HEWIS

The Health Education Workforce Impact Study (HEWIS)—originally known as the Tracking Study—is a long-term research initiative designed to understand how NOSM U’s distributed, socially accountable education model shapes the healthcare workforce across Northern Ontario and beyond.

Since its inception, HEWIS has provided essential evidence to demonstrate how NOSM U graduates contribute to equitable healthcare access, rural retention, and the development of generalist and community-focused medical practice.

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Origins and Early Vision

When NOSM U was founded in 2002, it was created with a social accountability mandate—to improve access to quality healthcare for the people and communities of Northern Ontario. To evaluate this mission in action, the university launched the Tracking Study in 2005, the same year NOSM U welcomed its first class of undergraduate medical students.

The study’s purpose was simple but ambitious: to follow NOSM U learners from admission through education, residency, and into independent practice—tracking where they work, what they practise, and how their training and background influence their career choices.

Health

‍Education

Workforce

Imapct

Study

Key Milestones

2005

Launch of the Tracking Study

The study began under the leadership of the Centre for Rural and Northern Health Research (CRaNHR) at Laurentian University, in partnership with NOSM U. It gathered longitudinal, multi-cohort data on learners, residents, and graduates to evaluate outcomes related to geography, specialty, and service scope

2008

Launch of the Tracking Study

‍By 2008, the study had expanded to include postgraduate residents and specialty trainees. Early analyses began to show a positive relationship between NOSM U’s distributed training and rural/northern practice.

2010
–
2015

National Recognition and Published Protocol

In 2015, the study’s methodology was formally published as a longitudinal, multi-cohort research protocol, cementing its national and international reputation as a model for socially accountable medical education research.

2019

Transition to NOSM U Stewardship

In 2019, NOSM U assumed direct responsibility for the Tracking Study’s data collection and storage from CRaNHR. Oversight was transferred to NOSM U’s Dr. Gilles Arcand Centre for Health Equity and the MERLIN Research Lab, ensuring institutional data governance and alignment with NOSM U’s evolving research infrastructure.

2021

Becoming HEWIS            

As NOSM U matured into a stand-alone university (2021), the Tracking Study evolved into the Health Education Workforce Impact Study (HEWIS). This new identity reflects the broader, more integrated approach to the study that is not only focused on physician outcomes but the overall health education workforce across Northern Ontario.

What HEWIS Tracks Today

HEWIS integrates survey data, regulatory databases, and administrative linkages—allowing for robust, evidence-based evaluation of NOSM U’s social accountability outcomes.
⦿    Undergraduate and postgraduate learners from admission through to five or more years  in independent practice.
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⦿     Practice location and service scope, including rural, remote, Francophone, and Indigenous community practice.
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⦿     Workforce retention and mobility within Northern Ontario and similar underserved regions.
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⦿      Education-to-workforce pathways, comparing learners who completed both undergraduate and postgraduate training at NOSM U to those who trained elsewhere.
HEWIS is one of the most comprehensive longitudinal education-to-practice datasets in the world. It tracks:

Impact and Findings

HEWIS data consistently demonstrate that NOSM U’s distributed medical education model is effective in strengthening the Northern Ontario physician workforce. Summaries of the physician workforce data can be found at the Northern Ontario Physician Workforce Data Dashboard. Some examples of key findings include:
⦿ Over half of NOSM U’s medical graduates practise in Northern Ontario 

⦿ Among those who completed both undergraduate and postgraduate training, across all programs, at NOSM U, up to 89% remain practising in Northern Ontario.

⦿ Fifty percent of incoming students desire to serve in family medicine and generalist roles, while after completing their undergraduate education at NOSM U, 62% of students match to family medicine, directly addressing local and regional workforce needs.
HEWIS integrates survey data, regulatory databases, and administrative linkages—allowing for robust, evidence-based evaluation of NOSM U’s social accountability outcomes.

Looking Ahead

HEWIS continues to evolve, expanding to include broader health-workforce sectors and emerging research areas such as:
⦿   Longitudinal integrated clerkships

⦿    Rural generalist and community pathways

⦿    Indigenous and Francophone workforce development

⦿    Advanced analytics linking HEWIS data to ICES and other provincial datasets
NOSM U remains committed to evidence-informed, socially accountable education. Through HEWIS, the university demonstrates not only where its graduates go, but how they contribute to transforming health outcomes across the North.

Meet members of the HEWIS

Erin
Cameron
Co-PI
Kerri
Delaney
Co-Investigator
Emily
Groot
Co-Investigator
Brian
Ross
Co-PI

References

Hogenbirk, John C., Roger P. Strasser, and Margaret G. French. 2022. “Ten Years of Graduates: A Cross-Sectional Study of the Practice Location of Doctors Trained at a Socially Accountable Medical School.” PLOS ONE 17 (9): e0274499.
Hogenbirk, John C., Patrick E. Timony, Margaret G. French, et al. 2016. “Milestones on the Social Accountability Journey: Family Medicine Practice Locations of Northern Ontario School of Medicine Graduates.” Canadian Family Physician Medecin De Famille Canadien 62 (3): e138-145.  
Hogenbirk JC, French MG, Timony PE, Strasser RP, Hunt D, Pong RW. Outcomes of the Northern Ontario School of Medicine's distributed medical education programmes: protocol for a longitudinal comparative multicohort study. BMJ Open. 2015 Jul 27;5(7):e008246. doi: 10.1136/bmjopen-2015-008246. PMID: 26216154; PMCID: PMC4521518.
Woolley, Torres, John Hogenbirk, and Roger Strasser. 2020. “Retaining Graduates of Non-Metropolitan Medical Schools for Practice in the Local Area: The Importance of Locally Based Postgraduate Training Pathways in Australia and Canada.” Rural and Remote Health, ahead of print, August 31.

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