Med students gain Aboriginal perspective on health

Northern clinical rotation marks new kind of partnership between UAlberta and First Nations health commission.

Colin Siu believes Aboriginal patients have much to teach doctors, which is why the University of Alberta medical student was excited about starting a new kind of clinical rotation in the northern Alberta community of Wabasca this week.

"I'm sure I will take away an incredible amount more than I am able to give at this moment," Siu said. "It's important to recognize the strength, diversity and resiliency of Aboriginal people."

Siu, 22, is the first medical student to take part in a new multi-layered rotation in Aboriginal health, marking a first-time partnership of its kind between a First Nations health commission and the U of A's Faculty of Medicine & Dentistry.

Working together, the Bigstone Health Commission, the U of A medical school and a clinic in Wabasca have created a rotation for U of A medical students that enhances the faculty's efforts to train doctors in rural family medicine by offering an enriched learning experience serving Aboriginal communities-in this case, Wabasca and the neighbouring Bigstone Cree Nation. The partnership was formed through the faculty's Division of Community Engagement, an academic unit mandated to engage and effectively serve various communities, including Indigenous and rural populations in Canada.

"We wanted to provide more opportunities for third-year medical students and residents to undertake intentional learning experiences with Aboriginal people," said Jill Konkin, associate dean of the Division of Community Engagement. "We want to help students develop an understanding that is their own so they can be the change agents to make the health-care system better for Aboriginal people. This initiative will increase the understanding and exposure of our students to Aboriginal people, their communities and their health and cultural issues."

Taking cultural learning to a new level

The faculty already works with doctors in First Nations communities to place students in clinical rotations, but the Bigstone partnership takes the learning experience to a new level, Konkin noted.

"With this placement, the Faculty of Medicine & Dentistry is starting to build relationships with the communities themselves, and we hope to reach similar agreements with other communities. We appreciate that the Bigstone Health Commission was willing to engage with us and build something different."

The rotation will see Siu, two other third-year students and a medical resident take up respective one- and two-month postings between now and next June, based at the Wabasca/Desmarais Healthcare Centre and a clinic in the hamlet, serving a population of 3,000 to 3,500 Aboriginal people. Siu led off the rotation Oct. 19, but before starting it, he completed an online training module and was asked to develop some of his own learning objectives.

"A key objective of this rotation is to have students get an idea of possibilities about positive reaction for change in the sense of building relationships and working with Aboriginal people," Konkin said.

A win-win for students and the community

During Siu's time working with the Bigstone Health Commission, he wants to learn more about Aboriginal culture and traditional healing, and build rapport with his patients.

"Medicine is a lot about storytelling, and this is an opportunity for me to learn some of the storytelling about Aboriginal background and about how to connect with future patients."

Aboriginal people are often stigmatized by society, including the health-care system, Siu said, and as a doctor, he wants to work to change that systemic discrimination.

In the face of socio-economic disadvantages, Aboriginal people "survive and thrive as a community, and it speaks to their resiliency and to their connections with their land and their methodology of healing," Siu said. "I want to grow my knowledge and be able to help in the future."

During his month in Wabasca, in addition to working out of the local clinic and health-care centre, Siu will also work within the Bigstone Health Commission's programs, ranging from public health, home care and mental health and wellness to an elders' lodge and another health-care centre at Calling Lake.

"This partnership with the Faculty of Medicine & Dentistry is a win-win situation for our community and for the Bigstone Health Commission because we always welcome new ideas to move forward in health-care delivery in our community," said Shelly Gladue, director of community and public health for the Bigstone Health Commission.

The experience will benefit the students and the community alike, Gladue says. "It will allow students to have front-line, hands-on delivery of care and experience of what it is like within a First Nations community."

Working with elders and others within the programs, the students will get some insight into Indigenous cultural traditions and beliefs. In turn, patients will have "extra assistance on their own health and a bit more one-on-one," Gladue noted. "They'll be heard on the issues they are facing, and I hope the students broaden their perspectives on what it is to have a First Nations client that they are serving."

Once he finishes medical school, Siu is considering a career serving inner-city or Aboriginal patients. "There's a real need there, and they require health-care practitioners who understand the full cultural story even before meeting the patient."