New medical school: acknowledging health care past to inform future developments

Each June, National Indigenous History month calls us to recognize and celebrate the rich history, diversity, and future of First Nations, Métis, and Inuit people. This year, as the SFU Medical School (SFUMS) continues development, we turn towards the historical and contemporary relationship between Indigenous Peoples and medicine in what we now call Canada. With an urgent need to meet the changing demand for healthcare in what is now known as British Columbia, the SFUMS intends to rise to the challenge of genuinely changing how medicine is taught and practiced in the province. This promise to change holds the institution accountable, in this month and beyond, to the communities it intends to serve.

The past and the present

According to a B.C. government report on Indigenous-specific discrimination in health care, our medical system is enmeshed with settler colonialism and racism that significantly impacts the wellbeing of Indigenous Peoples. This harm has led to many Indigenous Peoples, as well as other populations, having poorer wellness outcomes and lacking trust in Western medical providers and not seeking out medical care. This can be an uncomfortable subject to broach. We must improve the way things have always been done and change behaviours and attitudes that have been tolerated in the medical system.

Chris (Syeta’xtn) Lewis, Director of Indigenous Initiatives and Reconciliation, envisions a process that recognizes the truth about how Indigenous people have accessed medical care: “We have to understand the truth to reconcile the problems; we have inherited a medical system with systematic problems.” The past illuminates what the SFUMS must change to improve workplaces and outcomes in the future.

Envisioning the future

All those involved in planning for the new SFU medical school share a vision for moving towards reconciliation, new relationships, and building on a strong foundation of Indigenous Knowledges.

“This means that all aspects of the SFUMS – from the design of our facilities, to the development of our programs, to the admissions processes for students and to everything in between – begin with a grounding in Indigeneity and equity, diversity, and inclusion,” shares Kris Magnusson, senior advisor to the provost and workforce working group chair. Chris Lewis adds, “when all students are trained in an environment that privileges this knowledge that is culturally informed, students practice successfully and sustainably within Indigenous communities.” Dr. Sarah Strasser, interim vice-dean, anticipates “the school will admit a pool of strong Indigenous applicants” and for those applicants to have “strong and continuous support from both the school, their families, and communities” throughout their journey.

Dr. Evan Adams, Deputy Chief Medical Office for the First Nations Health Authority (FNHA), agrees that how medical students are trained must change. “We need clinicians who can work in community, not just physicians who can work in clinics.” He also emphasizes that training students in developing therapeutic relationship skills and having an awareness of community health, not just individual health, are important changes he hopes to see in the curriculum. By building strong reciprocal partnerships with Indigenous communities and health services over the coming years, Dr. Sarah Strasser hopes that for the Indigenous people the school will eventually serve SFUMS will be considered as “our Medical School” and the learners as “my student doctor”.

The school will also be built on a mandate of social accountability which Dr. Roger Strasser, interim dean, describes as partnering with patients and communities as experts in their own health. In addition to engagement with FNHA, the Métis Nation of B.C., and the National Consortium for Indigenous Medical Education (NCIME), there are plans to engage with Indigenous community-based organizations. This will ensure, at every level, there is feedback from the experts – the Indigenous community. Dr. Strasser also hopes to formally establish governance structures with decision-making power for Indigenous stakeholders, such as an Indigenous caucus.

In addition to ongoing community engagement, prioritizing the hiring of Indigenous faculty is another way to distinguish SFUMS as a leader. Dr. Adams reflected that “we need diverse physicians to serve diverse populations.” Kris Magnusson spoke to “prioritizing the early hiring of an Indigenous Medical Lead.” Dr. Sarah Strasser expects “we will have Elders involved and recognised by the school for their valuable wisdom and knowledge” in addition to a strong faculty.

Beyond one month

Those planning the SFUMS aspire to implement many changes over the course of the school’s development. This will mean doing things differently and going against the current. Dr. Adams suggests “reconciliation has ‘being in relationship’ at its core,” and that reproducing the status quo is not sensible if we are seeking improvements in how medical education and medical care are provided in the province.

From my own work over the course of the medical school’s development, I look forward to the ongoing work of the SFUMS reconciling with the Indigenous Peoples of these lands. It is my own hope that the school will share the strength, wellness, and joy present in Indigenous communities. There are many talented Indigenous physicians, healthcare workers and traditional healers I hope to see in the faculty once SFU reaches that stage. Until the doors open in 2026, let this month and every day be an opportunity to do better.