Northern Ontario facing a crisis in health care: Top doctor

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Dr. Sarita Verma counts her successes one by one — all 400,000 of them.

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Verma, president, vice-chancellor, dean and CEO of NOSM University, says about 400,000 residents of northern Ontario have access to a family doctor because of the work the Northern Ontario School of Medicine has done since its inception in 2005.

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In 17 years, the school has graduated nearly 1,000 new physicians.

“If they stay to do their residency, almost 90 per cent of them stay in Northern Ontario. No other medical school can say that,” Verma says. “The long game here is that NOSMU is probably the biggest factor in addressing physician shortages in Northern Ontario.”

That means about 900 new doctors are scattered throughout 90 communities in the north, which is good news; however, serious health inequities remain in Northern Ontario. As Verma argues, “there is a magnification of all the problems in health care accessibility in Northern Ontario.”

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For example, residents may be forced to drive for hours to seek care. Often, there is no cell service along the way, putting people in danger, especially during the winter months.

“We have four times the mental health and addictions you would see in the rest of the province,” she says. “You also see worsening chronic diseases.”

Verma says access to women’s health care teams remains a serious barrier, as there is a shortage of obstetricians.

“People have to go to urban communities to deliver their babies,” she notes. “We have challenges with Indigenous health because of remote communities, and we have poorer resources.”

Verma says health care in Northern Ontario is in crisis. There are not enough doctors, nurses or other personnel to run facilities and there have been instances where emergency rooms have been temporarily shuttered.

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Medical school trying to expand

But NOSMU – which is based in Sudbury and Thunder Bay – is trying to level the playing field by expanding its offerings, encouraging more physicians’ assistants, and growing its dietician programs. Verma says it is also looking into partnerships with other universities to offer education in rehabilitation, such as physiotherapy.

But she says the school will always remain, first and foremost, a place to train doctors.

“We’re doubling the size of our medical class. We started at 56 per year and we’re going up to 108, and we’re doubling the size of our residencies — we’re going from 60 to 123,” Verma says. “The future for us is an open book. We have plans over the next two years to develop new programs, even dentistry and pharmacy. We’re really interested in anything where there’s a need and where there are jobs.”

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NOSMU is being celebrated by the Ontario Medical Association (oma.org) as a success story in a new video series, Centered on Care. The series examines innovations in health care and looks at how “Ontario’s doctors are driving positive health care change across the province.”

NOSMU has the honour of launching the series with a three-minute video (tinyurl.com/bdct9dka) highlighting the challenges northerners face, as well as the ways in which the medical school has been filling gaps and increasing access to care.

As the OMA notes, “more than 800,000 Ontarians live in more than 90 communities in Northern Ontario, covering 90 per cent of the province’s geography. This massive region needs 360 additional doctors just to keep up with the demand. NOSMU is working to solve the physician workforce issue and make sure everyone in northern Ontario has a family doctor.”

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Verma says about 50 per cent of NOSMU graduates choose to pursue family medicine.

“That’s quite amazing, given the fact it’s about 22 per cent in the rest of the country,” she says. “There’s a concern about the decline in interest in family medicine, but that’s not the case at NOSMU.”

Medical school a success

The school is a success story and has found its flow state. Verma says the entire program flow at NOSMU works smoothly.

“Everything from admission right into practice has been really successful,” she offers. “I would say we’re one of the biggest success stories in Canada, in terms of health human resources, so that we’ve been approached by Simon Fraser University, Cape Breton University, Toronto Metropolitan University and York University — they’re all opening medical schools. They want to know what our secret sauce is, and truthfully, it’s actually pretty remarkable.”

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Verma says the school has a “fantastic” admissions process and “more than 90 per cent of our students come from the north.” She says the school seeks out students who want to work in rural or remote settings. When students train in northern communities and experience cultural diversity, they are encouraged to stay and set down roots.

“We have a focus on rural family practice and rural generalism,” she explains.

As Verma notes, students at NOSMU are as diverse as the landscapes of Northern Ontario — 16 per cent are Indigenous (compared to three per cent of medical students in other parts of Canada) and 25 per cent are Francophone.

Verma also attributes NOSMU’s success to the style of instruction and learning students undertake. From year one, students are immersed in various health-care settings in rural and northern locales, including Indigenous communities.

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“They go into a four-week immersion in first year,” she says. “They’re not sitting in classrooms; they’re out there in the communities. They’re very successful because they’re not sitting in a classroom listening to a lecture. For part of their training in third year, they spend eight months in a community, learning how to be a doctor.”

It has only happened once, but Verma recalls a situation in which a student was placed in a small community outside Sioux Lookout. She was alone when called to act.

“She was the only person there when a woman showed up and said, ‘I’m having a baby and it’s now.’ She delivered the baby,” Verma reminisces (that infant is now a healthy 12-year-old).

Immersion learning often means students need to learn to think on their feet, but Verma says NOSMU believes the hands-on approach is the best way to learn medicine.

”They are often the only person there, taking care of a motor vehicle accident or something with the physician,” Verma says. “They feel very competent going into practice.”

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