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The Thunder Bay Chronicle Journal's Sunday, August 28 issue, has four special stories about the importance of the new Northern Ontario School of Medicine and its first class of students that will be starting on Monday. The four stories include:

• Ready to operate - presenting some of the work that went into getting NOSM to its present position.
• Med school demographics - providing some interesting statistics about the students making up the first class of NOSM including the fact that 6 of the 56 students are Aboriginal.
• Med school good for local economy - discusses the financial impact that NOSM has on the local and regional social and economic environment
• Med school dreams come true in hometown - profiles how one medical student from Thunder Bay worked hard to be among the first class of students.

Copies of the full stories follow ...

http://chroniclejournal.com/story.shtml?id=28657

Ready to operate

By Stephanie MacLellan - The Chronicle-Journal

August 28, 2005

Years of planning, dreaming and preparation have led up to Monday.

That’s when the first 56 students at the Northern Ontario School of Medicine will arrive at Lakehead University for the first time as a class.

It’s the first medical school to open in Canada in 36 years, since Memorial University of Newfoundland added their school of medicine in 1969.

“We’re absolutely ecstatic,” said Dr. Roger Strasser, the school’s founding dean.

“We’ve had teams of people working very hard over the last few years on various elements, and they’re all coming together into the complete picture of the school.”

The work started a few years ago, but the idea of bringing a medical school to Northern Ontario has been debated for decades.

“If you go back, you can find references in the ’70s to initiatives (to build the school),” said Lakehead University president Fred Gilbert.

Discussion about a northern med school began in earnest after Dr. Robert McKendry’s report to the Ontario Ministry of Health in 1999.

Among his recommendations for improving Ontario’s supply of doctors, especially in rural areas, was that the province consider “a new medical school in rural medicine with a specific mission to attract students who are interested in working in the province’s small, rural and remote communities.”

That recommendation was hotly debated over the next two years. Committees of local representatives appeared before a task force, struck by then health minister Elizabeth Witmer, to advocate for a new Northern Ontario school.

It was April 2001 when the government announced the creation of the Northern Ontario Medical School, as it was called at the time, to be based at Laurentian University in Sudbury with a satellite campus at Lakehead University in Thunder Bay. Later on, the Lakehead site gained equal status as a partner.

After years of speculation, the convergence of a doctor shortage, government commitment and growing acceptance of different teaching models helped create the perfect situation to make the school a reality, Strasser said.

It’s already having a ripple effect for doctor recruiting efforts in the North, he said.

“Already in Thunder Bay and Sudbury, recruiters have been finding it easier to attract physicians because there’s a medical school coming, and those physicians are interested in the opportunity of being involved in the medical school in one way or another,” he said.

• • •

In the early days of planning, the med school came under fire from some who questioned the financial logic of building a new school.

The initial funding from the Ontario government was $95 million — $62 million for start-up and initial operating costs, and $33 million for building construction. So far, the school is on budget, Strasser said.

The government also pitched in for the school’s bursary fund, to help students pay for their education. The government will match donations up to a total of $5 million.

Critics told the Canadian Medical Association Journal that it would be a waste of money to build a rural school to teach students when the same education could be enhanced in the curriculum at existing med schools.

Not so, Strasser says. He learned this first-hand as head of the Monash University School of Rural Health in his native Australia.

Northern Ontario has similar health care needs, he said, and students don’t get a true sense of how to meet those needs in the city.

“Because of a combination of geography and climatic issues, and the cultural and social issues, and the different spectrum of health problems, there needs to be a different set-up, a different model of health-services delivery from what you have in the big cities,” he said.

“You can’t take a health service model in Toronto, and miniaturize it and transplant it to Northern Ontario.”

Then there are more practical considerations, said David Hawkins, executive director of the Association of Faculties of Medicine of Canada.

“One reason not to bring a student from Sudbury to Ottawa is because they become enmeshed there, and they might not come back,” he said.

“I think Canada needs both models — building new schools, and expanding existing programs.”

• • •

To train physicians to address uniquely northern concerns, there needed to be a new curriculum, said Dan Hunt, vice-dean of academic activities.

“There is a different standard of decision-making (for doctors) based on the resources available in a community,” he said.

“There are no easy answers. . . . That’s one of the reasons people trained in large urban settings don’t practise in small communities. They haven’t been exposed to these issues, and it’s pretty darn scary.”

The curriculum was built from scratch over the last three years, by academics from the med school working with doctors who serve Northern Ontario communities. They also looked at research on teaching methods from other schools in Canada and around the world.

What they came up with was a curriculum that teaches students in groups of eight using a series of six-week scenarios that mirror situations doctors often encounter in northern communities.

Through that, they learn the fundamentals of medicine and clinical skills required by accreditation bodies, and the specific health, social and practical concerns that make health care in the North unique.

For example, instead of a lecture on immunology, the students would read a case about a patient in a Northern community with an auto-immune disease. From the case, the groups would determine what they need to learn about the situation: everything from, “How does the immune system work?” to “What health facilities are available in the patient’s community?”

Each student researches a different question, and they return to the group with their findings. That way, the students educate each other, then present their findings to the faculty member serving as the group facilitator.

“Each of these cases demonstrates . . . what kind of decision making has to go on,” for communities of all sizes in the North, Hunt said. “It’s very contextual-related.”

Research shows students learn just as much in small group settings as they do in traditional lectures, Hunt said. Generally, they also enjoy classes more, because they feel a greater sense of control and involvement in what they’re learning.

In the first year of the program, students will apply what they’ve learned during a four-week placement in a First Nations community. There will be other opportunities for community placements as they work through the program, Hunt said.

While they’re away, they can still communicate with their classmates and professors using the Internet and video conferencing to share what they’ve learned.

Many of the lectures will be taught at both campuses using tele-conferencing technology, and all the course materials will be distributed using the Internet.

Every student will have access to a laptop computer, on loan from the school, to help them with their studies.

That will prepare them for working in the North, where doctors often use tele-health to help patients, Strasser said.

“There’s much more ready access to consultation and advice from specialists than there was before,” he said.

The technical components, case format and First Nations placements were tested in pilot projects using other students in the last year.

The curriculum for the third and fourth years of the program will be developed as students and staff learn what works and what doesn’t, Strasser said.

At the same time, the research opportunities at the school can also help the North. There is already research going on through the universities, the Northern Ontario Cancer Research Foundation and such, but the school will build on that, Strasser said.

“It will have a strong emphasis on addressing the particular health problems that are more prevalent in the North,” he said. That includes occupational injury and disease, cardiovascular disease, diabetes and the health problems known to strike aboriginal communities.

Since the research will be done here, the findings will show what will really help the people who live here, Strasser said.

“Already, the school has been amazingly successful at recruiting faculty members . . . who are world-class research scientists, well-established in their careers,” he continued.

“They’ve chosen to come to Northern Ontario to continue their research careers because of the opportunities, and the excitement of being part of the new medical school.”

• • •

A few days before student orientation begins, the whole thing feels almost anti-climactic to Fred Gilbert, after all the hard work that was done to get to here.

“It’s almost an expectation, rather than something that you want to celebrate,” he said. “Although when it actually occurs . . . it will be pretty special.”

But he agrees the med school’s part in Lakehead University is just beginning. There are possibilities for partnerships with other programs at the school that still have to be explored, both for research and academic programming.

“Some of our people in biology, kinesiology, psychology, nursing, social work — all of those programs will have some direct interfaces with the medical school,” he said.

He also speculates there might be more student interest in pre-medicine courses at Lakehead.

“That being the case, there might be some interest in putting together a more designed (pre-medicine) study,” he said.

As Hunt looked towards the med school and its future, two weeks before orientation was to start, his thoughts were on the biggest part still thing missing for him: the students.

“Once we have students, it will be so much easier to focus on their growth, and their learning, and helping them move through the curriculum,” he said.

“Right now everything’s theoretical. . . . The students become part of the solution.”

http://chroniclejournal.com/story.shtml?id=28658

Med school demographics

By Stephanie MacLellan - The Chronicle-Journal

August 28, 2005

When the Northern Ontario School of Medicine recruited students for its charter class, one goal was to assemble a student body that reflected the population of Northern Ontario.

Here is the final demographic breakdown of the first class of med students.

Total number: 56 (32 at Laurentian University, 24 at Lakehead University)

Lived in Northern Ontario for 10 or more years: 78 per cent

Lived in rural southern Ontario for 10 or more years: five per cent

Lived in rural communities in the rest of Canada for 10 or more years: 10 per cent

Lived in northern, urban communities in the rest of Canada: two per cent

Aboriginal: 11 per cent (six students)

Francophone: 18 per cent

Male: 34 per cent

Female: 66 per cent

Age range: 21 to 44

Average age, as of July 2005: 27.6

http://chroniclejournal.com/story.shtml?id=28659

Med school good for local economy

By Stephanie MacLellan - The Chronicle-Journal

August 28, 2005

The direct economic impact of the Northern Ontario School of Medicine on Thunder Bay is not expected to be known until the school releases its payroll figures.

But the potential for good economic spinoffs for the region is enormous, according to the president of the Thunder Bay Chamber of Commerce.

“It would be like if we opened up another mill or a mine here,” said Mary Long-Irwin.

So far, the school has hired a combined total of 350 clinical faculty members who will work with students throughout the North. There are also 22 employees at the senior leadership level, at both schools.

At the Lakehead University campus, 57 full-time and part-time staff have already been hired, including five full-time faculty.

The school is still recruiting faculty for the medical sciences and health sciences divisions.

“That’s significant, because those are jobs that have a definite impact in our community,” Long-Irwin said.

“Whenever somebody gets paid and they live here, they’re spending their dollars here, and that’s huge.”

Many of those hired came from out-of-town, which means added spending on real estate and other home expenses, she said.

Local businesses could also benefit from serving the laboratories and other facilities at the med school, like dry cleaners and lab supply companies.

There are also long-term possibilities for new business developments in the research and technology sectors as research funding starts to flow into the school, Lakehead University president Fred Gilbert said.

“There will be an attraction to business interests to be associated with what’s going on with the medical school,” he said.

That could include biotechnology or pharmaceutical companies.

“You can always count on some interest from the pharmaceutical companies, basically because they hope to be able to take advantage of not just the research, but the potential for clinical trials that can accrue,” Gilbert said.

Depending on the type of research conducted at the med school, there could also be opportunities for faculty to develop patents that could have business applications for the area, Gilbert said.

http://chroniclejournal.com/story.shtml?id=28656

Med school dreams come true in hometown

By Stephanie MacLellan - The Chronicle-Journal

August 28, 2005

Nicole St. Jacques’ education in Northern Ontario health care started at an early age.

As a three-year-old, she suffered third-degree burns, and had to make repeated trips from Thunder Bay to Toronto for treatments and surgeries.

“It was very costly on my family, and emotionally stressful,” she recalls, sitting on a bench on the Lakehead University campus.

“I remember my mom and my doctor were fighting with the government, trying to get these forms in, and they told us they weren’t going to reimburse us (for travel costs.)”

Eventually, Easter Seals helped with the costs, but the ordeal is still fresh in St. Jacques’ mind.

“It was just a big mess, and I know people deal with that every day here,” she says. “People really do need help here.”

Now 23, St. Jacques is ready to help. She’s one of 56 students in the charter class at the Northern Ontario School of Medicine, and she plans to use her training to practise medicine in Northwestern Ontario.

“It’s almost surreal,” she says. “I had worked so hard towards this goal, and realizing it was just surreal, it was exciting.

“It will be an amazing experience.”

Nearly 2,100 students applied to the med school this year. Of those, 396 were interviewed in Thunder Bay and Sudbury this spring before the final 56 were selected.

Students were selected for interviews based on grade point average and an application questionnaire, but also on personal background. Students who lived in Northern Ontario, or other northern or rural communities in Canada, were scored higher.

St. Jacques was born and raised in Thunder Bay. Growing up, she was always interested in science and medicine. She thought she would be a veterinarian when she grew up.

But at age 16, while she was student at Hammarskjold High School, she changed her mind. She wanted to be a doctor.

“I want to work with people,” she says.

When she graduated, St. Jacques registered at Lakehead University to study biology. Then she switched to applied biomolecular science, which teaches biotechnological, diagnostic and other applications of the science.

All along, she had her eyes on her dream of being a doctor in Thunder Bay. She started the LU Pre-health Club, and served as its president last year. And she carried an average in the 85 to 90 per cent range.

Last year, she also took part in a pilot project the med school organized for students to test out the case-based curriculum method.

She found the small group model perfectly suited to her style of learning, since it emphasizes group discussions over traditional lectures.

“There were so many different people’s perspectives that you wouldn’t normally have thought of if you were just given the material yourself,” she says.

“I was really surprised at how much I was learning, just participating in this pilot.”

When it was time to apply for medical school, St. Jacques applied to the Northern Ontario school and the University of Ottawa. She made it to the latter’s waiting list, but accepted the offer to study in Northern Ontario instead.

It was her first choice all along, and not just because it would let her save money by staying at home.

She thinks the curriculum is innovative and unique, and she likes the idea of doing placements in different areas — rural, urban and remote — throughout the North.

“I think that will really help us,” she said. “We’re dealing with the very broad citizenship of Northern Ontario, and all the different cultures. I think being exposed to all of it will help us in the future to be doctors.”

She also likes the idea of helping develop the curriculum for future students.

“People say, ‘Oh, you’re going to be a guinea pig,’ but that’s not a bad thing,” she said.

“I really like being able to be a part of that, to improve certain things, and to actually have my opinion count for something. . . . And hopefully it will benefit students in the future.”

Right now, St. Jacques wants to go into family medicine, but she knows the things she learns on her way to graduation might steer her toward another field.

Whatever happens, she’s sure she wants to practise in Northwestern Ontario, to help fill the gaps she sees in local health care.

“I love the city,” she said. “I want to be an advocate for the area.”