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Making of the Northern Ontario School of Medicine

Making of the Northern Ontario School of Medicine: A Case Study in the History of Medical Education

Geoffrey Tesson
Geoffrey Hudson
Roger Strasser
Dan Hunt
Copyright Date: 2009
Pages: 229
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  • Book Info
    Making of the Northern Ontario School of Medicine
    Book Description:

    Twelve contributors highlight the various aspects of the school's development and the unique opportunities it offers. The first new medical school in Canada in over thirty years, the Northern Ontario School of Medicine provides a blueprint for those interested in an innovative approach to medical education. This collection provides a fascinating and detailed account of the challenges and rewards faced by those who insisted on creating a patient-centered, community-based, and culturally sensitive learning environment for the physicians of tomorrow.

    eISBN: 978-0-7735-7649-0
    Subjects: Education

Table of Contents

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  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
  3. Preface
    (pp. vii-xiv)
  4. Acknowledgments
    (pp. xv-xvi)
  5. Chronology of the Development of NOSM
    (pp. xvii-xxii)
  6. Acronyms
    (pp. xxiii-xxiv)
  7. [Illustrations]
    (pp. xxv-xxvi)

    • 1 For the North, by the North, in the North: From Dream to Reality
      (pp. 3-19)

      The vigorous public debate that both preceded and accompanied the creation of the Northern Ontario School of Medicine was largely focused on the school’s being a solution to the physician shortage in Northern Ontario. Viewed from a broad perspective, creating more doctors is only one part of what is required to deliver good-quality health care to the dispersed population of Northern Ontario. Problems relating to attracting enough doctors to the North have been compounded by the difficulty of keeping them there once they came. The long-term solution was to be found in a whole range of initiatives, such as seeking...

    • 2 A New Medical School in the Big Picture: Setting the Scene
      (pp. 20-32)

      The Northern Ontario School of Medicine (nosm), which officially opened in the fall of 2005, is the first medical school to have been built in Canada in over three decades. It is also the first Canadian medical school with a special mandate to train physicians to practise in Northern Ontario and/or in rural communities in other parts of Canada. What makes nosm significant, other than the fact that establishing a medical school is a rare occurrence in this country? In this chapter I seek (1) to indicate the big picture within which nosm is situated and (2) to understand how...

    • 3 Learning Medicine in Rural and Remote Community Settings
      (pp. 33-46)

      The establishment in 1889 of Johns Hopkins Hospital in Baltimore, Maryland, as a model teaching hospital, along with the publication of the Flexner Report on Medical Education in the United States and Canada in 1910, set the trend for medical education in the twentieth century (Papa and Harasym 1999). Flexner recommended that medical schools be university-based and that their education programs be grounded in scientific knowledge. This led to a model of medical education in which the first half of the undergraduate program is classroom-based, with a focus on the basic sciences, and the second half is clinically based. The...

    • 4 The Rural Physician and Medical Education
      (pp. 47-62)

      The evening wind sighed in the spruce grove that surrounded the house as Michael lifted the steaming mug of tea to his lips. The ground, heavy with the fall rain, surrendered that almost chocolate odour so familiar in November. Snow was in the forecast. “That’s unlikely,” he thought out loud, “they’re never right these days.” The spindles of the porch railing offered little protection against the breeze but Michael barely noticed as his thoughts drifted.

      “There must not be anywhere else on earth where a doctor can leave the operating room of a fifty-bed hospital at four in the afternoon...


    • 5 Designing an Admissions Process for the Northern Ontario School of Medicine
      (pp. 65-82)

      This chapter describes the development of admissions policies and processes at the Northern Ontario School of Medicine (NOSM). Given that medical schools typically receive far more qualified applicants than they are able to accept, admissions policies and processes have functioned as important student selection tools, enabling the school to be more responsive to the needs of communities and to address physician recruitment issues in the region. The construction of NOSM’s admissions process has been guided by the school’s regional mandate, on the one hand, and by the available evidence regarding the effectiveness of different admissions procedures, on the other.


    • 6 Building a New Curriculum for NOSM
      (pp. 83-113)

      The historical, political, economic, and geographic forces that have contributed to the creation of the Northern Ontario School of Medicine (NOSM) are described in other chapters. As Fisher and Levine (1996) have noted, medical school curricula tend to have patterns shaped by both internal and external forces. It is the purpose of this chapter to present the unique NOSM curriculum and to identify the processes, events, concepts, and decisions that led to its creation.

      The foundation for what has become the NOSM curriculum is its educational social accountability mandate: “Providing undergraduate and postgraduate medical education programs that are innovative and...

    • 7 The Students
      (pp. 114-130)

      The intent of this chapter is twofold: first, to capture the reflections of the first wave of NOSM students who embarked on this new venture and, second, to give concrete expression to the demographic data of NOSM’s admissions process. We do the latter by examining the ways in which some of the students expressed their aspirations. Their comments illuminate the realities that lie behind the categories commonly used to select them and can provide important insights into the effectiveness not only of this program but also of rural medical education in general.

      Our discussion is based on a number of...

    • 8 Governance and Organization
      (pp. 131-154)

      In this chapter, we address two key organizational features of the Northern Ontario School of Medicine: (1) its governance structure and (2) its establishment as a quasi-autonomous organization (with its own faculty and administrative staff) that is also inextricably linked to its two host universities. We describe how NOSM’s governance structure was designed to enable it to serve as the single Faculty of Medicine for two independent universities – Lakehead and Laurentian. Implementing this structure and recruiting faculty and staff to run the new school posed some special and unique challenges.

      In Canada, medical schools are organized as academic units (usually...


    • 9 Socially Accountable Medical Education and the Making of the NOSM
      (pp. 157-182)

      Social accountability in medicine is related to the growth of state involvement in the support of medicine in Europe and elsewhere since the late nineteenth century. State intervention for the purpose of fostering national health insurance schemes and socialized medicine were part of a broad socio-political movement to make health care available to all citizens based on need rather than on ability to pay. For the state, this was, in part, a recognition that fit citizens were fit workers (and, if necessary, fit soldiers). In many countries, socialism, or the desire to avoid it, was also a factor.

      Over the...

    • 10 Beyond NOSM: Lessons for Others
      (pp. 183-202)

      At the time of writing, it has been over seven years since the Ontario government announced the creation of the Northern Ontario School of Medicine in May 2001. Each stage in its development – from the decision itself, to the hiring of the founding dean, the construction of the buildings, the creation of the curriculum, the arrival on campus of the first group of students, the successful accreditation visits, and the first graduating class – has been an occasion for celebration and an increasing sense that, in spite of widespread scepticism, this was indeed a valid approach to creating a medical school....

  11. References
    (pp. 203-220)
  12. Index
    (pp. 221-229)