NOSM’s community-engaged learning model has grown into something extraordinary

Roger Strasser, Founding Dean, Northern Ontario School of Medicine.


Born out of a widespread community movement to build a sustained network of physicians and health-care professionals in northern communities, the Northern Ontario School of Medicine (NOSM) was established in 2005 as the medical school in the North for the North.
NOSM was founded with an explicit social accountability mandate − meaning that the school’s education, research and service activities are directed toward addressing the priority health concerns of the peoples and communities of Northern Ontario. To achieve this, we designed a new model of medical education, grounded in the North.
Even though NOSM’s history is relatively short, our unique distributed, community-engaged learning model has grown into something extraordinary. Through interdependent partnerships that we have developed across the whole of Northern Ontario, communities are engaged actively in educating medical students and shaping the future of health care in their region. We work with them to understand what they are expecting of their physicians, and they help us identify what is reasonable and achievable through our curriculum.
This unique learning model is one of the reasons NOSM has become an international leader in rural and socially accountable medical education.
We view the entire geography of Northern Ontario as our campus. NOSM involves more than 90 communities, where our students, residents and other learners complete part of their clinical learning.
Students in our MD program spend four weeks in an Indigenous community in their first year, and another two four-week integrated community experiences in small Northern Ontario communities in second year. The comprehensive community clerkship sees our MD students living and learning in one of 15 small communities, excluding Thunder Bay and Sudbury, across the region for the entirety of their third year, allowing for more robust continuity exposure to the clinical demands as well as the professional and personal rewards of generalist practice in rural and remote settings.
And it’s not just about the doctors. NOSM participates in the education of a range of other members of the health workforce, including registered dietitians, medical physicists, physician assistants, physiotherapists, occupational therapists, speech language pathologists and audiologists. Learning in the community is about learning in context, and learners in all our programs have the opportunity to complete clinical placements in communities across the North.
For this to be practical, we rely heavily on electronic communications. Our digital Health Sciences Library is an essential piece of the puzzle, and with internet access, learners have access to educational resources and information equal to those available in an urban teaching hospital.
The distributed community-engaged learning model works in producing high-quality physicians and other health workforce, and contributes to improving access to care and the health of Northern Ontarians. In fact, 92 percent of NOSM medical students grew up in Northern Ontario, while eight percent come from other remote and rural parts of Canada; 62 percent of graduates choose predominantly rural family practice training, and of those graduates from the MD program who also completed their residency in Northern Ontario, 94 percent choose to practise in the North, including about one third in rural and remote communities.
Because so many of graduates are completing their residency and practising in Northern Ontario, our model is helping build professional networks in the North. Many graduates are now faculty members and an increasing number have taken on academic leadership roles at NOSM.
We are also in the last stages of approval to start a masters of medical studies, a distributed community-engaged learning opportunity for physician faculty. This program will allow physicians to undertake academic training without moving to a larger centre. They can pursue academic career progression by doing research in their own community and clinical setting.
When NOSM was founded, we didn’t take an off-the-shelf model and try to transpose it. We started with the Northern Ontario context and developed our own model of medical education for Northern Ontario, and it’s working, thanks to the hundreds of health professionals who serve as clinical faculty members for students, and the people of Northern Ontario, who have welcomed our learners into their communities and into their homes. n

Dr. Roger Strasser is the founding dean of the Northern Ontario School of Medicine.

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