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picardonhealth · 6 years ago

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Rural medicine: How a gamble to bring in doctors is paying off

Twelve years after the first class began at The Northern Ontario School of Medicine, many remote communities have ‘gone from crisis mode to planning mode’

André Picard, The Globe and Mail

Sunday, January 14, 2018

SUDBURY — When the Northern Ontario School of Medicine was created, it was based on a simple – but untested – premise: If you educate and train physicians in rural and remote northern communities, they will be more likely to practise there.

Twelve years later, the gamble is paying off better than anyone expected: 94 per cent of NOSM graduates who do a family medicine residency in the North stay there to practise, and 69 per cent of all graduates, specialists and GPs alike, have opted to work in remote and rural areas, particularly Northern Ontario.

"Has it worked?" Dr. Roger Strasser, the dean of NOSM asks. "Yes it has. Many northern communities have gone from crisis mode to planning mode thanks to our graduates. But we're still a long way from having the medical care we need in Northern Ontario." One of the success stories is Chapleau, located 850 kilometres north of Toronto. The blue-collar town went years without a physician before three NOSM graduates decided to set up shop for the 3,000 people in a catchment area that includes the township and the nearby reserves.

The trio established a family health team that operates a family medicine clinic, and they staff the ER in the small local hospital, oversee home care and long-term care, and run clinics in the two nearby First Nations communities, Brunswick House and Chapleau Cree First Nation.

"The area went seven years without a family doctor so there was no continuity of care and a lot of people's health was neglected. So, yes, they appreciate us," says Dr. Doris Mitchell, who graduated from NOSM in 2010.

A member of the Brunswick House First Nation, she worked as a nurse for 15 years before applying to medical school.

"I had aspirations to be a physician but I didn't want to leave the North, so NOSM was a perfect fit for me," she says.

Dr. Mitchell says that, after several years of practice, she really appreciates the school's hands-on approach to learning and its emphasis on rural medicine.

"They prepared us not only for the work environment, but for the emotional environment," she said.

Small-town medicine is rewarding because physicians dabble in a bit of everything, from minor surgery (sometimes even on patients' pets) through to trauma care and palliative care.

"The sense of community is wonderful but the reality is that working in your hometown can also be horrible," Dr. Mitchell says. There are unwanted pregnancies, suicides, heart attacks and deaths, and none of the patients are anonymous strangers; sometimes they are even family members and that can be awkward and ethically challenging.

The resources and technology can also be limited. Dr. Mitchell recounts the case of a car-crash victim with five fractures, as well as a perforated bowel and kidney, all of which had to be diagnosed without a CT scan or MRI, and whose care was complicated by the fact a snowstorm delayed the arrival of the air ambulance.

The right fit

The dream of a northern medical school dated back decades. When McMaster University was granted a medical school in 1972, there was hope that a school would also be established at Lakehead University in Thunder Bay. Instead, McMaster created a program to send its students to Northern Ontario for training and residency.

In 1999, the Ontario government established a commission to examine the province's physician supply and distribution problems. That report featured a single line saying the idea of a rural/northern medical school should be investigated.

An expert panel was appointed and they recommended against a school, saying they had reservations about the ability to attract qualified staff and quality training opportunities.

But access problems in the North were dire and the mayors of northern cities lobbied for a home-grown solution.

The Northern Ontario School of Medicine was approved in 2001, and the first class began in 2005, with two campuses, one at Laurentian University in Sudbury and the other at Lakehead University.

Today, NOSM has 64 places, split between the two cities. It gets more than 2,000 applicants annually. Tuition fees are $20,000 a year, middle-of-the-pack among Canada's 17 medical schools.

The selection process favours students from Northern Ontario, those from other parts of rural/remote Canada, francophones and Indigenous students, but there is no affirmative action program. "We consulted with the community and they don't want a quota because they feel it creates stigma," Dr. Strasser says.

NOSM does not use the Medical College Admission Test, because it has never been validated for francophone or Indigenous students. Instead, applicants undergo multiple mini-interviews, many of them involving community members such as patients, activists and First Nations elders.

Kimberley Edwards, a third-year medical student, says NOSM is the only medical school she applied to.

"Because of who I am, it felt like the right fit."

Ms. Edwards is Cree, but was brought up in Carleton Place, a small town outside Ottawa.

Like many NOSM students, she is older – she is 36 – and took a circuitous route to medicine.

After high school, she studied human kinetics at the University of Guelph. "But, to be honest, it didn't go so well. I was one of the only Indigenous students and I didn't feel like I fit in," Ms. Edwards says.

She left school and took a job in a sleep clinic, then went to Mohawk College to learn diagnostic heart sonography. That led to a job at the Ottawa Heart Institute, which sparked an interest in both medicine and the North. (Cardiac patients from Nunavut travel to Ottawa for care and the institute does regular clinics in Iqaluit, something Ms. Edwards loved.)

"Because my grades weren't great, I decided to return to school, and see if I could qualify for med school," she says of her decision to study in the physician assistant program at the University of Toronto. From there, she applied successfully to NOSM.

"I want to practise family medicine, to work with Indigenous people in the North, so the program has been great," Ms. Edwards says.

That decision on her future career was sealed when she spent a month in Moose Factory, not far (in northern terms) from Attawapiskat, where her father was raised.

George Payne, a first-year student, was brought up in Sault Ste. Marie but went south for school, at the University of Guelph, then Waterloo.

He was accepted to three medical schools, but chose NOSM because he wanted to be back in Northern Ontario. "I really missed the winters," he says.

Mr. Payne also loves the intimacy of NOSM. At the Thunder Bay campus, his class is only 28 students, and they mostly do problem-based learning in small groups and lots of field work.

"They really prepare you for the real world here," he says, excitedly recounting how he just returned from a placement with paramedics.

In first year, NOSM students must do a four-week placement in a remote Indigenous community. In second year, there are two two-week stints in rural areas, again often Indigenous communities. (There are more than 200 reserves in Ontario, most in the North.) In third year, there is an eight-month clerkship in one of 15 communities and, in the final year, students spend time in a tertiary hospital in places such as Sudbury or North Bay.

Almost two-thirds of NOSM graduates choose family medicine for their residency, double the national average; one-third chose general specialties and; only 5 per cent chose a subspecialty.

Andrew Ferrier is one who took the subspecialist route. He just began a five-year dermatology program at the University of Alberta in Edmonton.

He has studied both at Lake Forest College near Chicago (on a hockey scholarship) and University of Ottawa – where he earned a PhD in neuroscience – but, as a Métis from Cape Breton, he says rural life "has a big pull on my heart."

Dr. Ferrier had a placement in a dermatology clinic in second year and found his passion. He plans to return to Northern Ontario to practise. That's good news for patients – the wait list to see a dermatologist in Sudbury is more than 18 months. And patients in the North often have to travel to Toronto or Ottawa to see specialists.

Paul Heinrich, CEO of the North Bay Regional Health Centre, says NOSM has played an important role in attracting physicians to the region and retaining them. One in three new doctors at the hospital are NOSM grads.

But other measures have also helped.

A physician who chooses North Bay can qualify for a $25,000 relocation bonus from the regional health centre, and the city matches that amount; the provincial Northern Health Programs also provides an additional $80,000 over four years. In return, the doctor must commit to staying in the city for five years and taking on 1,200 patients.

"But the biggest draw isn't the money; it's the lifestyle," Mr. Heinrich says.

Dr. Renée Gauthier agrees.

She and three partners – all NOSM grads – opened the Northern Shores Medical Clinic after graduation.

"We all wanted to come back home because this is a nice place to live and raise a family," she says.

The clinic has room to take on a dozen physicians in total, and the need is there. North Bay, a city of 50,000, has an estimated 15,000 orphan patients.

François Doiron was a nurse with a family health team in Marathon, Ont., when he discovered his passion for rural medicine.

He applied and was accepted to three medical schools but chose NOSM. Dr. Doiron just graduated and is doing his family medicine residency with the Harbourview Family Health Team in Thunder Bay.

"I plan to practise in the North, so I wanted to be trained in this environment," he says.

While Dr. Doiron is almost two years away from completing his residency, he is already being wooed by several communities to set up a family medicine practice.

"The need is there, that's for sure," he says. "But I want to be careful not to be wooed by the money or the perks. I want to practise where I plan to spend my life."

#NOSM MedEd cdnhealth

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cnih · 9 months ago

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Benefits Of Studying In A Reputed Diagnostic Medical Sonography School In Ontario

Are you planning to Kickstart Your Career in Diagnostic Medical Sonography? Choose a reputed Diagnostic Medical Sonography School in Ontario.

Diagnostic Medical Sonography

Before that you should know why pursue Diagnostic Medical Sonography-

As a diagnostic medical sonographer, you play a key role in the accurate diagnosis of various medical conditions. You can provide accurate and quality diagnostic images. Undoubtedly, diagnostic medical sonography allows for a rewarding career path.

This course gives a promising job outlook. The demand and requirement for skilled sonographers continue to grow. It creates ample job opportunities in different areas of healthcare settings including hospitals, clinics, and imaging centers.

Sonographers constantly work with advanced equipment and techniques thus ensuring they are capable enough to deal with the needs of patients and healthcare institutions. This course offers a gateway to a competitive salary package.

Moreover, you can join reputed educational institutions for quality programs and high-tech facilities. These programs are specially designed to equip students with knowledge, skills and practical experience. You will receive a good education for success in your career.

Joining reputed educational institutions offers you access to quality programs and cutting-edge facilities. These specially designed programs aim to equip students with theoretical knowledge, practical skills, and hands-on experience. Therefore, a successful career path is within your reach as you receive an education par excellence.

Medical Sonography School

Key Benefits Of Joining A Reputed Diagnostic Medical Sonography School In Ontario-

High level of practical scanning skills and image evaluation

Clinical decision-making and problem-solving

High-level communication skills,

Ease in adapting to different environments,

Good eye-hand coordination and,

A passion for healthcare

Education Requirements For Diagnostic Medical Sonography Course-

High school diploma/GED

Transcripts for all education

Standardized test scores

Statement of purpose and letters of reference

To summarize, studying Diagnostic Medical Sonography offers numerous benefits. If your passion lies in healthcare, this course aligns perfectly with your interests. Nevertheless, the decision to select an appropriate school in Ontario can significantly impact your academic journey. There are several options out there, but it requires research for the best result.

Sonography School Ontario

Tips To Find A Diagnostic Medical Sonography School-

Accreditation of a school

Curriculum and Program Offerings

Faculty Expertise and Resources

Clinical Training Opportunities

Student Support Services

Program Duration and Flexibility

Cost and Financial Aid Options

Looking for the best Diagnostic Medical Sonography School in Ontario? We provide a comprehensive education that will prepare students to become entry-level sonographers. Visit www.cnih.ca today!

#Diagnostic Medical Sonography School Ontario

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cnih · 7 months ago

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Are you planning to Kickstart Your Career in Diagnostic Medical Sonography? Choose a reputed Diagnostic Medical Sonography School in Ontario.

#Diagnostic Medical Sonography School in Ontario

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cnih · 2 months ago

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Are you finding the best Diagnostic Medical Sonography Program in Canada? Look no further! The Canadian National Institute of Health’s spectrum of Medical and Dental diploma programs is your right stop. Experienced instructors, state-of-the-art facilities and ample opportunity for hands-on training make the difference. Our specialized selection of career training programs allows you to choose a path that’s right for you. Start Today! For more information, you can call us at 613.726.CNIH (2644) or 1.866.726.CNIH (2644).

#Diagnostic Medical Sonography Program Canada

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cnih · 3 months ago

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Looking for Diagnostic Medical for Sonography in Ottawa? CDN healthcare is your right stop. We strive to deliver the highest quality medical diagnostic results in the most professional and efficient manner. All imaging equipment is digital and falls into the Ministry of Health and long term care standards. For more information, you can call us at 613.726.CNIH (2644) or 1.866.726.CNIH (2644).

#Diagnostic Medical Sonography Ottawa

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cnih · 3 months ago

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Advancements in Ultrasound Technology: What Ultrasound Sonographers Need to Know

Ultrasound Sonographer Canada

As ultrasonic technology developed, how did everyday work for sonographers change? As the medical field grows, ultrasonic technology has grown dramatically providing faster diagnosis, more accurate imaging, and better patient care. This page addresses the most current developments in ultrasonic technology—that which all ultrasound sonographers Canada should be familiar with. a will keep you current in an industry that is rapidly changing.

Three- And Four-Dimensional Image Developments

Generation of 3D and 4D images is among the most important advances in ultrasonic technology. Three-dimensional pictures produced by 3D ultrasounds are clearer and more detailed than two-dimensional ultrasounds' produced flat images. This is considerably better with 4D ultrasounds, which provide time to the picture and generate real-time movie pictures.

Little, Portable Ultrasonic Instruments

Portable and mobile ultrasonic equipment have transformed the sonographer's job. Apart from their ease of use, these little devices are remarkably durable. Ultrasound Sonographer Canada captures excellent photos and might be utilized at the patient's bedside or elsewhere.

Integration Of Artificial Intelligence With Ultrasonic Imaging

Almost everywhere artificial intelligence (AI) is creating waves. There is not any difference in ultrasonic technology. In ultrasonic imaging, artificial intelligence integration refers to the use of machine learning techniques to improve picture quality, support result interpretation, and even automate certain testing process duties.

Using Elastography: Gauging Tissue Stiffness

Elastography is a recently advanced and sophisticated ultrasonic method for tissue stiffness determination. This substantially helps to diagnose diseases like thyroid problems, breast cancer, and liver disease. By determining the tissue's stiffness, sonographers can give more all-encompassing information that would support early diagnosis and therapy planning.

Improved Contrast Ultrasound

Another fascinating new invention about which sonographers should be aware is contrast-enhanced ultrasonic waves (CEUS). Under an ultrasonic examination, contrast drugs in CEUS aid to simplify blood flow and tissue vascularity visible. This method is very helpful in finding liver diseases, looking at renal masses, and keeping an eye on heart diseases.

High Frequency Ultrasonic Waves Directed At Surface-Oriented Constructions

High frequency ultrasonic waves help to capture images of superficial tissues like the thyroid gland, breast tissue, and joint components. Higher frequencies provide more clarity, hence sonographers may find tiny problems not seen on lower-frequency ultrasounds.

Conclusion

Every sonographer should keep current as ultrasonic technology develops. Including portable devices, artificial intelligence, elastography, CEUS, high-frequency approaches to 3D and 4D imaging is changing medical imaging. Knowing how to use these contemporary technologies will enable a Canada ultrasonic sonographer to improve their work.

Looking for the best Ultrasound Sonographer Canada services? If yes, you can get it from a diagnostic medical sonography school in Ontario. Contact us at 613.726.CNIH(2644) or 1.866.726.CNIH(2644).

#Ultrasound Sonographer Canada

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cnih · 4 months ago

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How Can Ultrasound Sonographer Canada Can Help You Detect Your PCOS Condition?

Are your periods irregular, are you not becoming pregnant, or are you gaining weight without cause? PCOS is a common hormonal condition that these symptoms may point to in women of reproductive age. Adequate management of PCOS requires knowledge of your symptoms and prompt diagnosis. Key ways an ultrasound sonographer Canada can help you detect PCOS and get the right treatment are as follows.

Understanding PCOS and Related Symptoms

PCOS is characterized by an overabundance of hormones, irregular periods, and cyst-filled ovaries. Even while weight gain, hair loss, and acne are common symptoms, every individual has different ones. Early detection of PCOS may help to avoid later problems like diabetes and infertility.

Using ultrasonography to diagnose PCOS

Without making direct touch, sonographers may check your ovaries and uterus using ultrasound imaging. It makes spotting cysts and figuring out the general condition of your genitalia simple. PCOS patients may have larger-than-normal ovaries with several little cysts inside of them, which makes imaging essential.

Ultrasound Sonographer

What Canadian Ultrasonographers Do

Sound waveform Sonographer Canada focuses on full pelvic ultrasounds. They can produce pictures of your reproductive organs using high-frequency sound waves, which tells them a lot about the state of your ovaries. Examining the ovaries allows one to find cysts, track their growth, and gauge the uterine lining thickness.

Early identification of PCOS is essential to effective therapy.

When PCOS is found early on, doctors can take action and create treatment plans in enough time. Ultrasound sonographers Canada are essential to this process since they provide doctors with exact visual data that helps them decide what is best for them to do. Ultrasonography is an important screening technique whether you are trying to control PCOS symptoms or are worried about your pregnancy.

Uses of a Canadian Ultrasound Sonographer

Talking to a Canadian ultrasound sonographer may help you in a number of ways:

Correct Diagnosis :

Quite clear pictures might help to verify or deny PCOS.

Specialised Medical Attention:

Options for therapy suited to your needs and symptoms.

Compiling changes:

Normal ultrasounds check for changes to ovarian cysts and the overall health of the reproductive system.

Help with assignments

Knowing what ails you helps you to make informed health choices.

Ultrasonography Canada

Find out more about your sexual health and start your road to overall health with Ultrasound Sonographer Canada. You may choose wisely for your health and get the right therapy if PCOS is diagnosed early.

Conclusion

To sum up, a lot of women suffer from PCOS, a complicated disorder that is much helped by Ultrasound Sonographer Canada. Modern ultrasound technology combined with their experience allows them to provide customized therapy and early intervention.

Looking for the best Ultrasound Sonographer Canada services? If yes, you can get it from a diagnostic medical sonography school in Ontario. Contact us at 613.726.CNIH(2644) or 1.866.726.CNIH(2644). Visit our website, cnih.ca, to know more.

#Ultrasound Sonographer Canada

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cnih · 5 months ago

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#Diagnostic Medical Sonography Program Canada

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cnih · 5 months ago

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When Do You Need To Get A Sonography Done?

Have you ever thought about when an ultrasound would be helpful? A lot of people don't know when to make an appointment for this important medical imaging test. Sonography, which is sometimes called ultrasound, makes pictures of the inside of your body using sound waves. There is no risk or pain in seeing what's going on below the surface. But when should you really think about getting a sonogram? Let's find out more about it and see when you need an Ultrasound Sonographer Canada.

What Does A Sonography Do?

Sonography, which is also called ultrasound, lets doctors see what's going on inside the body and see how blood moves between cells and organs. Since it doesn't give off radiation, it is safer for many people than X-rays. In Canada, as in other parts of the world, these tests are done by Ultrasound Sonographers who have been trained to understand what the pictures mean.

Ultrasound Sonographer

When Should You Get A Scan If You Know You Are Pregnant?

Pregnancy is one of the main reasons people get sonograms. These are the times when it's usually suggested:

The First Three Months:

Listen to the baby's heartbeat to make sure they are pregnant.

To guess when it will get there.

To find out if there are multiple babies (teenage twins, triplets, etc.).

The Second Trimester:

To keep an eye on the baby's growth and progress.

If you want to, find out what gender the baby is.

To find out how much placenta and uterine fluid there is.

Three-Trimester:

To keep an eye on the baby's growth and position.

To find the placenta.

As the due date gets closer, check on the baby's health and growth.

A Sonogram To Look For Abdominal Pain

If you have gut pain that you can't explain, your doctor may suggest sonography to:

Look around to see if you have gallstones.

Make sure to see if your liver is hurt or sick.

Scroll down to see the pancreas and spleen.

Find kidney stones or other problems with the kidneys.

Find aortic tumours in the belly.

Best Ultrasound Sonographer

Conclusion

Lastly, sonography is a good way to find out what's wrong with people and keep an eye on a number of health problems. In Canada, only a trained Ultrasound Sonographer can do these tests. They will make sure that the information you get is correct and useful.

Looking for the best Ultrasound Sonographer Canada services? If yes, you can get it from a diagnostic medical sonography school in Ontario. Contact us at 613.726.CNIH(2644) or 1.866.726.CNIH(2644).

#Ultrasound Sonographer Canada

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