COVID-19 is in northern Ontario — and there aren't enough doctors to handle it

The College of Physicians and Surgeons of Ontario is temporarily allowing graduating residents to serve as doctors and locums. Will that be enough to make up for the regional shortages?
By Jon Thompson - Published on Apr 06, 2020
On March 26, the CPSO introduced a temporary certificate that allows graduating residents to serve as doctors before having taken their professional examinations. ( Vasilev)



Even though her final professional exams have been suspended due to COVID-19, medical resident Brooke Wilson is taking her place on the front lines of the pandemic in Timmins. 

“We want to be able to provide care in this, a career-defining pandemic. We could help and really lend a hand, especially as we predict that many other physicians will be sick and not be able to work,” says Wilson, who recently graduated from the Northern Ontario School of Medicine, in Sudbury. “We’re trained and ready to go.”

On March 26, the College of Physicians and Surgeons of Ontario introduced a temporary certificate that allows graduating residents, such as Wilson, to serve as doctors before having taken their professional examinations. They will also be eligible to become locums — physicians who travel into communities on a short-term basis. 

Wilson, who is originally from New Liskeard, is setting up her own practice and will be joining the Timmins Academic Family Health Team on July 1, which had been her plan before the pandemic. 

“This is an extraordinary situation, which is why we've developed a special licence that ensures that residents can continue to practice medicine and that patients can continue to receive care from these otherwise qualified physicians,” CPSO spokesperson Shae Greenfield says in a written statement to “They’ve postponed those [exams] until September, which is why we’ve provided six-month provisional certificates.”

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In February, the CPSO estimated that there were 98 physician vacancies in northwestern Ontario — a region of nearly 250,000 people. Northeastern Ontario is short 45 family physicians, a figure that does not include specialists. 

These shortages can leave areas vulnerable to any spike in health-care demand. In Kenora, for example, five doctors are currently isolating with flu-like symptoms, and the locum systems that normally support small or medium-sized hospitals, such as Kenora’s, are not operating. This is before a single confirmed COVID-19 case has been listed in its catchment area.

The temporary certificates will add 35 NOSM graduates to the system. Alan Drummond, co-chair of the public-affairs committee of the Canadian Association of Emergency Physicians, says they’re badly needed. “Smaller hospitals tend to be already behind the eight ball, both in terms of technology and human resources, on a good day,” he says. 

But Catherine Cervin, NOSM’s vice dean, academic, says it will likely not be enough. “This would be a drop in the bucket. There’s a huge need across northern Ontario, in all our communities, particularly in our rural and Indigenous communities,” she says. “The pandemic has brought to the forefront an inequity that has existed in health care, and it has made the reality much starker. Rural communities in the north are underserved. They do not have an adequate complement of physicians to meet all the needs.”

Zaki Ahmed, the chief of staff at the Thunder Bay Regional Health Sciences Centre, though, notes that the new doctors could help small hospitals, where the loss of even one physician can disrupt the system.  “I think the final-year students should be deployed out into the region, where they can work with the overworked medical doctors that are out there,” he says. “Not every student is going to be the same, but a good final-year medical student would be very competent to do most of the things a regular physician would.” 

Under the CPSO changes, graduates will be legally subject to a supervising physician. Cervin suggests that a videoconferencing system called Regional Critical Care Response — already in use across the region — could also be used as a supervision tool. “This is a good idea with the provision that physicians in that position have support — from that network, from their other rural colleagues, and, critically, from the referral centers,” she says.

Ahmed, who estimates that he has worked with about a quarter of the graduating class, says that that system would be insufficient in smaller hospitals, where the physician would likely be working alone. “I’d feel very nervous to have a recent graduate out there and not know the person. If I’ve never supervised that student before, sometimes it can get very hairy, and it’s not just medical work,” he says. “It’s also the social acumen, it’s about handling the loss of someone — all of those things are very stressful, and if you’re out there on your own, it’s risky.” 

Jai Mashru was one of three NOSM students on a placement in Midland, when, on March 13, the Georgian Bay General Hospital pulled him and his colleagues out. Within two days, NOSM’s leadership decided to cut the eight-month placement short for all students.

“The best way to sum it up is, we felt a bit useless,” the Dryden resident says. “We got into this because we want to help — especially the senior medical students who have so much experience with patient interactions.” 

Not yet qualified for the temporary licence, Mashru wasn’t interested in “sitting around” during a global pandemic.  So he, along with other students, launched a crowdfunding campaign to bring medical equipment to northern Ontario. Using cloths and other household equipment, they also made 500 mock respirators for staff training, assembling the first 250 in 36 hours. 

More than 50 lower-year students have volunteered to support established physicians by buying groceries, taking on child care, and walking dogs. Another 30 have volunteered to assist northern health units with contact-tracing confirmed COVID-19 cases. Mashru says the Sudbury area health unit has thus far rejected the offer, but he’s determined to help: “We still feel like even though we’re being told there’s not much else we can do. We’re not going to take no for an answer.”

This is one in a series of stories about issues affecting northwestern Ontario. It's brought to you in partnership with Confederation College of Applied Arts and Technology. Views and opinions expressed in this article are not necessarily those of the college.

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