The Saskatchewan Human Rights Commission highlights discrimination in medical education

A report created by the Saskatchewan Human Rights Commission was brought forward on Thursday and delved into concerns of racism and discrimination at the College of Medicine after outcry back in 2020.

A group of physicians came forward highlighting concerns about racism and inequity in the medical profession, as well as the Saskatchewan medical education system.

Specific recommendations were made through a document created by the physicians called “9 Calls to Action” to address structural racism and create a more equitable learning environment.

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A letter was then published on Aug. 5, 2020 by Dr. Adebola Obayan called “My Experience with Racial Discrimination in Residency,” in which he talked about incidents of discrimination and mistreatment he experienced during his time in medical residency in Saskatchewan.

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A group of 19 physicians affiliated with USask then came forward on Sept. 1, 2020, with a letter demanding changes at the College of Medicine, as well as an investigation into allegations of past discrimination and mistreatment.

An investigation from the Saskatchewan Human Rights Commission then began with an invitation from the College of Medicine and the University of Saskatchewan.

The report that was brought forward on Thursday recognized that understanding the intrinsic equality and value of human beings was fundamental, noting it could ultimately affect the lives of physicians and patients alike, giving several examples:

  • On May 21, 2020, Samwel Uko, a 20-year-old Black Canadian, sought emergency care for a mental health issue at the Regina General Hospital. He was removed from the hospital, without being triaged or receiving care, and was later found dead in Wascana Lake.
  • On Sept. 28, 2020, Joyce Echaquan, a 37-year-old Atikamekw woman, died in the Center hospitalier de Lanaudière in Saint-Charles-Borromée, Quebec, having been subjected to verbal abuse. Racism and prejudice were contributing factors in her death.
  • In July 2017, the Saskatchewan Health Authority offered an apology after an independent report describing the experiences of Indigenous women who were coerced into tubal ligation procedures within the Saskatoon Health Region.
  • On Sept. 20, 2008, Brian Sinclair, a 45-year-old Indigenous man from the Fort Alexander First Nation, died at the Health Sciences Center Emergency Department in Winnipeg, Manitoba, having waited for 34-hours without assessment or treatment.
  • Inquests were launched into the deaths of Mr. Uko, Ms. Echaquan, and Brian Sinclair, and each of the subsequent official reports found racism to be a factor in their deaths.
  • The 2015 report of the Truth and Reconciliation Commission of Canada and the 2019 report of the National Inquiry into Missing and Murdered Indigenous Women and Girls have further documented anti-Indigenous discrimination within Canada’s healthcare systems.
  • The Truth and Reconciliation Calls to Action specifically asked medical and nursing schools to provide training in intercultural competency, conflict resolution, human rights, and anti-racism.

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The commission gathered information regarding discrimination in the health sector that started in November 2021 with conversations with stakeholders.

It noted the initiative didn’t have the aim of conducting formal investigations into allegations, but said in several cases there was enough specific allegations that formal human rights complaints could have been made.

The commission said people who reported experiencing discrimination often described several incidents.

“For me, as a student, I’ve had multiple encounters. Whether it’s someone making a joke about a person of color, or someone saying things to me directly about my skin color or my ethnicity, I often feel silenced. Honestly, like it was a pretty small incident, but it’s been repeating over and over … making comments weird about my skin tone,” read one comment.

Some of the respondents described instances of faculty using outdated and derogatory terms like “Orientals”, or slurs like the “n” word.

Some students felt like they were dealing with excessive criticism because of their race, and others wanted staff and faculty to have a better understanding of race issues to avoid making inappropriate comments.

Racist attitudes and behaviors towards patients were also reported.

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Cases of sexism were also reported by students, with some saying they’d overhear sexist jokes or comments from faculty, or deal with additional hurdles in certain specializations.

“Male surgeons tell female students interested in surgery, ‘Don’t expect your male colleagues to pick up your slack when you have kids and go down part time.’ Being told surgery ‘isn’t good for women.’”

Some students also noted being disappointed in the amount of LGBTQ2 content in the curriculum.

“I am frustrated that our queer education takes the form of two lectures in the first year, and then just a couple of things that pop up along the way. Like this case in our OSCE: ‘Wow, it turns out this student is gay. Wow, they must have a mood disorder’ – that sort of thing,” another comment said.

The report lists several other issues, some regarding a lack of data collection, concerns whether complaints resulted in any action, and a fear of possible repercussions.

It did list nine issues to be addressed by the College of Medicine:

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  • Implement a College-level EDI action plan linked to Research and Evaluation
  • Ensure education equity by supporting student diversity
  • Review and update curriculum and assessment mechanisms to eliminate discriminatory elements
  • Improve the student complaint process
  • Address uneven diversity in faculty and leadership positions
  • Pursue constructive relationships with Black, Indigenous, and other physicians
  • Strengthen work culture, building trust and pursuing employee satisfaction
  • Implement demographic data collection and data stewardship
  • Communicate the College’s Policy and Practice on Racism and other forms of discrimination

Global News asked Preston Smith, dean of the college, about whether there were immediate reactions to any of these issues.

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“If you look at all of those nine initiatives you can actually track the activities that are currently going on in all of them,” Smith said.

He stressed that this doesn’t take away from the fact that more needs to be done, but he gave examples of a revamped admissions program to bring a wider equity lens forward, and a joint initiative among medical schools called “Anti-racist Transformation in Medical Education”.

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