Surviving Hate is a multi-year investigation into how racism, hate, and discrimination affect Canadians — through the lens of public institutions. If you have experienced an incident involving racism or discrimination, you can also take the Surviving Hate survey.
THUNDER BAY — Elycia Monaghan’s “hopeful dream” is to become Canada’s first Inuk psychiatrist. During her placement as a nursing student in the mental-health ward at Yellowknife’s Stanton Territorial Hospital, Monaghan noticed that many of the patients she cared for were Inuit, but most health-care providers were not.
“I felt like, in order for a patient to feel heard or listened to or understood, it’s important to have physicians who look like them, listening to them — especially if it’s a mental-health issue,” says Monaghan. She notes the high rate of suicide among Inuit people, which is up to 25 times higher than the general population, according to the Canadian Centre on Substance Abuse and Addiction.
Monaghan is a third-year student at the Northern Ontario School of Medicine, in Thunder Bay. (The school also has a campus in Sudbury.) An Inuk who grew up in the Northwest Territories, she decided to study medicine because “helping people is really important, and learning is really important — that’s so central in medicine.”
She applied to NOSM because of its focus on northern populations and rural and Indigenous health. While she is enjoying her time at the university, she says, she also struggles with imposter syndrome.
“It was a big-time mental thing for me in first year, of feeling like, do I really deserve this? Do I really belong here? There are no other Inuk students in my class. I don’t even think there’s been any Inuit students at NOSM to begin with,” she says.
In its first 10 years, between 2006 and 2015, Indigenous students applying to NOSM were two and a half times more likely than non-Indigenous students to receive an offer of admission, according to a NOSM study. However, due to challenges such as financing their education and relocating, they were three times less likely to attend. (Charnel Anderson)
First opened in 2005 as a partnership between Lakehead and Laurentian universities, NOSM became Canada’s first standalone medical school, in April 2022. It has receivedinternational recognition for its social-accountability mandate, a self-imposed directive requiring the school to develop partnerships and be accountable to Indigenous, francophone, remote, rural, and urban communities in northern Ontario.
In the past five years, between 64 and 74 students — out of an average of 1,895 applicants — have been accepted into NOSM’s MD program, including an average of 8.8 Indigenous students and 15.2 francophone students per year. The majority of students accepted into the program over the same period, approximately 84 per cent, are from northern Ontario.
In an effort to recruit more Indigenous students — who have historically been under-represented in Canadian medical schools — NOSM has created a dedicated admissions stream for self-identified Indigenous students. According to its own statistics, the number of self-identified Indigenous students attending the university has increased, from 12 per cent in 2018 to 15 per cent in 2022.
“Our target is actually 20 per cent,” says Dr. Joseph LeBlanc, a member of Wiikwemkoong Unceded Territory and associate dean of equity and inclusion at NOSM.
“Reflect the concept of reparations”
This is part of a broader effort by Canada’s 17 medical schools to increase Indigenous student enrolment and retention. It stems from the Truth and Reconciliation Commission’s Calls to Action, in 2015, which urged “all levels of government” (and, by extension, public institutions such as universities) to work toward increasing the number of Indigenous health-care professionals in the country.
“Although the Indigenous population of northern Ontario is around 12 per cent, we set a target that reflects the concept of reparations. It’s the same with francophone students: they’re about 20 per cent of the population; our goal is 30 per cent of the class.”
As previously reported by TVO Today, efforts to meet the Calls to Action vary across the country. While the majority of Canadian medical schools have committed to implementing Indigenous health content across their four-year curriculum, just more than half have Indigenous professionals leading curriculum design. Students interested in clinical placements in Indigenous communities often face a dearth of opportunities.
Since its inception, NOSM has placed an emphasis on partnerships with Indigenous communities. All students participate in a mandatory month-long cultural-immersion placement in either an Indigenous community, such as Fort William or Eabametoong First Nation, or an Indigenous health organization in northern Ontario.
Reckoning with institutional racism
In 2018, NOSM convened an external panel to understand the experiences of Indigenous students, faculty, and leadership at the school. The panel, which included Indigenous health scholars such as Dr. Marcia Anderson and Dr. Sheila Cote-Meek, found that Indigenous students at NOSM had “encounters with numerous peers and faculty who expressed negative or racist comments towards Indigenous peoples.”
“These experiences not only undermined their learning but also their sense of self and ability to be open about their Indigenous identity and culture,” wrote the report’s authors.
The panel also found that Indigenous students struggled to find mentorship from Indigenous faculty and had difficulties connecting with other Indigenous students on campus.
To address its findings, the external panel issued 44 recommendations for NOSM, including developing “a broader community of support” for Indigenous students and facilitating the “formal mentorship of Indigenous medical students by Indigenous faculty and residents.” The panel also recommended mandatory cultural-safety and anti-racism training for faculty, staff, residents, and students.
Dr. Joseph LeBlanc, NOSM’s director of Indigenous affairs, says the university is instituting support for Indigenous learners with an eye to the future. “I hope that, over time, there are kinder colleagues in the classroom who value [Indigenous students’] participation and expertise,” he says. “It’s genuine that alumni who weren’t here for these changes had a worse experience, and that’s a legacy we’re learning from as well.” (Courtesy of NOSM University)
Shortly thereafter, in October 2018, Dr. Joseph LeBlanc was hired as NOSM’s director of Indigenous affairs.
“On my first day, they handed me the report and said, ‘Here, do something with it,’” he says.
Since then, NOSM has developed aformal equity strategy that directs senior university leaders to “embed, act and report back on specific anti-racism and anti-discrimination actions.” Last year, the university also introduced the four-year Indigenous Health and Wellness Collaborative Specialization, which runs concurrently with the MD program and includes a focus on mentorship opportunities for Indigenous students.
“As an Indigenous person in this role, I can see where we can do so much better,” says LeBlanc.
“But I feel empowered here as an Indigenous leader to do something that is more reciprocal and responsible to community, which is not common, I don’t think.”
NOSM has also told TVO Today that it plans to release a five-year update on 2018’s “External Panel Report on Indigenous Relations” this September.
Still a “long way to go”
Elycia Monaghan is one of the first students in the Indigenous Health and Wellness Collaborative Specialization program at NOSM. Through it, she’s learned how to make bear grease (a traditional Indigenous medicine) and received mentorship from an Indigenous doctor in Sudbury whom she talks to regularly.
“We just chat about how things are going, and that’s been a really great help,” she says.
Overall, Monaghan says, she feels that NOSM is “doing their best'' in terms of creating a culturally safe environment, “but there’s still a long way to go.”
Monaghan has two years of medical school left before she moves on to residency. She’s not certain whether she will pursue psychiatry, which requires five years of residency. It’s a commitment that “takes a lot of consideration,” says Monaghan, who is married and has a six-year-old son. She’s considering family medicine, which requires only two years of residency.
Either way, Monaghan says, she would like to return to the hospital in Yellowknife.
“I just finished a placement in Atikokan [General Hospital],” says Monaghan, in August.
“It made me realize how much I love rural communities and feeling how much of a difference you can make in a small community like that.”
About Surviving Hate
Surviving Hate is a collaborative journalism project by Humber College’s StoryLab seeking to fill the data gap on the reporting of hate crimes in Canada. Academic partners include Algonquin College, Trent University, the University of King’s College, Toronto Metropolitan University, Carleton University, and the Centre for Human Rights Research at the University of Manitoba. Our media partners are Canada’s National Observer, the Toronto Star, TVO Today, and J-Source. Surviving Hate is supported by the Inspirit Foundation, Google News Initiative, Journalists for Human Rights, and Humber College’s Office of Research and Innovation and Faculty of Media and Creative Arts.
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