Thank you very much.
First let me express my appreciation of the committee and for the opportunity to come and be with you today.
When I made some inquiries yesterday as to what you were interested in, in health human resources in rural areas, and I started talking about some of the issues, it kind of felt like I was going to be talking about my life's work.
In my brief introduction, I thought I'd tell you about who I am, introduce the Northern Ontario School of Medicine and the various initiatives we have there, mention my involvement with the World Health Organization and on an international expert panel, and then talk about my experience from previous times in Australia. I come originally from Australia.
Currently, I am the dean of the Northern Ontario School of Medicine, and I've been in that position, in fact, as the founding dean, since 2002. Before I came, there was no Northern Ontario School of Medicine.
Prior to that, I was in Australia. I was the head of the Monash University school of rural health. Monash University is a very large university with a very large medical school in metropolitan Melbourne. Melbourne is a big city like Toronto and Montreal, and I was the head of a rural branch of Monash University school of medicine.
I also was involved as the inaugural chair of an international working party on rural practice for WONCA, the World Organization of Family Doctors.
As I mentioned already, I'm a member of an expert panel advising the World Health Organization on developing recommendations on the retention and recruitment of health workers in rural areas.
I also am an advisor to the World Bank on the scaling up of the training of rural health workers.
I have brought a folder of information on the Northern Ontario School of Medicine. Unfortunately, most of it is in English, so it can't be submitted to the committee, but there's a folder available for each committee member, to look at when you have an opportunity.
The Northern Ontario School of Medicine serves as the faculty of medicine of two universities, Lakehead University in Thunder Bay and Laurentian University in Sudbury. As I imagine you're aware, those two communities are 1,000 kilometres apart. Northern Ontario is geographically vast, the size of Germany and France put together. The school was established with a social accountability mandate. That's a commitment to be responsive to the needs of the people in the communities of northern Ontario. There's also a commitment to innovation.
The education and training activities of the school are based on research evidence that shows three factors are most strongly associated with going into rural practice after education and training. The first is a rural upbringing, that is, having grown up in a rural area. The second factor is positive clinical and educational experiences as part of undergraduate education; that's in the MD program. The third factor is targeted training for rural practice at the post-graduate level--having residency programs that prepare the residents to practise in rural areas. At Northern Ontario School of Medicine, we're doing all of that. We've developed a distinctive model of medical education and health research that we call distributed community engaged learning. We have over 70 different locations across northern Ontario where our students and residents may undertake part of the clinical learning. We have a four-year MD program. The curriculum for that is very much grounded in northern Ontario and really prepares the graduate to have the knowledge and skills he or she needs and the inclination to pursue a medical career in northern Ontario or similar northern rural, remote, aboriginal, and francophone sorts of environments.
We also have residency programs in family medicine and eight major rural college specialties--again, very much with an emphasis on generalism.
We also have an accredited continuing education professional development program, which is largely available using electronic communications, so that many of the sessions are available by video conferencing and webcasting. We make heavy use of electronic communications.
Also, we are involved in education beyond strictly medical education. In the health sciences, we have a dietetic internship program. We're involved in education of physiotherapists and occupational therapists in northern Ontario. In collaboration with the University of Toronto Faculty of Medicine and the Michener Institute in Toronto, we have just established a physician assistant education program in northern Ontario as well.
We have a strong emphasis on interprofessional education. On the research programs at the school, the focus is on addressing research questions, the answer for which makes a difference to the health of the people in communities in northern Ontario. Again, the social accountability mandate really is the guiding light for the development and for all of the activities of the school.
The school admitted our first class--it's a four-year MD program--which had its official opening in 2005. We had our first graduates just last year, in 2009. So it's early days to talk about the outcomes.
In terms of the classes, for each of the intakes so far, roughly 90% of each class are students who have grown up in northern Ontario. Usually between 40% to 50% of the class are from rural and remote areas. We have a proportion of aboriginal medical students each year and francophone medical students. What we do is aim to represent the population distribution of northern Ontario in each class, and we've been fairly successful with that. We've done that in a way that does not sacrifice academic standards, so the grade point average of each class has been of the order of 3.7 on a four-point scale, which is very similar to the other medical schools in Canada.
The first group of students, of course, have now graduated. They're all matched in the first round of the national match into residency programs, and that's the first time that's occurred in Canada for over 10 years--a whole class matched in the first round. I think that's an indication that our students, our graduates, compare very favourably to the students and graduates of other medical schools, because the residency program directors wanted them in their programs. Seventy percent of those graduates are now pursuing mostly rural family medicine residency. To put that into perspective, that's more than double the national average of students going into family medicine residency. In our case, it's mostly rural family medicine. The other 30% of the graduates are mostly undertaking general specialty residency programs.
The early signs are certainly encouraging. The other indicator is that there's a national exam--the Medical Council of Canada exam--and our students, as a whole group, placed number six out of seventeen medical schools, in looking at their scores. In the section on clinical decision-making, they actually had the highest score of all the medical schools in Canada. So we take that as positive indicators of early success, really, for the Northern Ontario School of Medicine.
Just briefly, as I said, I wanted to mention the World Health Organization. We're just in the latter stages of completing guidelines and recommendations that will be presented, I think, to the World Health Assembly in May. There are four categories of these recommendations--I'm one of the members of the expert panel--and once this is finalized, it might be of interest to this committee to receive a copy and to review that document.