Ontario's desperate need for rural MDs reason for new medical school

Canada's first new medical school in more than 30 years will open at Laurentian University in Sudbury, Ont., in 2004, Ontario Minister of Health Tony Clement announced May 17. He said the new school will have 55 undergraduate students per year, 20 of whom will do 2 years of clinical training at a satellite campus at Lakehead University in Thunder Bay.

Clement also had major news for the province's 5 existing schools, which learned that their total enrolment will increase by 120 students, to a total of 692 first-year positions, by the fall of 2002. The new spots, as yet unallocated, will mean that enrolment in the existing schools has increased by 30% since 1999.

During a press conference conducted by satellite from Sudbury, Clement said the new school will be unique because not only will it train new physicians, it will also encourage them to practise in remote areas. During the same press conference, Laurentian President Jean Watters described Laurentian's relationship with Lakehead University as “a partnership.” The new school will mark the first time a Canadian medical school has employed 2 distinct campuses for its undergraduates, although the University of British Columbia is considering a similar relationship with the University of Northern British Columbia.

Clement said $3 million has already been allocated to planning for the new school. Lakehead and Laurentian estimate that start-up costs will be $80 million, but Clement said there are “no exact numbers. We are in the process of getting a team together to develop a business-plan model.”

Dr. James Goertzen, director of the Northwestern Ontario Family Medicine Residency Program in Thunder Bay, says lessons learned outside Canada, particularly in places like Australia, must be applied to the new school. “The challenge as we examine this concept of a rural–remote medical school is to look not just in Canada, because the track record in Canada for medical schools being designed for rural/northern practice is very poor,” says Goertzen, whose program has been training doctors for rural practice since 1991.

Clement says the new school will help address the longstanding problem of physician shortages in rural and remote areas. However, Dr. Carl Eisener of the Ontario Society of Rural Physicians notes that fully trained physicians won't start emerging from the new school for 10 years. While praising the creation of the new school, he said interim steps, such as funding for nurse practitioners, are also needed. The society says that Ontario alone currently has 400 openings for physicians in underserviced areas.

Although new spots for existing schools have yet to be allocated, the dean of medicine at the University of Toronto expects most of them will go to schools other than his. “Given our current large class size [190 students], as well as the acute need for physicians in smaller cities and rural areas and our research-intensive and highly urbanized setting, we believe it is in the public interest for other faculties to take primary advantage of this opportunity,” said Dr. David Naylor. He added that the U of T will be able to support the expansion of postgraduate training “at all levels.”

Although little planning regarding the undergraduate expansion has been completed, Naylor said both provincial ministries involved “have made it clear they will provide [the necessary] support.”