NOSM residents to train in NAN communities

Left to right are Matawa First Nation Management CEO David Paul Achneepineskum, NOSM Dean Dr. Roger Strasser and Eabametoong First Nation Chief Elizabeth Atlookan signing agreement establishing the Remote First Nations Family Medicine Residency Stream.

Four-year return of service ensures improved family medicine services

The Northern Ontario School of Medicine (NOSM), Matawa First Nations Management and the Eabametoong First Nation have signed an agreement to create a new Remote First Nations Family Medicine Residency Stream.
The new residency stream will allow medical school graduates to undertake postgraduate family medicine training in a remote First Nation community in Northern Ontario with a return of service commitment to serve in Eabametoong or another Matawa community for four years.
“We were first approached in the spring of 2016 by the Matawa First Nations tribal council because they were in the process of building a health co-operative and one of their ideas was to put in place a residency program that would serve Eabametoong and then grow to serve other Matawa communities,” said Jennifer Fawcett, NOSM’s director of post-graduate education.
“Eabametoong expressed a desire to do things differently in terms of physician services in the community, so through the work of the community members, health director Paul Baxter, our office, and NOSM, we came up with the idea of a residency program,” said Paul Capon, a political advisor for Matawa First Nation Management.
The residency stream began as a pilot in July 2017 with funding approved by the Ministry of Health and Long-Term Care and the selection of the first resident, Dr. Deepak Murthy, an international medical graduate from India.
The residency stream will accommodate two positions annually with the two more medical school graduates commencing this coming July. Residents undergo training in Thunder Bay initially, but will spend increasing amounts of time in Eabametoong and other Matawa communities.
Following the completion of their two-year residency, the docs will serve full-time in Eabametoong or another Matawa community in compliance as part of a four-year return of service agreement with the Ministry of Health and Long-Term Care.
When fully implemented, there will be four residents in the program every year – two first-year residents and two second year residents.
Graduates accepted into the First Nations residency stream undergo additional training in addiction medicine and cultural safety to prepare for practice in a remote Indigenous community.
Graduates of the residency stream will be equipped to “practise medicine in a way that is culturally appropriate, trauma informed and very interdisciplinary in sometimes very disadvantaged circumstances,” said Capon. They will learn to “think on their feet and out of the box.
“After going through this program, they will be able to work anywhere in the world. They could join Médecins Sans Frontieres or serve in the army. They will have a skill set that will make them very adaptable for overseas missions and crisis-type situations.”
Dr. Murthy trains with his preceptor, Dr. Claudette Chase, an experienced rural family physician with many years of experience serving Eabametoong.
The application process for the residency stream is unique, said Fawcett.
“Normally, candidates for residency programs participate in one interview. For the remote First Nations residency stream, they participate in two rounds of interviews. The first interview is with a selection panel consisting of family medicine faculty, together with members of the First Nation community. It’s to make sure the candidates meet the benchmark requirements for a family medicine resident. Candidates who meet those qualifications then proceed to a second interview with strictly community members in Eabametoong or another Matawa community, so it’s the community that makes the final decision on who will be admitted to the program. No one from NOSM sits on that panel.”
Eabametoong, one of the larger Matawa communities with a population of approximately 1,500, was selected as the initial site because it has the critical mass and facilities to host a full-time physician, but ultimately, the hope is to expand to other Matawa and Nishnawbe Aski Nation communities, said Fawcett.
Dr. Murthy came to Canada with his wife, who is also a doctor, approximately five years ago. Both had served in the Indian Army as physicians “in remote communities under adverse conditions.”
Dr. Murthy’s wife matched to a residency program in London, Ontario, and he opted to enroll in a fast-track nursing program for international medical graduates, thinking he would be too old to secure a residency spot himself.
“But Canada was very fair about it, and when my wife matched to a residency program, I thought maybe I should give it a shot,” he said.
As luck would have it, he had already spent some time in Eabametoong, having accompanied his wife on a one-week locum there. It was before the new NOSM residency program was even announced, so he had some familiarity with the community when the time came to apply.
Murthy is older than the average resident, having just turned 60, but he’s grateful for the opportunity to practise medicine in Canada and looking forward to serving the people of Eabametoong.

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