When NOSM University opened its doors in 2005, it premiered a new model of distributed, community-engaged medical education in Northern Ontario. Established with an explicit social accountability mandate to improve health equity, NOSM University educates future physicians, dietitians, and health-care professionals for practise in rural, Northern, Francophone, and Indigenous communities.
As part of NOSM University's social accountability mandate, researchers began tracking students and graduates to understand the long-term impacts of the model by conducting a longitudinal research study that is now internationally renowned. The study, called the Health Education and Workforce Impact study (HEWIS), surveys medical students in the first and fourth years of the MD program to understand their preferences, reasons for attending NOSM University, where they want to practise, and more.
"It's designed to help us understand not just the decisions that they make in their career, but why they make them," says Dr. Brian Ross, NOSM University Professor.
In May, Dr. Ross, along with co-collaborators Margaret French, and Drs. Sarah Newbery and Erin Cameron, published findings from 20 years of the study. Their results show that 51.3 per cent of NOSM University graduates have stayed in Northern Ontario to practise, and among graduates who stayed, the majority have chosen family medicine. The percentage of NOSM University MD graduates choosing family medicine is among the highest of all Canadian medical schools and is dramatically higher than the percentage of Canadian medical students who choose family medicine on average.
"In their first year, most students express a desire to become family doctors, and we successfully retain the vast majority," says Dr. Ross. "However, among those who initially indicate an interest in other specialties, approximately 40 per cent ultimately choose family medicine.
"If Canada has a family medicine problem, we have a solution," he continues.
Dr. Ross partly attributes these high rates to compulsory rural community placements throughout Northern Ontario. The mandatory third-year Comprehensive Community Clerkship requires medical students to spend approximately eight months living and learning in a Northern Ontario community and undertaking clinical experience anchored in family practices.
The tracking study offers valuable insights into what strategies are effective and how NOSM University is fulfilling its mandate. It also sheds light on the factors influencing whether graduates of NOSM University's programs remain in Northern communities after training or choose to leave. Dr. Ross says that the data can also be used to attract prospective students and medical residents and strengthen retention across all specialties.
"Much of this evidence demonstrates that our model works. It achieves its goal and is worth the investment due to its success," adds Dr. Ross.
The research team is also collecting data on medical residents physicians who have completed their MD degrees and are enrolled in mandatory specialty training, such as family medicine which is currently being prepared for analysis. Dr. Ross hopes this information will provide further insights into how retention rates can be increased across the North. "The essence of the tracking study is to understand what graduates do and why, enabling us to design programs and processes that will retain more doctors in Northern Ontario where they are needed."
To learn more about HEWIS at NOSM University, visit arcandcentre.ca/research/merlin.
