Aboriginal Physician Training in Canada: Closing the Equity Gap

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Aboriginal Physician Training in Canada: Closing the Equity Gap Dr. Jay Wortman International Medical Workforce Conference March 20-24,2007 Vancouver, British Columbia

Natural selection promoting genes for intelligence probably been far more ruthless in New Guinea than in more densely populated and politically complex societies where natural selection for body chemistry was instead more important. - Jared Diamond Guns, Germs and Steel

Physiological and Medical Observations among the Indians of Southwestern United States and Northern Mexico Ales Hrdicka, 1908 Virtual absence of chronic diseases including diabetes, cancer and heart disease Not attributable to shorter life expectancy

Archives of Dr. Otto Schaefer

What are the problems? What are the problems? Aboriginal people experience a poorer health status than the average Canadian Lack of Aboriginal health care providers Curricula that are not culturally appropriate Difficulty retaining health care providers to work in Aboriginal communities

The Equity Gap The Equity Gap Current estimate of Aboriginal physicians practising in Canada = 150 (IPAC 2007) Aboriginal population = 1.3 million or 4% of the Canadian population (2001 Census) Canadian ratio of physicians per 1,000 population = 2.1 Parity in Aboriginal physician numbers = 2,730 Equity gap (2,730-150) = 2,580

Why is this important? Why is this important? patients have better health outcomes when they receive care from a provider that can appreciate or relate to their ethnic background patients are more likely to visit a physician and be compliant with the physician s care when the physician provides culturally competent healthcare culturally competent physicians reduce the language and cultural barriers to health care

What is being done? What is being done? First Nations and Inuit Health Careers Program Pan-Canadian HHR Strategy - Aboriginal component Aboriginal Health Human Resources Initiative

Current situation in Canadian Medical Schools Western University of British Columbia * 5% of seats reserved for Aboriginal students * Aboriginal Admissions Subcommittee and Aboriginal Interviewing Panel University of Alberta * 7 positions per year University of Calgary * support of Native Centre

Current situation in Canadian Medical Schools Western cont. University of Saskatchewan * 6 first year spaces reserved University of Manitoba * special consideration category and supports available from the Aboriginal Student Centre * Aboriginal Health Electives and Rotation elective

Current situation in Canadian Medical Schools Central McMaster University * modified admission requirements, Aboriginal admissions subcommittee Northern Ontario School of Medicine * 2 seats per year minimum, recruiting program and premedical academic counselling, Aboriginal admissions stream University of Ottawa * 7 reserved medical seats and student cultural and educational supports Queen s University * 4 seats reserved, alternate method of applying

Current situation in Canadian Medical Schools Central cont. University of Toronto * Office of Aboriginal Student Services and Programs and Native Student s Association Western University * 3 seats McGill University * support from the First Peoples House

Current situation in Canadian Medical Schools Central (con t) Universite de Montreal * no supports or accommodations Universite de Sherbrooke * no supports or accommodations Universite de Laval * no supports or accommodations

Current situation in Canadian Medical Schools (continued) Atlantic Memorial University * Aboriginal liaison Officer to assist Inuit students Dalhousie University * 2 seats and Native Education Counselling Unit provides personal and academic support services

Recent Federal/Provincial/Territorial Government Initiatives Pan-Canadian HHR Strategy Aboriginal Health Human Resources Initiative Provincial and Territorial HHR Action Plans

Summary- What has been done to date Health Career Awareness and Promotion (Blueprint for the Future and Health in The Classroom) Scholarships and bursaries (NAAF s, CMA s, or MNC s) Access/Bridging Programs Reserved seats for Aboriginal students Social and educational supports

What still needs to be done: What still needs to be done: Partnerships - F/P/T, IPAC, AFMC, CMA Adapt curricula to be culturally sensitive Address barriers of admission for Aboriginal students Promote a career in medicine to Aboriginal youth Support bridging and access programs