A $1.2-million “out of the blue” donation to Canada’s youngest and smallest medical school from an American doctor will help create a centre for social accountability to address issues that affect Indigenous health, such as racism, says its dean.
Sarita Verma, dean of the Northern Ontario School of Medicine (NOSM) since 2019, says the gift, the largest in the school’s 15-year history, will allow it to go back to its roots. One issue the centre will look at is why the school’s distributed model of care has failed to keep doctors in remote and rural communities.
“We have a fairly robust tracking study that started which will go into the centre to understand what the factors [are]” Dr. Verma told The Globe and Mail in a phone interview from Sudbury. “What are the characteristics at admission that we need to change? And what are the factors and interventions that are needed in training people to make them feel like they are competent and confident?”
The donor is Dr. Hugh Robertson, a retired radiologist living in Louisiana, who was born and studied in Canada. As a medical student and physician he studied and practised in Cochrane, Ont., where his father had also practised. He recalls driving five hours in a makeshift ambulance to a remote Cree community on an island near Moosonee with a local physician to treat a young mother who was critically ill.
By the time they arrived with penicillin that would have saved her life, the woman inside the canvas tent had died. The young mother of three small children had fallen to what Dr. Robertson called an abortion with a contaminated instrument. He said the nearest hospital was too far away.
“They did whatever was necessary on their own,” said Dr. Robertson, who still calls Canada home, despite a 34-year career at Charity Hospital in New Orleans.
The doctor said he became interested in NOSM following his retirement.
“I very quickly thought of the really happy days in family practice, tremendous experience in rare diseases and things in Northern Ontario,” he said.
Some of Dr. Robertson’s donation is also going toward efforts led by Ornge air ambulance service to vaccinate 31 First Nations in Northern Ontario against COVID-19.
Dr. Verma said the donation will have an immediate effect and provide flexibility during a time of financial restraint. NOSM has two campuses – one at Lakehead University in Thunder Bay and another at Laurentian University in Sudbury, which recently filed for creditor protection after years of deficits and fallout from the pandemic.
“We’re going back to what ignited the creation of the medical school in the first place,” Dr. Verma said about the new centre.
NOSM opened in 2005 with a mandate of social accountability. The school’s undergraduate program receives about 2,000 applications each year for its 64 spots. Dr. Verma would like to increase admissions to 100 students, noting that about 8 to 13 per cent of students self-identify as Indigenous and 16 to 23 per cent self-identify as francophone.
She said about 92 per cent of students come from Northern Ontario, while the rest hail from “remote and rural Canada,” including Nunavut and the Northwest Territories. Eighty-nine per cent of those who get their medical degree and complete their residency at NOSM stay in Northern Ontario.
“So, we’ve done a good job,” Dr. Verma said.
However, the region is still short more than 300 physicians, she said, including about 120 family physicians and 180 specialists. And the doctors who stay in Northern Ontario are mostly in Thunder Bay and Sudbury.
“We have a real serious issue in rural remote and in First Nations communities where recruitment and retention is at a crisis,” she said.
Dr. Verma says NOSM has the opportunity to lead as a “voice of change” and that, in addition to training physicians for the workforce, it should be playing a major role in advocacy and policy development, rather than doing whatever it wants, as most medical schools do.
She says determinants of health in the north are different than those in the south, and are connected to power and decision-making in health care institutions.
“You can’t live in the north and not be aware of the issues of water safety, food security, housing, income, access to clinical care, but also lately – and I’m a woman of colour who’s the only [medical] dean of colour in Canada – racism,” she said.
“And maybe we should be looking at ways to reduce those barriers for people.”
Dr. Verma said partnerships for the new centre of social accountability will be developed with First Nations political groups, health authorities, other universities and hospitals. One of the first agreements will be signed next month with Nishnawbe Aski Nation. The political organization, which represents 49 First Nations, has been working on health transformation for its communities and helped get NOSM off the ground.
While Dr. Verma didn’t provide any timeline, she said the school will be looking for an inaugural director and board of governors to lead the development of the new centre.
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