The Health Professional interviewed two faculty members from the Northern Ontario School of Medicine to learn about some of NOSM’s unique features. Many thanks to Sue Berry, Interim Associate Dean of Continuing Health Professional Education at NOSM, and to Christopher Winn, Assistant Professor, School of Rehabilitation Science at McMaster University and NOSM, and Coordinator of the Northern Studies Stream (Physiotherapy), for their time and insights.

1. What is unique about the Northern Ontario School of Medicine?

NOSM is the first Canadian medical school to be hosted by two universities (Lakehead and Laurentian), with main campuses 1,200 kilometres apart (in Thunder Bay and Sudbury) and with more than 70 distributed community teaching and research sites across northern Ontario.

NOSM is uniquely grounded in the special features of northern Ontario, including:

  • Rural and isolated populations with vast distances between communities
  • Diverse cultures (e.g. First Nations, Francophone, Métis)
  • A variety of illnesses, injuries and health status patterns, such as higher rates of heart disease, diabetes and some cancers than in other parts of Canada (Northwest LHIN residents have the highest rate of diabetes mortality of all 14 LHINs)
  • A higher proportion of the population who smoke daily, are overweight or obese, and are physically inactive
  • Lower rates of medical doctor visits and influenza immunization

2. How does the Northern Ontario School of Medicine use cross-disciplinary team work in educating MDs and other health professionals?

NOSM’s goal is to graduate medical and health professionals who are generalists, as well as being innovative, resourceful, self-reliant, culturally competent, and fully acquainted with the rigours and rewards of health professional practice in northern, remote and culturally diverse settings. We are committed to a continuum of learning, research and interprofessional practice.

NOSM’s students and faculty study and practise in communities throughout northern Ontario rather than within a traditional medical school building. Partnerships with two northern LHINs as well as hospitals and health centres in urban and small rural communities throughout the North result in more than 70 distributed teaching sites where students work and learn alongside local physicians and other health professionals.

Medical students spend most of their first two years on campus in Thunder Bay or Sudbury, then are placed in a variety of northern community settings for their third year and return to campus and regional hospital rotations during their fourth year. When they have completed their MD requirements they will have spent close to 40% of their time studying and working in communities in northern Ontario and will have developed a special understanding of the challenges and attractions of life in the North.

3. What programs does NOSM offer rehabilitation students?

Through partnerships with other Canadian universities, NOSM offers rehabilitation students (audiology, occupational therapy, physiotherapy and speech and language pathology) as well as dietetic interns and physician assistants the opportunity to complete clinical placements in northern Ontario where they gain insight into the unique aspects of rural and remote practice. In addition, through a collaborative relationship with McMaster University, the Northern Studies Stream program allows occupational therapy and physiotherapy students to complete an entire semester of academic study on the NOSM campus in Thunder Bay.

In their placements in community settings such as hospitals, Community Care Access Centres, private practice clinics and First Nations health centres, students have opportunities to learn from, with and about established local health professionals. Chronic shortages of health providers in rural and remote regions often require the health provider and their student to fulfill the role of not just their own profession, but others as well. Consequently, this learning environment produces more resourceful and better-rounded graduates than if their practicum had been in a setting featuring only their own discipline.

Another benefit of NOSM’s distributed learning model is the enhanced opportunity for interprofessional collaboration; students from different professions will often have placements at the same time in a small community, where they work closely together and often live together, too. As a result they develop a solid understanding of what is involved in one another’s practice and an ability to work cooperatively with a wide range of health care professionals.

4. Is technology affecting health care delivery in northern Ontario?

Emerging technologies are making a significant difference to the delivery of health care in northern Ontario. Access to the Internet enables videoconferencing linkages and consultations between health professionals in different locations and between health professionals and patients throughout the North.

Health professionals are using the Internet for professional development and to discuss specific cases or share learning opportunities with one another without having to actually get together in the same physical location.

It has become much easier to provide the right care at the right time with technological communication capabilities. For example, someone who is receiving rehabilitation after a stroke might be assessed via webcam by a physiotherapist in a distant community and have their exercise regimen adjusted to permit further recovery – all without having to travel hundreds of miles. This creates not only cost savings to the health care system, but the increased level of convenience improves both patient and health provider satisfaction.

5. The multidisciplinary team approach in health care

Increasingly popular are multidisciplinary models of health care delivery, where a variety of health professionals work together to provide the medical and rehabilitation supports and services needed in the community. Students of NOSM will be uniquely suited to this practice approach because of the interprofessional learning opportunities they experienced in northern Ontario and the collaborative skills they mastered during their medical and rehabilitation education at the Northern Ontario School of Medicine. ggg