Like many rural and remote regions around the world, Canada's Northern Ontario has a chronic shortage of doctors and other health care providers. Recognizing that doctors who have grown up in a rural area are more likely to practise in the rural setting, the Government of Ontario decided to establish a new medical school with a social accountability mandate to contribute to improving the health of the people and communities of Northern Ontario. The Northern Ontario School of Medicine (NOSM), a joint initiative of Laurentian University in Sudbury and Lakehead University in Thunder Bay, was established as a rural, community-based medical school. NOSM is a long-term sustainable 'strategy that is expected to lead not only to more skilled doctors and enhanced health care with improved health outcomes, but also to broader academic developments for the universities and substantial economic developments for Northern Ontario communities.