As Ontario grapples with a shortage of family doctors, Dr. Michael Green, the newly appointed dean of NOSM University, has shared his insights on effective strategies to address the issue. Dr. Green, who took the reins as the Vice-Chancellor, Dean, and CEO of the Northern Ontario School of Medicine (NOSM) on November 1, believes the solution doesn’t lie in excluding international students from Ontario’s medical schools. Instead, he highlights the need for enhanced support for community-based medical training and increased investments in clinical teaching infrastructure.
A New Chapter at NOSM University
Dr. Green’s appointment comes as Ontario’s government continues to expand medical education across the province, including the opening of two new medical schools at York University and Toronto Metropolitan University. NOSM University itself is growing, with medical school seats doubling since its founding in 2005, reaching a new high of 108 seats. Dr. Green’s mission is to oversee this growth while also crafting a fresh strategic vision for NOSM, focusing on its commitment to community-based doctor training.
Supporting Medical Training in Communities: A Key Strategy
According to Dr. Green, simply adding more seats in medical programs is insufficient without the necessary resources to support training in community settings. He emphasizes the importance of establishing and funding community-based clinical teaching units to train students in family medicine and primary care. This approach aligns with NOSM’s model of decentralized medical education, which enables students to learn and practice in the very communities that need family doctors most.
“I would love to see support for the creation of community-based teaching units,” Dr. Green explained. “We need support to allow our community teachers to have more students in the community and deliver care.”
These units not only help in training future doctors but also strengthen local healthcare systems, ensuring new physicians experience firsthand the unique challenges and rewards of practicing in smaller communities.
Addressing Retention Through Better Working Conditions
While training more doctors is a critical step, Dr. Green notes that retention hinges on creating favorable working conditions. He emphasizes that new physicians need adequate clinical space, support for their practices, and fair compensation. Without these factors, new graduates may struggle to establish a viable practice in smaller communities and may leave for urban centers where these resources are more readily available.
“Even once docs are trained, they won’t stay if their working conditions are no good,” Green cautioned.
Questioning Ontario’s Ban on International Medical Students
In recent announcements, the Ontario government has outlined a plan to ban international students from medical schools starting in 2026. This measure is intended to ensure more seats are available for Ontario residents. However, Dr. Green, who previously served as president of the College of Family Physicians of Canada, questions the effectiveness of this decision. He notes that only 11 international students are enrolled in Ontario’s medical schools, and these students occupy supernumerary positions that do not displace Ontario applicants.
“I don’t really know what that’s about,” Dr. Green commented. “NOSM doesn’t have any international students, and there’s only 11 in all of Ontario.”
At NOSM University, enrollment is limited to Canadian citizens or permanent residents, with 91% of students hailing from Northern Ontario. This focus allows NOSM to channel its resources into training physicians who are likely to remain in the region, rather than accommodating international students who may have different career plans post-graduation.
Ontario to Restrict International Medical Students by 2026: Key Impacts and Goals
Promoting Rural Retention Through Community-Focused Education
NOSM University’s commitment to community-based training has long been central to its approach. Unlike traditional medical schools that often concentrate training in urban hospitals, NOSM integrates students directly into rural communities. This immersive model helps to foster stronger connections between students and the communities they serve, making graduates more likely to pursue careers in these areas.
Dr. Green is also optimistic about new provincial incentives, such as covering tuition for students who commit to family medicine careers in Ontario. While supportive of these efforts, he stresses that sustainable retention will require ongoing investments in community infrastructure, practice support, and collaborative partnerships between educational institutions and government agencies.
Expanding NOSM’s Capacity: Looking to the Future
Dr. Green’s vision for NOSM’s future growth is ambitious but pragmatic. He emphasizes that any further expansion of medical training capacity must be accompanied by resources for community integration, infrastructure development, and compensation improvements. By focusing on these areas, he believes that Ontario can address its family doctor shortage effectively without excluding international students.
As Ontario’s government continues its efforts to address healthcare needs, Dr. Green’s recommendations underscore a nuanced approach: prioritizing community support and sustainable working conditions over restrictive enrollment policies. His insights offer a valuable perspective for policymakers as they work to strengthen healthcare delivery in Ontario’s communities.
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