The Canadian Medical Association detailed the country’s physician shortage in a May statement, noting that Statistics Canada, the nation’s statistical office, reported in 2019 that approximately 4.6 million Canadians did not have regular access to a primary care provider.
Since that statement, a report on the Canadian Health Workforce Network website says that, although rural Canadians make up 22 percent of the nation’s population, less than 10 percent of the country’s practicing physicians work in these communities. Overall, Canada averages one doctor per approximately 450 residents, a ratio that reaches one in 3,000 in some remote areas.
To address the need, the Ontario government announced it would add 160 undergraduate seats and 295 postgraduate positions to its medical schools over the next five years. In particular, the Northern Ontario School of Medicine (NOSM) will gain spots for 30 undergraduate students and 41 postgraduate students.
The significance? NOSM works to “maximize the recruitment of students who have lived in Northern Ontario and/or students who have a strong interest in and aptitude for practicing medicine in northern urban, rural and remote communities.”
Professor Hugh Bartholomeusz, OAM, RFD, MBBS, FRACS, Vice Chancellor of Oceania University of Medicine (OUM) based in the South Pacific, comments that:
“Medical educators know that students who are aligned to certain communities by birth or upbringing are more likely to return after medical training.”
The shortage of doctors is not unique to one country or region. It is a global problem that is not new. In fact, OUM’s founding in 2002 stemmed from the need for more doctors in Samoa and other areas of the South Pacific. Over the years, its reach has expanded to students from more countries that need additional providers, while also bringing the study of Medicine to those with limited access to conventional medical schools.
“Since long before Zoom classes became the norm during COVID, our hybrid curriculum made medical school available to qualified individuals who simply could not relocate for four or five years in order to attend medical school,” says Professor Bartholomeusz. “Many of our students have had medical school in the back of their minds since they were children, but life intervenes. Even though many of our students were accepted at conventional medical schools, their work and family responsibilities simply made that dream unattainable,” he adds.
Could this also make medical education accessible to more Canadians? Especially in underserved or remote communities far from medical school campuses?
“OUM’s pre-clinical curriculum is delivered via live, interactive virtual classrooms during the first two years, guiding students in their mastery of basic sciences and system-based material,” says Ontario-based Associate Professor Nicolette McGuire, PhD, OUM’s Associate Dean, Student Welfare, who joined the faculty in 2012 as an Endocrine System instructor. “Learning the basic sciences in this distance-learning environment during their first two years provides more individuals with the opportunity to study Medicine and ultimately puts more licensed physicians into the medical community,” she says.
For hands-on training during clinical rotations, OUM has a broad network of hospitals and clinics in Australia, the US, and through its primary teaching facility in Apia, Samoa at the country’s National Health Complex. All three countries suffer from physician shortages and have added OUM graduates to their medical communities. An uptake in Admissions inquiries from prospective Canadian medical students indicates that the OUM curriculum model is appealing to those seeking their MD.
“The first-hand experience I gained completing OUM clinical rotations in Samoa gave me a great foundation for rural and remote residency training and now to work in rural Canada as an attending,” says Sonja Bruin, MBBS, CCFP-EM, OUM Class of 2014 and a Family Physician in rural Manitoba, Canada. “Working in a variety of different areas throughout Samoa’s islands, assisting with surgical procedures, performing deliveries, working in emergency, pediatrics and internal medicine departments really allowed me to hone my skills and made me comfortable working in remote settings. The rewards of working in rural settings are many. The close community relationships you establish are rewarding and the environment promotes autonomy and further enhancement of clinical skills.”
Making medical school available to students in rural settings, in addition to providing hands-on clinical training in those locations, encourages them to remain near their home communities which typically need services, says Dr. McGuire.
“The rural medicine model is working in Australia and we’re hoping that Canada also will benefit,” she adds.