Medical practitioners perform a vital service in their community and vow via the hippocratic oath to do no harm. But what if the healthcare system is causing a different kind of harm to its own doctors?
Results of a survey conducted by the Black Physicians’ Association of Ontario (BPAO) in 2018 noted that Black doctors were exposed to negative discrimination from superiors, their peers, and patients. The report also notes that Black physicians were choosing where to practice based on avoiding discrimination rather than career goals.
Black patients also face their fair share of medical mistreatment, with staggering amounts of medical discrimination found in local clinics and hospitals. This affects all racialized patients, especially Indigenous folks in Canada; going to see a doctor might come with the price of being ignored, discriminated against, or flat out misdiagnosed. A recent example of this is the case Bradford Mistakenchief.
In early February of this year Mistakenchief’s mother was left in a storage room in Foothills Hospital and was checked on once every 3 hours instead of the required once every hour. Mistakenchief’s mother was diagnosed with terminal liver cancer but was removed from her place in the hospital’s cancer ward and moved to make room for other patients. Both Mistakenchief and his mother were deeply disturbed by how they were treated, but these kinds of mistakes are not new.
There is a clear problem on our hands and healthcare needs to change. Luckily, there are advocates for patients and medical practitioners alike.
A physician in Canada since the early 2000s, Dr. Yetunde Kasumu is one of many immigrants who has chosen to practice medicine in Canada. Dr. Kasumu has experienced firsthand what it takes to become a foreign trained doctor in Canada. I had the privilege of having a spirited discussion with Dr. Kasumu about her journey and the state of the healthcare system.
Photo of Yetunde Kasumu provided by Pinnacle Medical Centres
Where did you attend medical school?
I completed my medical school at Ogun State University (now Olabisi Onabanjo University) in Nigeria. After relocating to Canada, I completed the Clinical and Skills Assessment Training (CSAT) program at Memorial University of Newfoundland.
How did schooling differ?
In Nigeria, one doesn’t need a first degree to study medicine. It’s six years of medical school and one year of house job which is an important year of clinical experience under supervision before one is allowed to practice medicine independently. Here, in Canada, most high school graduates that have a passion for medicine are not able to continue into the field either because they lose interest after their first three or four years at university or they get frustrated with the effort and time required to get admission to medical school.
What was the process of becoming a doctor in Canada like for you?
First and foremost, I had to write the Evaluating Examination of the Medical Council of Canada (MCCEE) for foreign trained physicians interested in practicing in Canada and after passing that exam, I then challenged the Medical Council of Canada Qualifying Examination (MCCQE) Parts 1 and 2 to become a Licentiate of the Medical Council of Canada. In addition, I applied to the CSAT program at Memorial University Newfoundland which is usually a six-month training program in different medical disciplines. I was given the opportunity to finish the program in five months because of my performance at the assessment stage of the program. In addition, I had to work in rural Newfoundland and Labrador (St. Anthony) for two years after the training which I found very beneficial and rewarding in honing my medical skills and experience.
How did you feel when you finally passed your evaluation test?
When I passed the Medical Council of Canada Qualifying Examination the first time I sat for the examination and I felt really good and happy knowing that I was on my way to becoming a Licentiate of the Medical Council. The MCCQE is just one of the hurdles foreign trained physicians have to overcome to become licensed in Canada.
What kind of experiences have you had here in Alberta?
Moving to Alberta from Newfoundland and Labrador came with all the challenges of moving to a big city from rural Canada. The practice structure and expectations are different. In St. Anthony, NF, everyone knew everyone and the communities are in a hurry to make you feel at home and comfortable so that you don't want to leave. I have also had great experiences in Alberta but the workload is totally different. The practice of family medicine here in Alberta is indeed more demanding and doctors have to see way more patients daily.
How did it differ from elsewhere in the country?
People’s response to a visible minority physician in rural Canada with a great need for physicians is quite different from what one experiences in the city. Physicians are generally appreciated more in rural Canada because of the shortage of physicians in these places.
What do you think could aid with reducing medical discrimination in the Alberta Health Care system?
The issue of medical discrimination in the Alberta Health Care system can be addressed to a very large extent through diversity in the workplace. Visible minorities are underrepresented in the healthcare profession relative to their population among the general Alberta public in addition to holding fewer leadership positions in the organization. A conscious effort by the leadership to encourage people of colour to the profession will go a long way in addressing the issue. Participating in an inclusive and culturally safe workplace is very important in the healthcare profession and should be treated as such. Reducing medical discrimination in the long run improves quality and access to medical care for the general population. Representation matters!