How to increase the number of Indigenous physicians in Canada: report

A new report from the Conference Board of Canada highlights the barriers and potential solutions to encourage, welcome and retain Indigenous physicians. The report is based on case studies, insights from existing programs and interviews with 26 Indigenous medical students, residents, physicians and subject matter experts. The main message is that solutions require more than upping the number of seats reserved for Indigenous applicants to medical school. Numerous systemic barriers need to be addressed before Canada can fulfill the call to action for more Indigenous physicians made by the Truth and Reconciliation Commission. Barrier: Limited access to educational pathways or career guidance in elementary and high schoolIndigenous students may not have the same opportunities for career advice or educational pathways that would prepare them for medical studies, the report states. Proposed solutions: Mentorship and educational programs that nurture an interest in medicineSome of these programs exist, like Camp Med, run by Northern Ontario School of Medicine University (NOSM). It lets grade 10 and 11 students from northern Ontario have hands-on experience for a five-day summer program. Queen’s University runs Weeneebayko Health Education Campus in Moosonee, Ont., which is designed to support Indigenous students from the Western James Bay region. One initiative provides high school students with prerequisite support and mentoring. A program at the University of Ottawa launched by Nunavut Tunngavik Incorporated and the Government of Nunavut helps train Inuit physicians. It includes support in Inuktitut and culturally relevant mentorship.Barrier: Entrance tests (MCAT, Casper) and prerequisites may exclude some Indigenous applicantsCut-offs based on grade point averages, MCAT and Casper scores may lower the chances of Indigenous applicants getting invited to interview for a spot in medical school. This shrinks the applicant pool.Proposed solutions: Indigenous-specific admission pathwaysMany medical schools have this, although all differ in how the pathways work. The variation in application pathways between schools may make applying to more than one medical school more difficult to navigate. Some schools have dropped the MCAT and/or the Casper requirement, and others have talking circles instead of interviews. Barrier: Relocation to study Some students may have to leave their home community for up to a decade to study medicine, which may be emotionally difficult and has high travel and relocation costs for an extended period of time.Proposed solutions: Funding and more training in remote communitiesThere are a number of federal government-funded programs to help with tuition, and national organizations, like Indspire, provide bursaries or scholarships. Medical schools are expanding training opportunities, which may allow students to train closer to their home community. Barrier: Making sure Indigenous medical learners and physicians feel seen, heard and respectedStudents and early-career physicians are more likely to do well when they see themselves and their culture reflected in the course material, faculty, leaders and peers, the report notes. Proposed solutions: Creating culturally-safe spacesSome universities are highlighting the diversity among Indigenous peoples. McGill University has a course on Inuit health and other universities ensure students have a connection with Elders, access to ceremony and peer networks. Many also have culturally safe spaces for study and gathering. Support for Indigenous physicians needs to continue after graduation, the report says. Mentorship, Indigenous leadership and the work of the Indigenous Physicians Association of Canada all contribute to retention and strength of Indigenous physicians. Overall systemic changes, such as addressing and combating racism against Indigenous people is important. While early-career Indigenous physicians are expected to be advocates, leaders or educators, this type of unpaid work can lead to burnout. The Indigenous Physicians Association of Canada created guidelines to address this issue. Melanie Osmack, the executive director of the association, recently ran workshops to help non-Indigenous healthcare workers prepare for the National Day of Truth and Reconciliation. Often Indigenous physicians get asked to do something on that day when it should be a day for non-Indigenous people to reflect. While there has been progress in embedding cultural safety and Indigenous governance in medical education and healthcare, implementation varies across the country. There is more work to be done, the report concludes.The report, Answering the Call, is available on the Conference Board of Canada’s website.

How to increase the number of Indigenous physicians in Canada: report

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