Dr. Roger Strasser
My research program over the last decade has focused on the workforce, social and economic impact of introducing a socially accountable medical school to Northern Ontario, a previously undeserved remote rural region of Canada. The research has demonstrated dramatic improvements in access to healthcare for people in the remote rural communities of Northern Ontario in terms of successful recruitment and retention of doctors who are skilled rural generalists. In one study, eight small rural communities that had 30 FTE vacancies before Northern Ontario School of Medicine (NOSM) reported only one FTE vacancy and reduced expenditure on recruitment at the time of the study. 95% of NOSM MD graduates have chosen generalist medical careers. 94% of the doctors who completed both undergraduate and postgraduate training in Northern Ontario are practising in the region. In addition, there has been substantial economic impact and social impact in this previously socially and economically under-resourced region. For example in 2017, $43 million government investment led to over $122 million of new economic activity that would not have occurred without the medical school, associated with around 800 new FTE jobs. This economic benefit flows to the small rural communities as well as the larger urban centres. The social impact included a sense of empowerment and optimism about the future in these communities.
The Remote Rural Workforce Stability Framework research program brought much of this Canadian research together with parallel research involving partners in four other countries that ultimately demonstrated a robust and effective framework for successful recruitment and retention of the remote rural health workforce. The World Health Organisation (WHO) is considering adopting this Framework as part of a global toolkit for implementing the WHO Policy Guidelines on increasing access to health workers in remote and rural areas through improved retention. Over the last 10 years, this dissemination has included: 17 monographs, including book chapters; 46 articles in peer-reviewed journals; 39 peer-reviewed conference abstracts; 90 invited international conference presentations, including 18 keynote addresses. In addition, I have provided consultant advice to many Canadian, Australian and international government and non-government organizations. In 2017-18 alone, I provided technical/expert advice to: Health Quality Ontario via the Health Equity External Advisory Committee and the Technical Working Group to Review Geographic Stratifiers; the Ontario Health Ministry as a member of Health Workforce Advisory Table; the University of Alabama Rural Programs; the United States Agency for International Development (USAID) Human Resources for Health 2030; the Organisation for Economic Co-Operation and Development (OECD); the World Bank; and the World Health Organization (WHO). In addition, I provided consultant advice in developing new medical education programs modelled on NOSM including: the Finnmark model of University of Tromso, Norway; the University of Waikato medical school proposal in New Zealand; the Scottish Graduate Entry Medicine (ScotGEM) program; the University of Ulster medical school; Cardiff University in Wales; the University of Fribourg in Switzerland; and Umea University in Sweden. I helped develop the Rural Road Map for Action endorsed at the Canadian Rural Health Summit in Ottawa, and currently I am drawing on the Remote Rural Workforce Stability Framework in advising the Norwegian government funded program “Rural Health for Peace” in Colombia.
2. Strasser R, Cheu H. The Needs of the Many: NOSM Students’ Experience of Generalism and Rural Practice. Can Fam Physician 2018; 64: 449-455. Part of an ongoing research on Generalism in medical education and health services, this paper confirms the importance of medical students undertaking clinical education in community clinical settings supervised by generalist practitioner role models.
3. Strasser R, Hogenbirk, Jacklin K, Maar M, Hudson G, Warry W, Cheu H, Dube T, Carson D. Community engagement: A central feature of NOSM’s socially accountable distributed medical education. Canadian Medical Education Journal 2018, 9(1): e33-e43. This article summarizes much of the research that has explored the impact of the educational innovations implemented by the Northern Ontario School of Medicine.
4. Strasser R. Will Australia Have a Fit-For-Purpose Medical Workforce in 2025? (Invited Perspective) Med J Aust. 2018. 208 (5): 198-199. In this paper, I have distilled insights from many years of research into health services and health workforce with particular focus on the education and training system producing the right mix and distribution of doctors to address population health needs in all parts of Australia.
5. Mian O, Warry W, Strasser R. How underserviced rural communities approach physician recruitment: changes following the opening of a socially accountable medical school in Northern Ontario. Can J Rural Med 2017; 22 (4): 139-147. This article reports research into the success of rural communities in recruiting doctors who have undertaken their education and training in these or similar communities.
6. Hogenbirk JC, Robinson JR, Hill ME, Minore B, Adams K, Strasser RP, Lipinski J. The economic contribution of the Northern Ontario School of Medicine to communities participating in distributed medical education. Can J Rural Med. 2015; 20(1): 25-32. Part of economic impact research, this paper presents the benefits to rural communities of rural education.