Needs of the many: Northern Ontario School of Medicine students' experience of generalism and rural practice.

OBJECTIVE: To explore the Northern Ontario School of Medicine (NOSM) student and graduate experience of generalism in rural practice, in the context of a growing discourse on generalism.
DESIGN: Qualitative analysis.
SETTING: Northern Ontario School of Medicine in multiple sites across northern Ontario, which is the NOSM campus. PARTICIPANTS: A total of 37 graduating medical students and 9 practising NOSM graduates.
METHODS: The Centre for Rural and Northern Health Research and NOSM tracking studies use mixed methods drawing on data from various sources. This paper reports on an arts-based study using semistructured interviews. MAIN
FINDINGS: Key themes from student observations include an affinity for the northern Ontario environment and a recognition that rural medicine involves a broad scope of practice. Students from NOSM consider generalist care to be a comprehensive service with a strong focus on responding to the health needs of the communities they serve. Beyond primary care, a rural medicine "true generalist" is viewed as a complete package-a physician who provides care ranging from promoting prevention to performing specialist tasks.
CONCLUSION: Rural practitioners, particularly in family medicine, are extended generalists with a broad scope of practice guided by the health needs of the communities they serve. The NOSM students' and graduates' experience of rural generalism is positive and highly influential in determining their career directions, including specialty, scope, and location of practice. The generalist approach of NOSM might be effective beyond rural applications and an advantageous approach for foundational medical education. Students and graduates report that NOSM's distributed community-engaged learning prepares them well for rural generalist practice. Copyright© the College of Family Physicians of Canada.