What is it about?

Northern Ontario is an economically deprived and chronically underserviced region with many remote and rural communities, similar to many underdeveloped regions worldwide. In 2002, Northern Ontario School of Medicine (NOSM, renamed NOSM University in April 2022) was established with a Social Accountability mandate to improve the health of the people and communities of Northern Ontario. NOSM University selectively recruits students from Northern Ontario or similar backgrounds and delivers Immersive Community Engaged Education whereby students and trainees are living and learning in community and clinical settings where they are expected to serve after completion of training. This PLOS article reports the specialty and practice location of NOSM University trained physicians 10 years after the first NOSM graduation.

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Why is it important?

Conventional medical schools are located in big cities and provide most of their medical education and post-graduate residency training in big city teaching hospitals. Most students in these medical schools come from financially advantaged urban neighbourhoods and subsequently pursue medical careers as urban hospital-based specialists. Around the world, there are shortages of family physicians and other primary care specialists, particularly in economically disadvantaged remote and rural regions. The NOSM University approach is to “grow your own” physicians by recruiting students from rural and underserviced communities and providing the majority of their clinical learning in underserved community settings. In 10 years after the first graduation, 77% of NOSM graduates are family physicians and another 14% are generalist specialists such as general internal medicine, general surgery and paediatrics. The vast majority (92%) of the family physicians who undertook their undergraduate and postgraduate medical education in Northern Ontario are practising in Northern Ontario. This research shows that purposeful selection and distributed immersive community engaged undergraduate medical education and postgraduate residency training will encourage and enable more physicians to practise in these economically deprived and underserved regions around the world.


I greatly enjoyed adding to the international literature that is evaluating solutions designed to improve the care of people in underserviced regions. One important step in this journey is ensuring that medical doctors and other health care providers set up their practice in these underserviced regions. John C. Hogenbirk For me, bringing this research to publication in PLOS is personally and professionally satisfying because it provides new and important evidence that confirms the value of “grow your own” socially accountable, immersive community engaged medical education developed and delivered in underserviced communities, by underserviced communities, for underserviced communities. My hope is that other medical schools will draw on this new knowledge in their own context to prepare their graduates to be physicians with the skills and commitment to provide high-quality healthcare where it is most needed. Roger P Strasser.

John Hogenbirk
Centre for Rural and Northern Health Research - Laurentian

Read the Original

This page is a summary of: Ten years of graduates: A cross-sectional study of the practice location of doctors trained at a socially accountable medical school, PLoS ONE, September 2022, PLOS, DOI: 10.1371/journal.pone.0274499.
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