The Truth and Reconciliation Commission’s 2015 final report called on governments to increase the number of Indigenous health-care workers and ensure the retention of Indigenous health-care providers in Indigenous communities, but three years later, there is still a significant gap in the number of Indigenous doctors to serve their own communities.
It’s an issue that those like Tibetha Kemble, director of Indigenous Health at the University of Alberta are looking to address.
“Indigenous physicians understand the lived reality of Indigenous patients,” Kemble said on the importance of having Indigenous doctors in First Nation communities.
“I think the specific experience of colonization, the impacts of residential schools has left a legacy of mistrust in Indigenous patients in particular.”
Kemble said traditional healing methods are also important to Indigenous cultures, something outside medical professionals may not understand.
According to the 2016 Stat Canada census, of the 93,985 specialists and general practitioners in Canada, less than one per cent (760) identify as Aboriginal, but Indigenous people make up more than 4.5 per cent of the population.
In 2017, the federal government pledged $828.2 million over five years towards improving the health outcomes of First Nations and Inuit, including specific funds for mental health programming, primary care and maternal and child health. In 2018, $498 million with $97.6 million per year ongoing was earmarked to sustain access to critical medical care and services, including 24/7 nursing services in 79 remote and isolated First Nations communities.
Kemble said access to medical school can be expensive and many students, especially those who grow up on a First Nations reserve, don’t have access to multi-generational wealth that can help pay for school. It can also be difficult for students to access the Medical College Admission Test, and to move away from their home communities.
“For Inuit students in particular, often the location and distance from home, being separated from community is often a barrier too,” she said.
“Even in my little Grade 1 yearbook, it said, ‘What do you want to be when you grow up?’ and I said, ‘I want to be a doctor,” said second-year medical student Sean McKenzie.
McKenzie studies at the University of Alberta and is a member of the Mid-Isle Metis Nation in B.C. He said when he was accepted into medical school, his community started to reach out to him.
“They were very open and said, ‘I want to share my experience with the health-care system so you can change it,” McKenzie said.
He said it opened his eyes to the struggles that First Nation communities face, which drives his passion to help others.
“So many of them don’t have access to a family physician and of those getting treatment, oftentimes, it’s sub-par and inadequate treatment,” said McKenzie. “It’s kind of provided by inconsiderate doctors who judge individuals based on their ancestry alone.”
McKenzie said it is also difficult for Indigenous students who want to take up a specialty to return home because training and jobs are located in major centres. McKenzie said he hopes, once he’s fully licensed, that he will be able to help his own community, and other remote First Nations, by flying in and out as a locum.
WATCH: Improving health care of Indigenous Canadians
Universities across Canada are also working to encourage more Indigenous Canadians to apply to medical school.
For the past 30 years, the medical school program at the university held five spots per academic year for Indigenous students as long as they met eligibility requirements.
The U of A said the quota was originally established to address the under-representation of Indigenous Peoples in health professions. It was intended to ensure at least five Indigenous students per year were accepted into the medical program. Lately, though, it’s become more of a limitation and was recently changed.
Kemble wants other U of A faculties and medical schools across Canada to make similar admission changes.
Watch: Health minister discusses claim of discrimination against indigenous peoples (Jan. 2016)
— With files from Slav Kornik