The College of Medicine has always been a recognized leader in social accountability; our Social Accountability Committee was established in 2004, leading to our Division of Social Accountability, created in 2011. This team has been ably led by Dr. Ryan Meili and is best known for its Making the Links program, which educates students in advocacy and provides them with experiences in local and global socio-economically deprived communities. This year, we have added resources to the division to allow for the expansion of Making the Links and the addition of an Indigenous stream.
I challenged Dr. Meili to develop a plan for advancing social accountability at the College of Medicine to the next level. He has consulted widely over the last six months and is now ready to bring forward that plan, the College of Medicine Social Accountability 2016-2020 Strategic Plan.
Some data collected as part of the background, demonstrating the level of need provincially, is startling, in particular:
Just under 100,000 (10.1% of the population) Saskatchewanians were living in poverty in 2010 and 64% of First Nations and Métis children are living below the poverty line in our province (Plante & Sharp, 2014).
On March 21, we were fortunate to have Dr. Robert Woollard, Professor of Family Medicine from UBC, former chair of the Committee on Accreditation of Canadian Medical Schools and world-renowned scholar and advocate for social accountability, at the college as a guest speaker. Dr. Woollard will assist us as we develop social accountability in medicine in Saskatchewan.
Last week, our health science students hosted the third annual Health Innovation and Public Policy conference. We had superb presentations by our own Dr. Kish Wasan, Dean of the College of Pharmacy and Nutrition, Dr. Danielle Martin, Vice-President Medical Affairs and Health System Solutions at Women’s College Hospital and founder of Canadian Doctors for Medicare, Dr. Cindy Forbes, President of the Canadian Medical Association and Dr. Naheed Dosani, Palliative Care and Family Physician at William Osler Health System and Inner City Health Associates, McMaster University.
Our students are fabulous role models in advocacy, as demonstrated by their organization of this conference. Physician advocacy is now a competency mandated in the new CanMEDS guidelines. In their article, Building a Generation of Physician Advocates: The Case for Including Mandatory Training in Advocacy in Canadian Medical School Curricula, doctors Tahara Bhate and Lawrence Loh make a compelling argument for mandatory training in advocacy in Canadian medical schools.
In a further example of advocacy, one of our own residents was asked on completion of his residency, “What would you change?” He spoke passionately about the numerous times he witnessed both intentional and unintentional racism directed towards Indigenous patients. His courage was impressive and the examples he provided were distressing. I’d like to bring to your attention to an excellent paper by the College of Family Physicians of Canada (CFPC), Health and Health Care Implications of Systemic Racism on Indigenous Peoples in Canada prepared by the Indigenous Health Working Group of the CFPC and the Indigenous Physicians Association of Canada—our own Dr. Veronica McKinney was one of the principal authors.
This is a great document for all of us to read and then reflect on what we can do to eliminate systemic racism in health care, and how we teach and act as advocacy role models for our learners. For me, the greatest reminder of how far we have to go came from the authors of the Truth and Reconciliation final report. They wrote: “For over a century, the central goals of Canada’s Aboriginal policy were to eliminate Aboriginal governments; ignore Aboriginal rights; terminate the Treaties; and, through a process of assimilation, cause Aboriginal peoples to cease to exist as distinct legal, social, cultural, religious, and racial entities in Canada.” This quote illustrates so clearly how we got here and how far we have to go in eliminating systemic racism in health care.
As always, I welcome your feedback.