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Demonstrating impact and leading for change

Foremost on in our minds these days is the filing for court protection under the Companies’ Creditors Arrangement Act (CCAA) by Laurentian University. Many of you, our friends and partners, have expressed concern for NOSM and the effect this may have on us. As NOSM’s degree-granting institutions, both Laurentian University and Lakehead University hold endowments, tuition and research funds for our School. These are complex relationships that I am managing with Ray Hunt, Chief Operating Officer, Grace Vita, Director of Risk Management, and our legal counsel. We are working collaboratively to ensure our assets are protected. NOSM is a not-for-profit corporation and a separate legal entity, so our position may be unique as this serious matter unfolds.

Meanwhile, it is full steam ahead with our incredible strategic plan, The NOSM Challenge 2025.

It is already the end of February and so much has happened. I have asked Dr. Sarah Newbery to give you an overview of the School’s strategic direction Transform health human resource planning and about her work as NOSM’s inaugural Assistant Dean, Physician Workforce Strategy.

The need and what we’re doing about it

Guest Blog by Dr. Sarah Newbery

When we focus on health human resources in the North, similar questions and comments repetitively come up:

  • “It’s been seven years of being on a wait list and I still don’t have a family doctor.”
  • “I have been waiting for my specialist appointment for more than a year, and I am suffering.”
  • “I want to see a doctor in the emergency room who understands why it’s hard for me as an Indigenous person to feel safe getting care. Sometimes locums who come from the south just don’t seem to understand who we are.”

These are snippets of conversation and feedback that many of us have heard. People in many different communities and settings have expressed their challenges with accessing timely, comprehensive care that feels safe to them as patients.

These are not new issues. NOSM was created almost 20 years ago in response to these exact messages from the people of Northern Ontario. We now have an opportunity to tackle these issues in new ways, and build the physician and health-care workforce that meets the needs of the people of Northern Ontario, while ensuring that clinicians here feel deeply satisfied with their work and are happy to stay.

We need reliable data that we can share to understand what motivates our graduates to stay, and to understand the factors that can enable our success, making us more effective. Some of this can now be found on the physician workforce strategy page on NOSM’s website.

We need to study interventions that are successful. This work is beginning as we need to pin point exactly where the need is. Starting in the Northwest LHIN region in 2017, the Chiefs of Staff of all hospitals and clinics began sharing their physician workforce needs. They were able to show some significant gaps in our workforce which, in part, led to Summit North. The information has since been gathered community by community through local clinicians and recruiters. This data has been shared with our two Health Force Ontario regional advisors as it gives a snapshot of our current needs.

For the first time, the information has been collated by medical discipline. What we know is that we need at least 313 full-time physicians across Northern Ontario right now, with the highest need in absolute numbers being family medicine—in particular, rural generalist family medicine—followed by psychiatry, pediatrics, anaesthesia, and emergency medicine. Although the numbers needed are small in specialties like neurology, plastic surgery and respirology, entire services depend on our ability to recruit specialists in these domains.

The Ontario Medical Association (OMA) has provided information that indicates that at the end of 2019 we had 1,700 physicians whose primary practice location is Northern Ontario. Of those, 1,010 are family physicians and 690 are specialists. Overall, 40 per cent of our physician workforce is female, with an increasing rate of one per cent a year.

The number of physicians that we currently need overall—313—represents almost five full NOSM classes of 64 medical students. The challenge for us is that we need the 313 physicians now, not five years from now.

Besides our work to better understand the data, we are undertaking several initiatives to move the needle forward on physician workforce outcomes, including:

  • Renewing our approach to electives, bringing external learners to our communities.
  • Marketing postgraduate opportunities at NOSM. The “Doctors Wanted” campaign highlights our need for leaders, advocates, adventurers, change makers and excellent clinicians.
  • Launching the Rural Generalist Pathway to support rural-focused learners.
  • Connecting NOSM to key health human resource decision tables, including Health Sciences North and Thunder Bay Regional Health Science Centre, and aligning training to meet the need.
  • Communicating transparently with our faculty and enhancing faculty development to support recruitment and retention.
  • Working with the OMA to inform negotiations and advocate for the North on issues in clinical service and for the human resources to deliver the academic mission of the School.
  • Renewing the work of the Northern Physician Resources Taskforce with the input of other partner organizations including the Ontario Hospital Association (OHA), OMA, the northern municipal associations and PTOs like NAN.
  • And importantly, creating opportunity for expansion of the medical school to allow for more undergraduate admission and more postgraduate training opportunities.

I look forward to the day we hear new feedback from the people of Northern Ontario. Transformed messages that reflect growth, safety and opportunity, such as:

  • “My last family physician retired, but I didn’t have to wait at all for a new family doctor.”
  • “My family physician referred me to a specialist, and my appointment is just a couple of weeks away!”
  • “Our community’s economic development plan is moving forward so well partly because our local health-care system is stable and reliable, now new teachers and professionals want to move here!”
  • “Every time I go to the hospital, I feel safe.”

I believe that we will get there. As we embark on this renewed journey, please know that your work as clinicians and as faculty is recognized and valued by NOSM, our patients and the communities that we serve together.

Thank you,

Dr. Sarah Newbery
Assistant Dean, Physician Workforce Strategy

The last word by Dr. Verma 

I know things have felt uncertain and there is a sense of vulnerability with variants of the virus threatening us out there. As a collective, I encourage all of us to focus on what’s best for our families, our communities, as well as our learners, our School and our strategic priorities. Also take courage in knowing what is best for your mental health, your team effectiveness, and your individual contribution. The changes we all make will help realign our talents, gifts and passions to our collective vision.


Photo of six people in front of an airplane.
Pictured above: Dr. Bill McCready, NOSM Special Advisor and
Senior Associate Dean; Dr. Alexander Presello, NOSM resident;
and, Jacqueline Harvey, NOSM medical student join the Ornge
team in Thunder Bay.

NOSM Supports Ornge with Operation Remote Immunity

On Monday, February 22, 2021, NOSM’s first of 22 teams, consisting of learners, clinical faculty and staff joined Ornge, Nishnawbe Aski Nation, and many other partners in the roll out of COVID-19 vaccines to fly-in First Nations communities. They will travel to Wunnumin, Eabamatoong (Fort Hope), Bearskin Lake, Kitchenuhmaykoosib Inninuwug (Big Trout Lake), Deer Lake, Martin Falls, North Spirit and King Fisher Lake.

Read more.


Dr. Lee Toner appointed Interim Associate Dean of NOSM’s MD Program 

There has been a leadership change at NOSM. As of February 8, 2021, Dr. Lee Toner became the appointed Interim Associate Dean of Undergraduate Medical Education. Dr. Toner is an Emergency Doctor and Accreditation Specialist, an Associate Professor at NOSM, and offers a wealth of experience as we manage innovations in our MD program. Dr. Toner will be interim in the role until a search can be conducted in 2022.

Good luck to all interview candidates 

Heartfelt best wishes go out to all NOSM medical students who have upcoming CaRMS interviews. You have our full confidence. To all aspiring NOSM learners who are participating in admissions interviews in early March, good luck and enjoy the experience. What a year to join NOSM, we are inspired by your ongoing perseverance and drive. Thank you all for your continued aspiration to be part of the health care solution for Northern Ontario.



NOSM assists in mass vaccination clinics 

NOSM volunteers will be helping with urban mass vaccination clinics planned for Thunder Bay and Sudbury, to begin this spring. Please continue to follow the advice and direction of your district public health unit who will advise the public on mass vaccination schedules and eligibility. NOSM is proud to be working with all health-care partners on this historical initiative.


Thank you to the honourable speakers and attendees of Northern Lights 2021 

Daring Leadership in Difficult Times is the theme of this week’s Northern Lights 2021, NOSM’s annual pan-Northern leadership forum. The School experienced record high registrations by physicians across Northern Ontario who joined to hear our dynamic speakers, including: Dr. Jane Philpott, family physician and former Member of Parliament, currently Dean of the Faculty of Health Sciences, Director of the School of Medicine, Queen’s University and CEO of the Southeastern Ontario Academic Medical Organization (SEAMO); and Dr. Gigi Osler, Chair Canadian Medical Forum, President-Elect Federation of Medical Woman in Canada, Co-Chair Virtual Care Task Force, Otolaryngology Head and Neck Surgeon, and Former President Canadian Medical Association. It is a privilege and an honour to participate.


NOSM’s Francophone Affairs Office is proud to present a webinar series in French on a variety of health issues. From dermatology, mental health and addictions, take these opportunities to improve your knowledge… and in French!

Register today, we look forward to seeing you online!

 

NOSM Supports Ornge with Operation Remote Immunity

On Monday, February 22, 2021, NOSM’s first of 22 teams, consisting of learners, clinical faculty and staff joined Ornge, Nishnawbe Aski Nation, and many other partners in the roll out of COVID-19 vaccines to fly-in First Nations communities. They will travel to Wunnumin, Eabamatoong (Fort Hope), Bearskin Lake, Kitchenuhmaykoosib Inninuwug (Big Trout Lake), Deer Lake, Martin Falls, North Spirit and King Fisher Lake.

The goal is to complete all doses in 31 fly-in communities and Moosonee by the end of April. NOSM has organized 22 teams to be deployed between February 22 and April 2. All participants were vaccinated and completed mandatory flight safety and cultural awareness training. More teams may be selected in the future, depending on need.

Participation on Operation Remote Immunity fits well with NOSM’s social accountability mandate to improve access to care to rural and remote communities.

NOSM was established as a stand-alone legal entity to address the chronic shortage of physicians in Northern Ontario and improve the health of the people in the region. Through the value of social accountability, NOSM graduates, faculty, learners and staff lead health-system transformation in Northern Ontario.

Related articles:


Pictured above: Dr. Bill McCready, NOSM Special Advisor and Senior Associate Dean; Dr. Alexander Presello, NOSM resident; and, Jacqueline Harvey, NOSM medical student join the Ornge team in Thunder Bay.

Innovation in times of crisis: how NOSM faculty created curriculum that challenges students to advocate for impactful change

As the world faced the unprecedented health crisis of COVID-19, faculty at the Northern Ontario School of Medicine (NOSM) made pivotal changes to its fourth-year MD curriculum. At a time when students were not able to work on the frontlines, NOSM faculty worked quickly to introduce a new curriculum that focused on building advocacy leadership skills that would lead to impactful change.

“The new curriculum provided students with the opportunity to pursue topics that matter to them while having real, positive impacts on patient care and population health in Northern and rural contexts,” says Dr. Erin Cameron, NOSM Assistant Professor. “Much about medicine is learning how to advocate for individual patients or advocating for change at the institutional and community levels.”

The new curriculum was broken into parts: academic sessions related to the pandemic; Research and Advocacy Pandemic (RAP) Rounds, a forum for discussing emerging evidence, clinical practices, and public health strategies around COVID-19; and the Northern and Rural Health Advocacy Projects, where students identified an issue and undertook an advocacy project to address the issue.

“The idea was to learn from and through the pandemic in real-time, with a focus on our Northern Ontario setting,” explains Dr. Cameron. “As a socially accountable medical school, this new addition to the curriculum provides students with more opportunity to be health advocates. It was a team effort and is something we will continue for years to come.”

A recent project with a positive impact is Project Connect. A group of students are collecting gently used cell phones to be repurposed and given to survivors of intimate partner violence.

Rebecca Bourdon is a fourth-year NOSM medical student who is helping spearhead the local #ProjectConnect effort. She says the new curriculum made a lasting impact on her.  “As future health-care providers, it is important to remain vigilant in observing, and active in addressing, any gaps in healthcare as they occur, especially those that affect unfairly disadvantaged and vulnerable groups who may be unable to adequately advocate for themselves. The advocacy curriculum allowed us to uncover disparities in public health, particularly those either created or compounded by the pandemic. It gave us the opportunity to leverage our position to support and lobby for ways to address these inequities. This invaluable experience has ingrained in me the importance of being a health-care advocate, a role l will continuously strive to assume as a future physician.”

The goal of the advocacy projects is to complement the existing curriculum of the NOSM MD program, which is a mandatory academic requirement for the Northern and Rural Health course and Social and Population Health course. Other fourth-year medical student projects include new apps, educational infographics for patient education, advocacy letters to Ministers and Members of Parliament and action plans to support mental health.

The pandemic provides a rich teaching and learning environment that is ever evolving,” says Dr. Cameron. “Students received academic credit for undertaking the advocacy activities and making a difference in Northern Ontario.”

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The Northern Ontario School of Medicine (NOSM) is an award-winning socially accountable medical school renowned for its innovative model of distributed, community-engaged education and research. With a focus on diversity, inclusion, and advocacy for health equity, NOSM relies on the commitment and expertise of the peoples and communities of Northern Ontario to educate health-care professionals to practise in Indigenous, Francophone, rural, remote and underserved communities.

For further information, please contact: news@nosm.ca

NOSM University