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Two Northern Ontario communities share successes with recruitment

Sault Ste. Marie and Sioux Lookout are great places to work—and the word is getting out

Dr. Mara Boyle didn’t originally think that her career would lead her to family medicine—or to Sioux Lookout. Plans changed when her third year of NOSM University’s MD program brought her to the small town, four hours north of her hometown of Thunder Bay.

“I didn’t really want to be a family physician when I arrived in Sioux Lookout in my third year. I thought that I was going to become a specialist,” Dr. Boyle explains. “One of the aspects of working in Sioux Lookout is that you practise a broad scope of family medicine. I found it difficult to think about putting myself into a specialty after my Comprehensive Community Clerkship. That’s been a big driver for my career: why I chose family medicine, and why I returned to Sioux Lookout, first for residency and then to practise.”

Dr. Boyle is not alone. Of the 11 physicians contracted at Sioux Lookout’s Hugh Allen Clinic, seven are former residents. Six physicians—more than half of the doctors at the clinic—completed a NOSM University residency in the community.

Hugh Allen Clinic Manager, Linda McNaughton, cites residents as the single greatest success story for local physician recruitment, and she points out the positive experiences that residents often have.

“I think our success can be attributed to the variety of roles and the opportunity to be flexible with scheduling and preferred medical practice. The work in the clinic is very well supported by experienced long-term support staff and seasoned mentors with over 30 years of experience. Being able to walk down the hall to get advice and share experiences is very rewarding,” McNaughton says.

These opportunities for mentorship and flexibility in practice are aspects that Dr. Boyle appreciates. For instance, she valued an opportunity to be mentored by the obstetrics team, and then to join their practice.

“One of the special things about Sioux Lookout—and it is immediately apparent—is that the physicians really are a community,” she says. “Everyone holds each other up. The very strong collegial environment was a huge draw, and it made a big difference in my transition from residency to practice. If I needed help in the middle of the night, I always knew there was someone who would pick up the phone.”

This strong sense of community extends beyond work. Dr. Boyle notes that her personal and professional lives have merged: the physicians get together regularly, and their children have become friends. “It’s a very vibrant physician community,” she says.

Like Dr. Boyle, Dr. Allison Webb in Sault Ste. Marie is a family physician whose practice includes obstetrics. Dr. Webb, too, is a NOSM University alumna who completed both her Comprehensive Community Clerkship and her residency in the community where she now lives.

“During my Comprehensive Community Clerkship, my first impression was that—professionally—Sault Ste. Marie was very supportive to work in,” Dr. Webb says. “Students were treated like real people, our time was respected, and everyone appreciated that we were there to learn. The staff were happy, and everyone I talked to liked working here. It seemed like a good place to practise, with lots of collegial support. I had a very positive experience.”

“In that year, I played in a curling league, golfed, and skied. It gave me that community experience I wanted to have. I found a lot to do in the community and was able to have a fun, fulfilling life outside of medicine,” she continues.

Although Dr. Webb met her husband in Sault Ste. Marie, it wasn’t a given that they would stay there. She says that she chose Sault Ste. Marie for her residency and career because she felt supported to work, learn, and grow in her practice, and because the city had a lot to offer.

Personal and professional lives are both major factors in where physicians decide to live and work, according to Carrie Stewart, Manager of Physician Recruitment and Retention at Sault Area Hospital. Local recruitment efforts are led by a recruitment and retention committee and are based on a tri-party agreement funded by the City of Sault Ste. Marie, Sault Area Hospital, and the Group Health Centre.

“Actions that the city takes—such as developing downtown, events, music, and restaurants, mountain bike trail expansion—all help bring doctors to Sault Ste. Marie. Our coordinated city-wide effort allows us to showcase our whole community, different practice options, and how our community is supportive and welcoming,” Stewart says.

Stewart’s job involves keeping connections to those completing medical education from Sault Ste. Marie as well as attracting physicians from across Ontario, nationally and even internationally. Prospective physicians’ community visits are individually tailored based on professional as well as community needs. Visits often include options for spousal employment, schools, daycare, recreational activities, and personal interests of the entire family.

“If I had to say there’s a secret sauce to recruitment, it’s open and honest communication with physicians,” she says. “It’s a long process of building connections to make sure the entire family is supported. It doesn’t happen overnight.”

In fact, some of the community’s greatest success comes from a placement very early in medical school, years before learners start their residency or practice: the NOSM University Summer Studentship Program. This program is often students’ first clinical experience and is open to first- and second-year medical students, as well as learners studying in a wide variety of medical fields, including nursing, rehabilitation studies, medical radiation, lab technicians, dieticians, midwifery, and respiratory therapists. For medical students in Sault Ste. Marie, it aims to offer diverse learning, including clinical exposure in both hospital and community placements such as emergency room and ambulance ride-alongs.

And it’s working. Stewart says learners placed in the city often come back to Sault Ste. Marie again and again for medical rotations. Over the last 20 years, 202 physicians have been recruited to the community. Impressively, 23% have completed NOSM University’s Summer Studentship Program.

A host of other options, including clerkships, electives, residency spots, and core rotations, also bring medical learners to the community. These options are central to recruitment, Stewart says. Over half of the 202 physicians recruited completed training in Sault Ste. Marie as part of a medical rotation.

“Even if medical learners are from the area, it doesn’t mean they are familiar with the medical community,” Stewart points out. “We aim for our learners to feel immersed.”

Still, physician recruitment and retention remain a challenge in Northern Ontario.

“The challenges for recruitment are now so great that it is all hands on deck,” says McNaughton. She points out that, while the Sioux Lookout Regional Physicians Services Inc. is the regional lead on recruitment, the Hugh Allen Clinic does much of its own recruiting. The Municipality of Sioux Lookout also plays a role, and the community is currently establishing a recruitment and retention committee.

Dr. Boyle agrees that recruitment is a challenge and says that it was largely local physicians who recruited her to Sioux Lookout. “Doctors end up taking on a recruiting role and chatting with residents and friends,” she says. “Everyone has such a varied practice, and there was lots of assistance in helping me envision what I wanted my practice to be.”

While challenges remain, both communities have made significant strides towards physician recruitment, due in large part to the positive experiences had by medical learners.

“To do this alone would be very difficult. I’d suggest going with a community-wide effort and building that relationship with NOSM University and bringing as many learners as you can. Create that warm welcome within the medical community and that will be your best marketing. They will be back, and they’ll spread the word,” says Stewart.

In Dr. Sarita Verma’s latest President’s Report, we turn our minds to the cornerstone of our work: Health Equity.
🔗 report.nosm.ca

Meet “Nsidwaamjigan,” ceremonial object created to open NOSM University convocations

On May 26, 2023, hundreds of people stood respectfully in silence, listening to the powerful sounds of Indigenous singing and drumming, waiting for the graduates to appear. Then, as the formal convocation procession began, a carved eagle’s head club emerged, leading the way.

The carefully-hewn head is the end of Nsidwaamjigan, the beautiful new ceremonial object that will now open all of NOSM University’s convocation ceremonies. Created by Algonquin artist Bradly (Dreamwalker) MacDonald, a Waskabe (Helper) based in North Bay, Nsidwaamjigan means “it recognizes achievements” in Anishnawbemowin, and the baton-like object was named by a group of Elders and Knowledge Keepers.

Learn how to pronounce Nsidwaamjigan

While Nsidwaamjigan holds some similarities to a ceremonial mace or staff, it is also distinct. For that reason, the Elders and Knowledge Keepers resolved that it should be referred to by its name alone: Nsidwaamjigan.

For the artist, taking on the creation this piece was an important way to honour healers.

“Everybody that comes to NOSM University is a healer,” says MacDonald. “The most selfless path is to be a healer. It’s a hard commitment to go on the journey. For many healers, they forsake all the different things they have in their lives and they focus on other people’s lives. The healers are extremely important.”

“Healers will see thousands upon thousands of faces,” he continues. “It takes a great deal of commitment. You give honour to the people being served as well as their future generations by the thousands.”

As MacDonald speaks about Nsidwaamjigan, it’s clear that the object is rooted in a philosophy of interconnectedness.

“Instead of saying that certain things have a soul and others don’t, we recognize that everything has a soul,” he says. “We have everything within us that connects us to everything. It’s a matter of how much we can find that and love that. Everything in life is sacred. The root of everything in life is the sacredness of how we treat things.”

Nsidwaamjigan is in the form of a tree, representing the tree of life. It features petroglyphs, which symbolize the sacredness of family connection. Petroglyphs “have been here since the beginning,” and harken back to “the oldest petroglyph, the Milky Way,” says Bradly. It includes four branches—black, red, yellow, and white—which represent the guardians of different directions of the Universe and of the Earth, and a balance rooted in all things. The eagle on the top of Nsidwaamjigan represents the sun, an awakening, the enlightenment of a person’s self, and the realization of what it means to be a healer.

The history of ceremonial maces is rooted in colonialism. The first maces date back to the Stone Age, and early maces were clubs used to physically protect the king’s person. In contemporary use, maces are present at many legislative assemblies—in fact, some governments cannot legally convene without the presence of the mace—and they represent authority. Canada is one of many commonwealth countries where a mace is used in the House of Commons to represent the authority of King Charles III.

Maces also have a longstanding use in convocation ceremonies. In Britain, the oldest extant maces date from the 15th century and belong to the University of Saint Andrews and the University of Glasgow. At a time when only the white male elite attended university, convocation ceremonies were gatherings of the upper-class, and maces had the practical purpose of guarding against attacks, as well as a ceremonial use.

In today’s academic settings, a mace is said to represent the independent authority of the university. In a North American context, they are primarily used at convocation ceremonies.

Bradly acknowledges the object’s colonial history and notes how the meaning is different for him, “This is a recognition of people’s honour. It is their honour that helps guide them and what they’re doing,” he says. “It’s an empowering tool rather than a controlling one. This is not a war club. It’s letting people know that they are to be honoured. We honour you, because you are a healer.”

Dr. Joseph LeBlanc, Associate Dean, Equity and Inclusion, liaised with the Elders and Knowledge Keepers about the use of the piece. “We wanted this piece to depart from the colonial role that maces have played at universities,” he says. “Nsidwaamjigan represents the spirit and intent of this institution. When we talk about anti-racism and anti-oppression, we need to arm our graduates with tools for those battles.”

Approximately 20 Elders and Knowledge Keepers received Nsidwaamjigan to its home at NOSM University during a pipe ceremony. After smudging, the Elders and Knowledge Keepers sat with Nsidwaamjigan and discussed what it means to them.

Although Nsidwaamjigan includes a carving of an eagle head, the Elders and Knowledge Keepers note that it is not an eagle staff, which is a distinct ceremonial object with an important role in some Indigenous ceremonies. The feathers on Nsidwaamjigan are from turkeys and grouse, both important and healthy food relations.

Dr. Sarita Verma, President, Vice-Chancellor, Dean, and CEO of NOSM University, is very enthusiastic about the piece. “Being a new university, we had a terrific opportunity to do something different, and we took it,” she says. “What’s more, I’m thrilled with the result. I think Nsidwaamjigan is a beautiful contemplation on what NOSM University is all about.”

Nsidwaamjigan is in the form of a tree, representing the tree of life. Its features include an eagle head, four branches, and petroglyphs.

An eagle’s beak is at the end of Nsidwaamjigan.

Turkey and grouse feathers are among the materials used in Nsidwaamjigan.

Artist statement

The base has four directional roots.

Each one is equal parts in importance and necessary in balance and growth.

Spiritual: Commitment remembering the sacredness of all life and honouring the beauty in all things around us.

The first breath of life, the promise never to forsake the beauty of this great mystery and always strive upward to make the future generations dance in harmony (like the leaves in the morning sun).

Mental: Commitment to dispel misconceptions and bring forth harmony by striving to the highest standards of integrity.

This agreement with ourselves is to honour each aspect of our growth with love and compassion.

Physical: Commitment to keep our bodies and hearts clear and in harmony with natural balance. We are also born into this sacred life as humane healers that assist in bringing forth balance to many that suffer.

Commitment to ease the suffering of others is the highest calling of humanity because it brings honour to your future generations.

Emotional: Commitment to experiencing the beauty of life and bringing back the original experience of wonder from before any trauma, be it very small or large.

Knowledge and great depth of feeling is essential in traditional understanding.

The figure of a being

At the center of the roots sits our story from the beginning of everything and that is where we see our future. Completely in balance and ready to fulfill the promises we give in the beginning.

On the opposite side are the fundamental petroglyphs of family and our guiding spirit.

Our inner power that constantly brings us gifts to face the world and journey forth as family in harmonious celebration.

The tree is the tree of life and the center of our understanding that all forms of life and visions of sacredness are equal and important, because we are all family.

From here we are open to our spiritual journey and understanding of Traditional Knowledge.

 

Dr. Allison Webb, NOSM University alumna, named Program Director, Family Medicine Obstetrical Surgical Skills Residency Program

NOSM University is pleased to announce Dr. Allison Webb as the incoming Program Director, Family Medicine Enhanced Skills Obstetrical Surgical Skills Residency Program, effective August 1, 2023.

A family physician in Sault Ste. Marie, Dr. Webb is passionate about providing maternity care in Northern Ontario and understands the unique training needs of NOSM University learners, as well as the challenging realities of practice within our northern communities.

Dr. Webb is an alumna, having completed her MD, residency, and the enhanced obstetrical surgical skills residency program with NOSM University. She is an Assistant Professor and has acted as a primary preceptor and competency coach to many Family Medicine residents at NOSM University. Dr. Webb looks forward to continuing this mentorship within her new leadership role.

On behalf of the NOSM University community, we extend an immense thank you to Dr. Peter Hutten-Czapski, outgoing Program Director. Dr. Hutten-Czapski’s commitment to NOSM learners is sincerely appreciated.

NOSM University