs. Jane Philpott and Gigi Osler, on February 25- 26. Together we will explore daring leadership in an ever-changing and unpredictable world. Dare to engage in difficult conversations with courage and empathy. Dare to support leadership diversity, equity and inclusion on your teams, with your colleagues and at NOSM. Register here.

NOSM University