Then and now: How Canada's medical and health sciences schools have advanced Indigenous health

Ten years ago the University of British Columbia launched what was at the time the first undergraduate elective course on pharmaceutical care for Indigenous patients. The course was the result of advocacy by two assistant professors who saw the challenges in Indigenous care as they were starting their careers as pharmacists. Today, Indigenous health has become a standard—if not always mandatory—offering in many health sciences programs and curricula at medical and pharmacy schools across the country. The offerings range in focus from Indigenous health education, attracting more students from Indigenous communities and creating greater awareness of the cultures and practices of Canada’s first inhabitants and their implications for healthcare providers and policymakers. One school, McGill University in Montreal, has dedicated a physical space to scholarship in Indigenous health at its department of family medicine. “We want it to be a focus in integrating Indigenous ways of knowing into the western academic world,” Dr. Marion Dove, chair of the McGill’s department of family medicine, told the McGill Reporter. Read: Northern pharmacy practice: Lessons in collaboration, adaptation and reconciliation Richard Budgell, a Labrador Inuk who is a family medicine professor at McGill, expressed his hopes of reconceptualizing medicine by bringing in Indigenous perspectives. As an example he highlighted an Inuit concept, called Inuuqatigiitsianiq, based on harmonious relationships among people who share a space. But how do the ideas around Indigenous health translate into learnings for students in health sciences? Larry Leung, one of the two UBC assistant professors behind the elective course on pharmaceutical care for Indigenous patients—the other assistant professor is Jason Min—outlined a course content built on five key pillars: colonialism, power and privilege, cultural safety and humility, health and healing, and ethical engagement. The content is delivered within the context of pharmacy practice and healthcare, through Indigenous perspectives. Read: Manitoba health authority promises to help address racism in healthcare services “All of this is overseen by an Indigenous advisory committee to ensure they have a voice,” said Leung. “They have final say on what the curriculum looks like.” The learnings extend beyond the classroom. Third-year students who sign up for the course are paired with various Indigenous partners—who could be healthcare providers, health directors, elders and knowledge keepers—who work with them on a project during the school term. “For example, a project could be traditional medicine preservation or revitalization, creating patient workflows with better pharmacist integration, or providing COVID-19 education to communities,” explained Leung. UBC recently introduced a workshop on Indigenous cultural safety, which is mandatory for all students in health sciences including pharmacy, medicine, dentistry and nursing. Reciprocity is key to building programs focused on Indigenous health, said Leung. Read: Health Research Foundation offers $500K grant to study underrepresented populations and virtual care “When Indigenous people contribute to a school’s curriculum it benefits the academic institution, the professors and students but the key question is: what is the benefit for the Indigenous people who are contributing?” he asked. “While it’s true that there are long-term benefits to Indigenous communities when we train ethically sound pharmacists and other healthcare professionals who will provide better care in the future, we have to also be cognizant about providing a benefit today.” At UBC, one immediate benefit to both the university and to its Indigenous advisers is the exchange of knowledge, said Leung. “We’re not only building Indigenous health education for our students, we’re also providing something in return, such as our knowledge of medications, that our advisory committee members can take back to their communities,” he said. Ongoing surveys about the course have shown a high approval rate—of around 97%—among students who have taken it, including those who have graduated and are now practising pharmacists. “One key feedback was that this cannot be an elective—it needs to be mandatory,” said Leung. “We took this as evidence to advocate for a mandatory course that we piloted this year.” Read: App allows Indigenous communities to collect their own health data

Then and now: How Canada's medical and health sciences schools have advanced Indigenous health

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