Remote First Nations Stream

Remote First Nations Site Director: Dr. Diane Bannon
Assistant Site Director: Dr. Kim Varty

Program goals

The NOSM University is committed to the education of high-quality physicians and health professionals, and to international recognition as a leader in distributed, learning-centred, community-engaged education and research.

Our program’s vision is to educate doctors based on the CanMEDS-FM roles to develop the skills and attitudes necessary to deliver excellent, culturally respectful health care to the communities of Northern Ontario, including rural and remote areas.

As a socially accountable medical school, accountable to the needs and the diversity of the populations of Northern Ontario, candidates best suited to the NOSM U Family Medicine Remote First Nations Stream are those with a vested interest in rural medicine and the health of Indigenous Peoples, who can adapt and thrive in a hands-on, distributed rural residency program that requires flexibility, travel away from their primary location of residence, and future practice in remote First Nations communities.

Residents can expect Family Medicine training that will prepare them for eventual practice in any community, and especially in rural, remote and Indigenous northern Ontario communities.

Program Highlights

• Community immersion in Eabametoong First Nation which will allow residents to become embedded in Indigenous culture and traditional practices, and experience the rewards and challenges of delivering health care in remote First Nations communities
• Other diverse opportunities exist to encounter, immerse in and deliver health care to First Nation peoples within northern Indigenous communities in the Matawa Tribal Council Area
• In addition to core Family Medicine training, opportunity to learn about traditional healing and medicine therapies from Elders and other community members, and to undertake academic curriculum designed around Indigenous health competencies
• Concentrated training opportunities in cultural competency, addictions and mental health, and interprofessional team care
• Early integration as a key member of an interdisciplinary health care team dedicated to professionalism, high quality patient care in a community context with excellent medical education
• A diverse variety of community based primary care, in-patient and outpatient experiences emphasized from the beginning of residency
• Unparalleled preceptor support from physician faculty and preceptors whose primary focus is patient care and teaching
• Commitment to resident learning
• Financial support for resident travel to and from core clinical placements away from the home base and all mandatory educational activities at non-home base locations
• Housing support for core rotations away from home-base/primary residence for up to 6 months per academic year
• Opportunities to participate in a scholarly project under expert guidance
• Funding available for research, professional development and conference participation
• Exceptional lifestyle balance with a wide variety of outstanding northern Ontario recreational opportunities

In addition to the two-year family medicine program, residents in the Remote First Nations Stream are given an additional 6 months of self-directed enhanced skills training in order to ensure they are provided increased time and exposure to various competencies and experiences associated with comprehensive clinical practice in remote First Nations communities.

These learning experiences may be focused in areas such as, but not limited to, rural and remote medicine, Indigenous health, medevac training, Elder teachings and cultural safety training. These enhanced training exposures provide our learners with the added time, support and flexibility to adapt to their individual learner needs with the realities of family practice in remote Indigenous communities. Upon successful completion of core of the Family Medicine Program, NOSM U Family Medicine residents will be compensated at the PGY3 salary level during this expanded enhanced skills training period.

Graduating Residents will be accorded a two-year Return of Service (ROS) with Ontario Ministry of Health and Long-Term Care, providing physician services to the Thunder Bay based Matawa Health Co-operative (MHC). The MHC serves multiple Matawa communities in both urban and remote locales where physicians will be able spend approximately 1 week a month in a remote setting, such as Eabametoong First Nations, alongside their other duties as assigned by the MHC.

Further details on the Matawa Health Cooperative and Matawa Communities can be found on the Matawa First Nation website at www.matawa.on.ca

Remote First Nations Stream Clinical Curriculum

The NOSM U Family Medicine Clinical Curriculum incorporates a diversity of experience and proficiency in areas integral to community-based family practice. Each resident will spend significant time in the community practice of family medicine preceptors. Residents participate in all aspects of the practice, including provision of continuous care to their own patients within the community and participation in the care of community patients referred to Thunder Bay whenever possible. Participation in the care of the practice’s patients in multiple environments including the hospital, patient’s home and other scenarios is encouraged.

Domains of Care and Curriculum Objectives:

Across the Life Cycle

• Care of Children and Adolescents
• Care of Adults
• Care of Elderly
• Maternal and Newborn Care
• Men’s Health
• Palliative Care
• Women’s Health

Care of Underserved Patients

• Behavioural Medicine & Mental Health
• Indigenous Health
• Learning about Traditional Indigenous Health Practices

Procedural Skills

• Procedural and Surgical Skills

Example Rotation Schedule

Additional / Cultural Curriculum

Additional curriculum that’s specific to the Remote First Nations Stream includes (but is not limited to) cultural safety courses, addictions, plastics, advanced airways and trauma informed care. Additional community guidance will also be gained through mentorship from a community based liaison to engage with community elders for teaching, and to provide residents in this Stream with Elder support.

Elder Teaching Program
When residents are completing their week-long rotations in a First Nations Community, they have the opportunity to meet with and learn from Elders in the community. These teaching sessions focus on cultural teachings and practices, traditional healing and medicine, ceremonies, and other topics which are guided by the Elders. The community liaison will assist with scheduling these sessions with Elders.

Clinical Excellence
i. Suboxone Training Certificate
ii. Attend the following conferences:
a. Society of Rural Physicians of Canada Rural and Remote Medicine Course
b. Family Medicine Forum (during PGY1 or PGY2)

Cultural Safety Training
i.   Complete the San’yas online learning modules or equivalent
ii.  Indigenous Led Trauma Informed Care
iii. Attend the following four conferences by the end of residency
a. International Meeting of Indigenous Child Health (held every two years)
b. Association of American Indian Physicians Annual Meeting and Health Conference

Additional Courses to Prepare Residents for Isolated Practice
i.   Airway Interventions & Management in Emergencies (AIME)
ii.  Advanced Trauma Life Support (ATLS)
iii. Pediatric Advanced Life Support (PALS)
iv. Advances in Labour and Risk Management (ALARM)
v.  Plastics – Rural Care

Remote First Nations Stream Training Sites

Residents will have training opportunities in three communities based on the volume and availability of clinical experiences. These communities include Eabametoong First Nation, Sioux Lookout, and Thunder Bay.

Residents who match to the NOSM U FM Remote First Nations Stream will be home-based out of Thunder Bay, which will be their location of primary residence.

Residents will travel to Eabametoong First Nation as their primary remote First Nation community, and will be placed with a Family Medicine preceptor, as well as community members and health professionals for various rotations and learning experiences. Additional core rotations and training experiences will take place in the community of Sioux Lookout.

Throughout the program, elective rotations (which can take place outside of these three communities) provide additional flexibility and enable residents to tailor their training to achieve competence in the domains of care and their individual learning objectives not met by immersions in the regular core rotations. Diversity of experience during elective rotations is encouraged and recognized as being extremely valuable.

Eabametoong First Nation
Eabametoong First Nation (also known as Fort Hope) is located on the shores of Eabamet Lake in the Albany River system, in Northwestern Ontario. The community location is approximately 240 km north of Beardmore and is accessible by airplane, water or winter/ice roads. The nearest road/railway town is Armstrong, 155 km southwest. Eabamet is 362-air km North of Thunder Bay; 347-air km Northeast of Sioux Lookout; & 217-air km northwest of Geraldton.

Community Profile – Eabametoong

Eabametoong First Nation Community Website

wanted.nosm.ca/eabametoong-first-nation/ 

Sioux Lookout
Residents in Sioux Lookout have great opportunities to be placed with Family Medicine preceptors who provide the full spectrum of scope of practice, including emergency care, obstetrics, and inpatient care.

Community Profile – Sioux Lookout

Municipality of Sioux Lookout Website

Thunder Bay
Thunder Bay provides diverse hands-on training for Family Medicine residents in a closely knit medical community. You will have exposure to many different family practice styles, including solo, group, and inter-professional team-based practices with many providing in-hospital care, walk-in clinics, palliative care and maternal/newborn care. Thunder Bay is a regional referral centre for Northwestern Ontario. The high-volume tertiary care hospital, Thunder Bay Regional Health Sciences Centre (TBRHSC), is a 375-bed tertiary care academic centre offering a comprehensive range of services in state-of-the-art healthcare facilities with a fully integrated Regional Cancer Centre Program. Other medical facilities in the city include the St. Joseph’s Care Group which offers complex care, physical rehabilitation, long term care, mental health and addictions; Norwest CHC; and the Thunder Bay District Health Unit.

Community Profile – Thunder Bay

City of Thunder Bay Website

Indigenous Medical Education

NOSM University is committed to continuing to build with First Nations and Métis peoples of Northern Ontario to promote a healthier North, minobimaadziwin.

Indigenous Medical Education | NOSM