Aboriginal Physician Training in Canada: Closing the Equity GapAboriginal Physician Training in Canada: Closing the Equity Gap
Dr. Jay WortmanInternational Medical Workforce Conference
March 20-24,2007Vancouver, British Columbia
Dr. Jay WortmanInternational Medical Workforce Conference
March 20-24,2007Vancouver, 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 DiamondGuns, Germs and Steel
Physiological and Medical Observations among the Indians of Southwestern United
States and Northern MexicoAles Hrdicka, 1908
Physiological and Medical Observations among the Indians of Southwestern United
States and Northern MexicoAles Hrdicka, 1908
• Virtual absence of chronic diseases including diabetes, cancer and heart disease
• Not attributable to shorter life expectancy
• 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
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 GapThe 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 = 2.1Parity in Aboriginal physician numbers = 2,730Equity gap (2,730 - 150) = 2,580
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 = 2.1Parity in Aboriginal physician numbers = 2,730Equity 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 backgroundpatients are more likely to visit a physician and be compliant with the physician’s care when the physician provides culturally competent healthcareculturally competent physicians reduce the language and cultural barriers to health care
patients have better health outcomes when they receive care from a provider that can appreciate or relate to their ethnic backgroundpatients are more likely to visit a physician and be compliant with the physician’s care when the physician provides culturally competent healthcareculturally 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
First Nations and Inuit Health Careers Program
Pan-Canadian HHR Strategy - Aboriginal component
Aboriginal Health Human Resources Initiative
Current situation in Canadian Medical Schools
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
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
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
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
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
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
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
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
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
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)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
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
Recent Federal/Provincial/Territorial
Government Initiatives
Pan-Canadian HHR Strategy
Aboriginal Health Human ResourcesInitiative
Provincial and Territorial HHR Action Plans
Pan-Canadian HHR Strategy
Aboriginal Health Human ResourcesInitiative
Provincial and Territorial HHR Action Plans
Summary- What has been done to date
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
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
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