Edonton: The University of Alberta has the oldest aboriginal medical program in Canada dating back to 1988 and has graduated the most aboriginal doctors of any such university program in the country — 73 as of June 2011.
Dr. Jill Konkin isn’t bragging, not yet.
“There is a screaming need for physicians for aboriginal communities and I would suggest that we aren’t doing our job until we have enough physicians, both aboriginal and non-aboriginal, to meet that need,” says the associate dean of community engagement, responsible for indigenous, inner city, global and rural health.
In 2007, there were 200 self-declared aboriginal doctors in Canada when 1,500 to 2,000 would be representative of the aboriginal population.
Virtually every medical school in the country has initiatives targeting aboriginal students because aboriginal physicians are much more likely to move to communities with underserviced aboriginal populations and/or underserviced aboriginal populations in larger communities, than non-aboriginal physicians, Konkin says.
“We also know that our medical school classes are much too monolithic, in particular in a socio and economic diversity way of looking at the world.”
The issue is of equal concern to medical students themselves, 50 of whom, from the U of A and University of Calgary, met last month with Alberta Health and Wellness Minister Fred Horne and MLAs from across the province.
The students say a disproportionately high number of medical students come from high-income families, something they hope to change by advocating for prospective medical students from rural and aboriginal communities, and low socio-economic backgrounds. They propose various initiatives including a new bursary or financial assistance program for medical student applicants and government funding to develop a mentorship program for these under-represented groups.
Currently 25 of 679 students enrolled in medical studies at U of A are self-declared aboriginal students. Part of the problem in trying to attract more is that high school graduation rates for aboriginal people are significantly lower than the rest of the population.
“If you don’t graduate from high school, you don’t go to university, and if you don’t go to university, then there’s no way you’re going to get into medical school,” Konkin explains. “Part of what we’re doing is realizing that it’s our responsibility to help increase the number of aboriginal applicants … so some of our programs now are much more aimed to high school and public school students and communities.”
The message the school is trying to get out is that aboriginal kids are able and needed in medical schools and other health professions, but they have to stay in school to get there.
It’s hard for aboriginal students to see themselves in a western medicine world, Konkin says. A significant cultural shift is involved “so there needs to be some supports available to aboriginal students.”
For example, aboriginal medical students and students in other health programs such as dentistry could meet once a week to support each other and to hear elders tell stories and talk about the culture.
“Aboriginal students also need to see much more information about aboriginal culture, health and medicine within the curriculum,” says Konkin, something she hopes to see incorporated over the next four or five years.
Medical schools are feeling pressure to do more from groups such as the Association of Faculties of Medicine of Canada and the Indigenous Physicians of Canada who have put together a curriculum around aboriginal health issues, such as diabetes, that they expect medical schools to incorporate.
“I guess the message I need to get out is that we’ve really only just begun to expand the indigenous health programs to do many more things than just try and recruit students that are already out there and qualified to come to medicine,” Konkin says. “We’re expecting we will have not only more aboriginal students in our program, but also more students in our program who understand the issues and are willing to choose careers in medicine that will better serve aboriginal people.
“Stay tuned. We’re right at the beginning of a huge initiative that we expect will have some significant differences in the next couple of years.”