Canadian Journal of Rural Medicine

: 2019  |  Volume : 24  |  Issue : 4  |  Page : 103-

Is Northern Ontario School of Medicine there yet?

Peter Hutten-Czapski 
 Scientific Editor, CJRM, Haileybury, ON, Canada

Correspondence Address:
MD Peter Hutten-Czapski
Scientific Editor, CJRM, Haileybury, ON

How to cite this article:
Hutten-Czapski P. Is Northern Ontario School of Medicine there yet?.Can J Rural Med 2019;24:103-103

How to cite this URL:
Hutten-Czapski P. Is Northern Ontario School of Medicine there yet?. Can J Rural Med [serial online] 2019 [cited 2022 Oct 4 ];24:103-103
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Full Text

I am proud to be on faculty at the Northern Ontario School of Medicine (NOSM), a school at the forefront of rural and decentralised educational reform. NOSM's success in these efforts has led to extravagant claims such as 94% of graduates practising in Northern Ontario.[1] For 6.6 million rural Canadians at the 2016 census,[2] this is an impressive number, so you would be forgiven to think that the NOSM has fulfilled its social mandate and we are overflowing with graduates in rural Northern Ontario. Except that, we most definitely are not.

From unpublished workforce data from Health Force Ontario, over the last 3 years, there has only been a net recruitment of eight physicians to all of rural Northern Ontario. We can account for four of those gains in my community of Temiskaming Shores, so perhaps some of us are overflowing. The claim of 94% is no comfort to many other communities in deficit, just down the highway from us. Where has the promise gone wrong?

Northern Ontario is a political construct of a carefully demarcated territory that happens to be resource driven and thinly populated. NOSM was created to deal with unmet needs for physicians in the territory and can be forgiven for putting things in a combined rural and northern (emphasis mine) lens.

Northern Ontario is 44% rural by population. The 94% headline is derived from a statistic in a single paper that actually represents 48 family physicians practising in Northern Ontario from 51 trained over 3 years. Those family physicians did both their undergraduate medicine and postgraduate family medicine at NOSM (only 25% of the undergraduate class did both their undergraduate and postgraduate training at NOSM and went into family medicine). The largest share of that cohort went to northern cities. Only 18/51 of them (36%) ended up in a northern rural practice or an average of about six NOSM-trained students per year entering rural practice across all of Northern Ontario.

No wonder, many faculty see learners from NOSM, but not back as colleagues.


1Hogenbirk JC, Timony PE, French MG, Strasser R, Pong RW, Cervin C, et al. Milestones on the social accountability journey: Family medicine practice locations of Northern Ontario School of Medicine graduates. Can Fam Physician 2016;62:e138-45.
2Statistics Canada. No date. “Population and Dwelling Count Highlight Tables, 2016 Census.” Population counts, for Canada, Provinces and Territories, Census Divisions, Population Centre Size Groups and Rural Areas, 2016 Census – 100% data Last updated 2019-02-20. [Last accessed on 2019 Jul 14].