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Canadian Journal of Rural Medicine
CJRM Summer 2001 / été 2001

President's message:
On a rural medical school

Peter Hutten-Czapski, MD
Haileybury, Ont.

CJRM 2001;6(3):177.

An historic announcement was made May 17th, 2001. The first medical school in the world with "rural" in its name will be formed over the next few years in Northern Ontario. Starting in 2004, the school will eventually graduate 55 students per year. It will be centred in Sudbury, but teaching will be highly decentralized throughout Northern Ontario. Quite a feat for its promoters (which include the Ontario Region of the SRPC [Society of Rural Physicians of Canada]1), but it didn't come easily.

First of all, this is a bit of a slap in the face to existing Canadian medical schools. For all their good intentions they produce few rural doctors. They recruit, usually from the urban rich (with average neighbourhood income in excess of $80 0002), teach predominantly in the cities, and their graduates end up with skills that relate to urban practice. Statistics Canada figures show that 31% of Canadians live in predominantly rural regions,3 but less than 5% of the graduates of one of our largest medical schools (University of Toronto) practise in rural areas.4

Second, not everyone is convinced that this school will be either "northern" or "rural." The administrative centre will be in Sudbury, which is below the 49th parallel and has a population of 92 000. Some argue that the administration would be better shared with Thunder Bay — still south of the 49th and not rural, but smaller and more isolated. Then there is the position of some academics that the resources would have been better spent "ruralizing" existing medical schools. These are all valid considerations.

Second-guessing Ontario's Minister of Health aside, the proposed pedagogical structure is evidence-based, with admissions focussed on people of rural origin and with teaching decentralized to rural centres. Laurentian University in Sudbury already is rural-friendly and has 400 Aboriginal students — this will not be like a school in southern Ontario. Furthermore, the SRPC has 2 representatives on the interim governance structure.

It will be another 10 years before the first graduates will show us how successfully "rural" the school will be, but with the SRPC involved, we know that we will get results.

In the final analysis it probably matters less if this new medical school makes good policy than that it makes good politics. Northern Ontario, chronically short of both specialists and generalists, was crying out for an "in the North, by the North, for the North solution." If you were going to expand the number of medical students anyway, then why not build a rural school?

Correspondence to: phc@srpc.ca
References
  1. Rural medical school. Rural News 2000;2(28). (accessed 2001 Jun 22).
  2. Taggart K. Students, university at odds over tuition's effect on med school class. Med Post 2001;37(18):2C.
  3. Statistics Canada. Population structure and change in predominantly rural regions [PDF format]. The Daily 2001;Jan 16:no 21-006 XIE.
  4. McKendry R, for the Ontario Ministry of Health and Long-Term Care. Physicians for Ontario: Too many? Too few? For 2000 and beyond. Govt of Ontario; 1999 Dec. p. 52. (accessed 2001 Jun 22).

© 2001 Society of Rural Physicians of Canada