Manitoba’s MDs mandate steps to end anti-Indigenous racism

Manitoba’s doctors are embarking on a path the profession’s regulator hopes will eliminate anti-Indigenous racism in medical care.

The College of Physicians and Surgeons of Manitoba is mandating that MDs complete a course of anti-racism training before November 2027.

Two other initiatives go into effect as of today — National Indigenous Peoples Day. The first, a standard of practice, requires that doctors report racist behaviour. The other is a restorative practices program to provide education and support to physicians who cause harm to First Nations, Métis or Inuit patients, either intentionally or unintentionally.

“It is very difficult to practise medicine in Manitoba in any context without interacting with, supporting, caring for people who have Indigenous ancestry or who are from our First Nations, Métis and Inuit population and who have had suffered the health effects of colonialism,” Dr. Ainslie Mihalchuk, registrar of the college, said Friday.

“That is part of why we feel it’s important that, to practise in Manitoba, you need a baseline understanding of how colonialism impacts health. If you can have that understanding, then you inherently will be a better provider for the people here.”

A report on race, ethnicity and Indigenous identity released Tuesday by Shared Health and the University of Manitoba’s Ongomiizwin Indigenous Institute of Health and Healing revealed issues in seeking and receiving health care in the province.

It showed that Indigenous patients in hospital emergency departments were most likely to leave without being seen and against medical advice, including higher-acuity patients.

“The data supports that we have opportunity to do better,” Mihalchuk said. “This is about understanding needs of humans and that the needs of certain groups of humans are different than others, and that it’s on us as leaders and providers in the health system to recognize that this data points to the fact that our systems are not serving these people in the best way.

“That should lead us to collectively try and say, ‘What do we need to do differently?’”

She pointed to other examples of anti-Indigenous racism in Canadian health care — from the death of Brian Sinclair, who died after waiting 34 hours without being seen at the Health Sciences Centre ER in 2008 to Joyce Echaquan, a mother of seven, who died in 2020 at a hospital north of Montreal moments after recording health-care staff hurl racist remarks at her, to experiments performed on residential school students.

“We were part of that. The medical profession, the healing profession has participated in that,” Mihalchuk said.

“I think we need to understand how, although we might see ourselves as nice people, there’s a lack of trust — that’s not on individuals. It’s on systems and societies and structures that are older and bigger than we are,” Mihalchuk said.

The college self-regulates 3,500 physicians in Manitoba.

The 30 per cent of internationally trained doctors in the province may have had no exposure “to the stories of how Manitoba came to be and who lived here before,” Mihalchuk said.

The province often relies on foreign-trained doctors to work in rural and remote communities and areas with large Indigenous populations, she said.

“Asking for people to have a common understanding of the human beings that they’re serving in the practise of medicine doesn’t feel like a big ask, because we believe that it’s a good investment.”

There are four college-approved courses — three for those in active practice and the fourth is the Indigenous health program that’s part of undergraduate or post-graduate medical training at the University of Manitoba.

Mihalchuk said the college received advice from an Indigenous advisory circle about the training and how to discipline those who don’t meet the new standard.

Rather than the traditional rigid, “blame, shame, punish” approach, the college is moving toward a restorative justice approach, she said.

“It’s more about healing the harm and going through a process that keeps both parties — the complainant and the person complained about — intact and whole at the end of a process that’s not about blame, shame and punish.

“We are leaders,” she continued, “in the country who are doing this work and really it’s about creating a safe space to work on this together as a profession and to contribute to ‘better.’”

Doctors Manitoba said in an email it is providing professional development funding for the training that counts toward the hours of continuing education doctors have to complete every year to improve their practice and maintain their licence.

carol.sanders@freepress.mb.c