NOSM University - Family Medicine - Remote First Nations Northern Ontario
2021 R-1 Main Residency Match - first iteration
CMG RoS Stream for CMG
NOSM Postgraduate Education -Family Medicine
955 Oliver Road
Thunder Bay, ON, Ontario, P7B 5E1
Program Contacts
Important Information
IMPORTANT NOTICE: Community Reference Letter Requirement
- Please note that supporting documentation requirements for your application to the Remote First Nations stream differ from the other NOSM Family Medicine streams (Thunder Bay, Sudbury, North Bay, Sault Ste. Marie, Timmins, Rural Northern Ontario and MOTP), and will require a customized personal letter, as well as additional reference requirements, including a Community Reference Letter. Applications submitted without the Community Reference Letter are considered incomplete and will not be considered any further in the selection process.
- Applicants who match to this stream may not choose any other community as their home-base / location of primary residence.
IMPORTANT NOTICE: 2 Years Family Medicine + 6 Months Enhanced Skills Training
- In addition to the two-year family medicine program, residents in the Remote First Nations Stream are provided an additional 6 months of mandatory 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 are focused in areas such as, but not limited to, rural and remote medicine, indigenous health, 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 Family Medicine residents will be compensated at the PGY3 salary level during this expanded enhanced skills training period.
Return of Service
This position comes with a four-year Return of Service (ROS). The Return of Service for the NOSM Family Medicine Remote First Nations Residency Stream is comprised of 2 parts:
- 2 years of service to Eabametoong First Nation, a remote community located approximately 300km northeast of Thunder Bay, ON. This community is only accessible by plane.
- The second component is 2 years of service in a road-access Matawa First Nations community in Northern Ontario. These communities are: Aroland First Nation, Constance Lake First Nation, Long Lake #58 First Nation, and Ginoogaming First Nation.
Please note that any candidates with pre-existing ROS obligations must disclose these obligations at the time of application.
IMPORTANT NOTICE:
Although MOTP applicants may apply, their Return of Service Agreement to the Department of National Defence does conflict with the ROS requirements of this program. MOTP candidates are not encouraged to apply unless they are in a position to dissolve their current contract and obligations to the Department of National Defence.
General Instructions
Program application language: English
Supporting Documentation / Information
• Canadian Birth Certificate or Act of Birth
• Confirmation of Permanent Residence in Canada
• Passport page showing Canadian Citizenship
• Canadian Permanent Resident Card (both sides of card)
IMPORTANT NOTICE: As per the Ontario Provincial Eligibility Criteria, if you are submitting a Canadian Birth Certificate or Act of Birth, or Confirmation of Permanent Residence in Canada document, you MUST submit a government issued photo I.D. to accompany your citizenship documentation.
Letter of Reference - 2 Letters Required
The Letters of Reference should provide an assessment of your medical knowledge, clinical skills, interpersonal skills, ability to communicate effectively, your suitability for working within small communities, working with Indigenous Peoples, working and living in a First Nation community - including a remote First Nation, your attitudes toward learning, and commitment to Indigenous Health Care and Family Medicine.
Community Reference Letter - 1 Letter Required
One reference letter must be from a community member who has known you for at least two years and can attest to your commitment to community practice and your ability to integrate effectively into a First Nations, remote, or other rural community.
This reference can be written by an individual who knows you personally (e.g. a spiritual leader, member of a not-for-profit group, committee or volunteer organization/association that you've been involved with, a teacher, healthcare professional, employer/colleague, etc.), who can attest to your personal suitability for life in a remote, northern community, and your suitability for this residency program. This is a non-clinical reference that should focus on any related experiences, skills, knowledge, community involvement, personal qualities/characteristics etc. that make you an ideal candidate and fit for this stream.
IMPORTANT NOTICE: Applications submitted without the Community Reference Letter are considered incomplete and will not be considered any further in the selection process.
Order from your registrar.
Medical Student Performance RecordOrder from your Dean's office.
CASPer examThe CASPer Test
All applicants to the NOSM Family Medicine Program are required to complete an online assessment (CASPer), to assist with our selection process. Successful completion of CASPer is mandatory in order to maintain admission eligibility.
CASPer is an online test which assesses for non-cognitive skills and interpersonal characteristics that we believe are important for successful students and graduates of our program and will complement the other tools that we use for applicant screening. In implementing CASPer, we are trying to further enhance fairness and objectivity in our selection process.
In order to take CASPer, you will be responsible for securing access to a computer with audio capabilities, a webcam, and a reliable internet connection on your selected test date. CASPer can be taken practically anywhere that you can satisfy the aforementioned requirements. No exceptions will be provided for applicants unable to take CASPer online due to being located at sites where internet is not dependable due to technical or political factors.
Please go to www.takeCASPer.com to sign up for the Canadian Postgraduate Medical Education test (CSP20201) and reserve a test using a piece of government-issued photo ID. You will be provided with a limited number of testing dates and times. Please note that these are the only testing dates available for your CASPer test. There will be no additional tests scheduled. Please use an email address that you check regularly; there may be updates to the test schedule. The tests for the 2021 admission cycle will be open for registration in September 2020.
Please direct any inquiries on the test to support@takecasper.com. Alternatively, you may use the chat bubble in the bottom right hand corner of your screen on the takecasper.com website.
The CASPer test is comprised of 12 sections of video and written scenarios. Following each scenario, you will be required to answer a set of probing questions under a time contract. The test typically takes between 75-90 minutes to complete. Each response is graded by a different rater, giving a very robust and reliable view of personal and professional characteristics important to our program. No studying is required for CASPer, although you may want to familiarize yourself with the test structure at takeCASPer.com, and ensure you have a quiet environment to take the test.
CASPer test results are valid for one admissions cycle. Applicants who have already taken the test in previous years will therefore be expected to re-take it.
PhotoThe personal letter (maximum 1000 words) should focus on the following:
- Experiences contributing to your interest in Family Medicine and in particular, to working, living, and serving in remote First nations settings;
- Aspects of the NOSM Remote First Nations Family Medicine program that interest you;
- Connections or personal qualities that make you an ideal candidate for practice in a remote First Nation and other Northern settings;
- How this program will assist you in becoming an excellent and culturally competent Family Physician;
- Your greatest challenge if you are accepted into this program;
- Additional information about yourself that should be considered by the Selection Panel.
If your transcript/CV indicates academic difficulty, failure(s), repeat of a year or any gaps in your education or work history please attach a supplementary statement to the beginning of your Personal Letter entitled "Transcript/CV Addendum" explaining the above.
Optional: you may submit abstracts of any recent publications.
Review Process
Applications submitted after file review has opened on February 8, 2021
Supporting documents (excluding letters of reference) that arrive after file review has opened on February 8, 2021
Letters of reference that arrive after the unmasking date on February 8, 2021
Applications for the Remote First Nations Stream will be reviewed and scored independently by two reviewers:
- A Northern Ontario School of Medicine Family Medicine Faculty Member; and
- A Community Member of Eabametoong First Nation
An average of the two scores will be generated for each applicant and the program will offer interviews to approximately the top 3-4 candidates.
Interviews
Interviews for the Remote First Nations Northern Ontario stream will be held at some point between March 8 and March 28, 2021.
Step 1 Interview: Team A - NOSM Interview (Interview Period March 8-28, 2021)
Candidates will participate in a 60-minute panel-style interview with an interview team comprised of both community members of Eabametoong First Nation, as well as members of the NOSM Family Medicine Program (Faculty/Resident). Interviews will be conducted online via AdmitHub.
Step 2 Interview: Team B - Community Interview (Interview Period March 8-28, 2021)
Candidates will participate in a second 60-minute panel-style interview. The interview team will be comprised of community members of Eabametoong First Nation and a NOSM Faculty Member, who will serve as a Physician Advisor on the panel. Interviews will be conducted online via AdmitHub.
Ojibway, Cree, OjiCree (or other Indigenous language) interviews may be requested by candidates, and every effort will be made by the program to accommodate these requests.
Selection Criteria
The NOSM Family Medicine Residency Program will review candidate’s applications based on:
- demonstrated interest in the health of Indigenous Peoples
- demonstrated interest in Family Medicine ability to fulfill all CanMEDS-FM roles
- demonstrated interest in clinical practice in northern Ontario and/or rural medicine
- interest in Mental Health, Addictions and Public Health issues an asset
- strength of references
- excellent interpersonal and collaboration skills
- evidence of education related to cultural safety
- evidence of resilience, self-directed learning and reflective practice
- desire to train in a remote First Nations community supplemented with needed experiences in a larger Northern Ontario community
- knowledge of Indigenous Peoples of Canada history and challenges
- connection to northern Ontario educationally, professionally, or personally
Program goals
The Northern Ontario School of Medicine (NOSM) 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.
Selection process goals
Through our selection process, our program aims to identify candidates who have a strong academic history with demonstrated competence and interest in family medicine (e.g. FM rotations, electives, scholarly activities, conference involvement and other related work or life experiences). We are seeking candidates who possess superior clinical and communication skills and have the ability to relate to patients, their families, and caregivers with compassion, empathy, sensitivity and humility.
We are looking for candidates who possess the ability and willingness to work collaboratively (within and across professional domains) in a team dynamic to secure optimal patient outcomes, while exemplifying the highest standards of professional behavior -- inclusive of responsibility, respect, and self-awareness.
We are also looking to identify candidates who would be a good fit for our program. 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 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 (see return of service obligation).
We also believe that candidates who are resilient, can prioritize their personal well-being and work-life balance, and are also committed to self-reflective learning, continuing professional development, and quality improvement, are well-suited to our program. Through our selection process we aim to identify and successfully match candidates who possess these attributes as well.
File review process
Review team composition : Applications for the Remote First Nations Stream will be reviewed and scored independently by two reviewers:
- A Northern Ontario School of Medicine Family Medicine Faculty Member
- A Eabametoong First Nation Community Member
An average of the two scores will be generated for each applicant and the program will offer interviews to approximately the top 3-4 candidates.
Average number of applications received by our program in the last five years : 0 - 50
Average percentage of applicants offered interviews : 26 - 50 %
| File component | Criteria |
|---|---|
| CV | Academic & work background/experiences, personal/professional accomplishments, communication skills |
| Electives | FM elective(s), diverse range relevant to the discipline, rural and/or northern/Indigenous an asset |
| Examinations | |
| Extra-curricular | Personal interests, volunteerism, community involvement, work-life balance & wellness. Include in CV |
| Leadership skills | Any leadership roles held throughout training should be outlined in the CV |
| MSPRs | Patient interactions, FM rotation competencies, any academic, personal or professionalism concerns |
| Personal letters | Experiences, interest/knowledge in FM and our program, personal/northern/rural/stream suitability |
| Reference documents | Commitment to FM, performance, knowledge/clinical skills, character, attitude towards learning |
| Research/Publications | Scholarly activities with related focus to Indigenous, underserved, rural or remote populations. |
| Transcripts | Strength of academic record, any red flags/concerns |
| Other file component(s) |
Community Reference Letter: Related experiences, skills, knowledge, commitment to community involvement & working with underserved populations, personal attributes, suitability for this stream/life and practise in a Remote First Nations community. Transcript/CV Addendum: If any part of your application indicates academic difficulty, failure(s), repeat of a year or any gaps in your education or work history, a supplementary statement at the beginning of your Personal Letter is required. Please entitle your statement as "Transcript/CV Addendum", explaining the above. |
Elective criteria
We recognize that the COVID-19 pandemic has impacted candidates’ opportunities to arrange and complete electives and would like to reassure you that a lack of elective activity this year will not negatively impact your application to our program.
Interview process
Interview format :
We do not re-schedule interviews for applicants after we have completed the scheduling process.
| Interview components | Criteria |
|---|---|
| Collaboration skills | Demonstrated ability to work well in a team setting/multidisciplinary environment |
| Collegiality | Personable, respectful towards others, values the importance of a supportive/collegial atmosphere |
| Communication skills | Able to reflect and communicate responses clearly and concisely, can communicate well with others |
| Health advocacy | Advocacy for patients, including geographically isolated and marginalized populations |
| Interest in the discipline | Genuine passion for Family Medicine and future practice goals |
| Interest in the program | Knowledge of Indigenous history, cultural practices, Northern ON. patient populations & challenges |
| Leadership skills | Qualities such as: proactive/takes initiative, accountable, innovative, motivated and goal-oriented |
| Professionalism | Conducts themselves in a professional manner, self-aware, unbiased, morally/ethically responsible |
| Scholarly activities | We do not formally evaluate this component during the interview |
| Other interview component(s) |
Problem-Solving Skills: Overcoming challenges, conflict resolution, ability to rationalize and take appropriate action. Personal Attributes: Personal characteristics and interests, experiences, learning style/attitude towards learning, practise goals, community involvement |
Information gathered outside of CaRMS application
Specifically, we may consider:Ranking process
The behavior(s) exhibited below during the interview process may prevent an applicant from being ranked by our program :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
Program Curriculum
This residency program is for 2 years.
Program length of training exceeds the Royal College or College of Family Physicians of Canada standard.
Length of Training
2 Years Family Medicine + 6 Months Enhanced Skills Training
In addition to the two-year family medicine program, residents in the Remote First Nations Stream are provided an additional 6 months of mandatory 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 are focused in areas such as, but not limited to, rural and remote medicine, indigenous health, 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 Family Medicine residents will be compensated at the PGY3 salary level during this expanded enhanced skills training period.
Program Overview
The NOSM Family Medicine program is an accredited program of the College of Family Physicians of Canada (CFPC). We follow the Triple C competency-based curriculum in all of our training streams. Utilizing the CanMEDS-FM competencies, along with the CFPC's Priority Topics and Skills Dimensions, our curriculum is built with community Family Medicine in mind. All of our rotations are largely community based, with several opportunities within our hospitals. The vast majority of teaching is provided by Family Physicians. Comprehensiveness of practice, along with continuity of care and education are central to our work. Depending on the stream, the approach to scheduling of clinical experiences will vary. All Family Medicine residents will receive ongoing coaching and feedback, both informally and formally through out workplace-based assessment methods. Regularly scheduled periodic reviews provide an opportunity for self-reflection and coaching from a Competency Coach. Candidates who are self-directed and engage in reflective practice are particularly suited to our residency program.
FM Remote First Nations Stream residents will have training opportunities in three communities, based on the volume and availability of clinical experiences. These communities include:
- Eabametoong First Nation (Fort Hope)
- Sioux Lookout
- Thunder Bay
Residents who match to the NOSM FM Remote First Nations Stream will be required to home-base out of Thunder Bay, which will be their location of primary residence. Residents will be required to travel to Eabametoong First Nation (EFN) as their primary remote First Nation community. Residents can expect a longitudinal training experience with their community immersion in Eabametoong First Nation and will be placed with a Family Medicine preceptor, as well as community members and health professionals for various rotations and learning experiences, which will range from approximately 1-3 weeks in duration.
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.
Clinical Curriculum
The NOSM 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 | Curriculum Objectives |
|
Across the Life Cycle
|
|
|
Care of Underserved Patients
|
|
| Procedural Skills |
|
Throughout the program, elective rotations 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.
Sample Clinical Curriculum
This is the typical Family Medicine Clinical Curriculum for the Remote First Nations Stream.
*Note: Family Physicians (preceptors) who do not do hospital rounds – the resident is required to do 3 additional weeks of Internal Medicine.
PGY1 Clinical Curriculum |
|
| Family Medicine Rural | 16 weeks |
| Internal Medicine | 8 weeks |
| Emergency Medicine | 4 weeks |
| Obstetrics/Women's Health | 4 weeks |
| Mental Health | 8 weeks |
| Pediatrics | 4 weeks |
| Electives | 8 weeks |
PGY2 Clinical Curriculum |
|
| Family Medicine | 24 weeks |
| Emergency Medicine | 4 weeks |
| Addictions/Pain Management | 4 weeks |
| Psychiatry | 8 weeks |
| Obstetrics/Women's Health | 4 weeks |
| Electives | 8 weeks |
|
Additional 6 Months Clinical Curriculum |
|
| Family Medicine | 8 weeks |
| Internal Medicine | 8 weeks |
| Electives | 8 weeks |
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. Canadian Society for Addiction Medicine Annual Meeting and Scientific Conference
b. Society of Rural Physicians of Canada Rural and Remote Medicine Course
c. Family Medicine Forum (during PGY1 and 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
Academic Program
The Family Medicine academic program consists of academic sessions, courses, and retreats. At this time, protected time every week affords a half of teaching, separate from clinical duties. These sessions will cover the vast majority of CFPC's Priority Topics, along with some hands-on skills including simulations, procedural skills and other small group learning. Due to the pandemic, we have moved to a virtual method of delivery, with an eye to come together occasionally for mini-retreats at the end of the blocks. In the first year of residency, all residents will participate in the Core Curriculum offered to all NOSM residents, across all specialties, which will cover key topics such as the Resident as Teacher, Indigenous health, medical errors and patient safety, etc. In addition, specific sessions in second year will be tailored to preparation for CFPC examination.
The NOSM program also provides financial support for residents to obtain certification in Advanced Cardiac Life Support (ACLS) and Neonatal Resuscitation Program (NRP). Residents are also provided with some financial support to attend other courses or conferences such as Family Medicine Forum and Society of Rural Physicians Rural and Remote Medicine Conference.
Other learning sessions, virtual or in-person, are scattered throughout the year to address learning needs.
We value the importance of Wellness and encourage protected time for residents to gather and dialogue with each other on a regular basis.
Scholarly Activity
While the role of Scholar will evolve through the two-year program, a number of activities are planned in the program:
- Scholarly activity, including research and quality improvement (QI), supported by a Tutor
- Ongoing didactic and small group sessions focused on Evidence-Based Medicine, Research and Quality Improvement
- The opportunity to participate in Resident Research Day, where everyone will share their Scholarly Activity with peers.
These activities contribute to a the development of effective teaching practices, formulating and investigating scholarly questions, and disseminating and communicating knowledge to professional audiences. Residents also contribute to the quality improvement of the Family Medicine program by providing feedback on the clinical experiences and academic curriculum; this data is collected and utilized by the program to augment the overall program curriculum.
Additional Information
Training Site(s) / Community Details:
Residents who match to the NOSM FM Remote First Nations Stream will be required to home-base out of Thunder Bay, which will be their location of primary residence.
The resident will have training opportunities in three communities based on the volume and availability of clinical experiences. These communities include:
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.
Eabametoong First Nation Community Profile
Eabametoong First Nation Community Website
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.
Sioux Lookout Community Profile
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.