NEWS FROM #CCPL19 Work to be done to address diversity in medicine
In a conference focused on the broad and challenging issue of showing leadership in bringing more diversity and equity to medicine, it was personal stories of discrimination and taking on leadership roles that seemed to move the 350 delegates most.
Canadian Conference on Physician Leadership in Montréal, during a panel discussion, two speakers were given standing ovations: Dr. May Cohen, a pioneer on gender issues and a leading female physician and Dr. Nadine Caron, Canada’s first Indigenous general surgeon. They shared the podium with Dr. Henry Annan, a black Canadian and immediate past-president of the Canadian Federation of Medical Students and Dr. Michael Negraeff, a pain specialist and disabled physician.
“I didn’t choose leadership. But there were a number of things I found were voids in our health care system when it came to helping people with pain,” Dr. Negraeff said.
With the theme, “Diversity, Inclusion & Engagement: The Leadership Challenge,” the conference featured a number of plenary presentations and breakout sessions focused specifically on the challenges of bringing more inclusivity to medicine in Canada today. Addressing diversity is “arguably one of the most crucial issues for leadership and medicine in our time,” said Dr. André Bernard, chair of the board of directors for Doctors Nova Scotia. Top
The conference featured leading experts and current research demonstrating the extent of the challenges facing today’s physician leaders, but it also presented moving narratives from physicians who are part of underrepresented groups in medical leadership — women, Indigenous Canadians, medical students, residents, and physicians of colour.
Rather than deal only with the overt bias and racism still facing some physicians, delegates were schooled on the unconscious biases they may harbour that could impact their ability to fairly assess and promote physicians who are not white and male. “I hope this conference has shone a hard light on the work that still needs to be done,” said current Canadian Medical Association president, Dr. Gigi Osler.
Although many agreed with Dr. Osler, speakers such as Dr. Dennis Kendel, a veteran physician leader and mentor, gave object lessons in how those who are privileged can help support and mentor others. In fact, Dr. Kendel helped lead a breakout session with Ottawa psychiatrist and physician well-being expert, Dr. Mamta Gautam, on how male physicians can support their female peers in taking leadership roles. Top
“I am a poster boy for the ‘Old Boys Club,’” Dr. Kendel said, “but I am committed to transforming [this] culture in medicine to foster diversity, inclusion, and equity in our profession. When in a leadership role, our responsibility includes opening doors for others to grow, identifying and removing roadblocks, and providing sponsorship.”
The need for ongoing advocacy and support for women physicians to achieve more leadership roles in medicine was an ongoing theme at the meeting. Many speakers quoted similar statistics about the lack of representation of women in the senior echelons of academic medicine despite their having made up half of medical school enrollees for more than two decades now. For example, it was noted that only 17% of current or pending medical school deans in Canada are women. Top
The conversation about diversity at the conference began with a plenary presentation on the first day from Dr. Gurdeep Parhar, executive associate dean and clinical professor, Faculty of Medicine, University of British Columbia. He presented data showing how unconscious biases and stereotyping continue to hamper women physicians and physicians of colour. Dr. Parhar also gave delegates practical tips on how to acknowledge and deal with these forms of bias.
“Leaders need to be knowledgeable about aspects of cultural diversity and continue to learn about other cultures,” Dr. Parhar said, adding that self-awareness was a good place for physicians to start in addressing their unconscious biases. He also cautioned against blindly relying on those who profess to be experts in a particular culture or race. Top
A similar presentation, backed by results of numerous well-designed trials, was given on the second day by Dr. Maydianne Andrade (PhD), vice-dean of Faculty Affairs and Equity, University of Toronto. She noted “even people of goodwill” can unwittingly show bias and this does not automatically make you a bad person.
Although Canadians generally value equity and diversity and most Canadian organizations have equity statements, she said there is hard evidence that inequities continue to exist even though they have been recognized for years. Top
Dr. Andrade provided practical tips on how to overcome bias when assessing other individuals for jobs or promotions. “Leaders can encourage, require, and reward education and performance against targets [but often don’t],” she said. “Rigorously monitor your judgements and base them on outcomes,” she added. Dr. Kendel commented later: “If you haven’t achieved gender balance on the search list for a [leadership] position, you haven’t looked
A session that was repeated and dealt with advancing a culture of equity and diversity in medicine featured Drs. Osler and Bernard as well as a medical student and a resident of colour. Chika Stacy Oriuwa discussed her experiences as the only black student in a class of 259 at the University of Toronto.
“Advocacy is a form of self-preservation,” she said, commenting on why she continued to advocate for the rights of black medical students despite facing overt racism.
A question repeated throughout the meeting was whether there is a need for quotas, with most of those voicing an opinion speaking in favour of some form of affirmative action to address current imbalances. Top
Addressing inequities “is not for the faint of heart,” Dr. Osler also noted, and others talked of facing ongoing discrimination for speaking up on this issue. Dr. Osler spoke about deliberately taking advantage of her role as CMA president to be a voice for inclusion.
“I believe the investments we are making today to move the diversity needle in the forward direction will make it easier for us to get to a place where we can be proud of the representation in our profession, even at the highest echelons,” Dr. Annan tweeted. It was a sentiment many delegates in the conference would echo.