'I often times feel silenced': Sask. medical students reluctant to speak up about racist encounters

Students at the University of Saskatchewan College of Medicine are reluctant to speak up when faculty make racist comments, according to a new report from the human rights commission.

At the request of the U of S, the commission held over 50 conversations with students, faculty and staff, as well as recent graduates and ‘other external stakeholders.’

Within the high pressures of medical school, the report paints the picture of an environment where students felt speaking up about discrimination would be considered unprofessional. Racialized faculty described feeling alone and misunderstood when trying to call attention to bias.

“It was not the aim of this initiative to conduct a formal investigation into specific allegations. However … in several cases, the allegations relayed were specific enough that they could have potentially sustained formal human rights complaints,” chief commissioner Barry Wilcox writes.

“These types of experiences tended to appear in situations where there already existed mistrust, miscommunication, absence of communication, and missed opportunities to resolve disputes earlier or lack of confidence in complaint-resolution processes.”

Some students of colour shared what they described as minor, but repetitive and impactful comments about their ethnicity.

“For me, as a student, I’ve had multiple encounters. Whether it’s someone making a joke about a person of colour, or someone saying things to me directly about my skin colour or my ethnicity. I often times feel silenced," the student said.

"Honestly, like was a pretty small incident, but it had been repeating over and over … making weird comments about my skin tone.”

Other students described faculty using outdated or derogatory terminology like “orientals,” and “racist slurs, including the ‘n’ word.”

Students told the commission they were subject to poorly-handled discussions of race or racism led by faculty. Some said they felt unable to respond freely or to leave, others said faculty did not respond positively to feedback, the report says.

In one case, the report describes a medical student who decided against pursuing a professional field to avoid having a particular doctor as their supervisor.

The student affairs office at the medical college documented three cases of students who were subjected to racially or ethnically offensive remarks or names, but Wilcox says the commission’s discussions indicate there were many more incidents that went unreported.

International students to the commissioner there seemed to be different standards applied to them.

“Other students aren’t expected to be as proficient, or as composed, or as good at giving seminars as we are as internationals. We are held to a higher standard, and if we don’t meet that standard, then we are scrutinized heavily.”

Some reported colleagues made discriminatory comments about patients, particularly Indigenous patients in the emergency department.

Others shared experiences of sexist comments from instructors.

“Male surgeons telling female students interested in surgery: ‘Don’t expect your male colleagues to pick up your slack when you have kids and go down to part-time.’ Being told surgery ‘isn’t good for women.’”

Students and staff with disabilities also described a fear of speaking out or asking for accommodations. Not only is disability discouraged among students, the report said, but some people said it was absent from curriculum and standardized patients — actors used to portray patients for training purposes.

Preston Smith, the dean of the U of S college of medicine, said he was troubled to read some of the instances listed in the report.

"In my messaging internally to the college and leadership and student body, I've been emphasizing the fact that there is information in this report that is distressing, and that individuals in reading this report should know that there's supports within the college," he said.

"Even more distressing to me was looking around the world and knowing this was happening, and not knowing how much was happening in my own college." 

The U of S says the report is an important first step toward making its medical school more inclusive.

"We can't own what we don't know about and we must own this. And we can fix what what we take ownership of unless we know and understand what's actually happening on the ground, and from the voice of those people that are impacted," Smith said. 

The report outlines a number of areas the college could improve, including strengthening the student complaint process, recruiting a more diverse faculty, strengthening the work culture and to better track student and employee demographic data.

Smith said some of this work is already underway at the college. The U of S is the only Canadian medical school accepted to the Icahn School of Medicine's Anti-Racist Transformation in Medical Education project, he said. The project aims to rid medical schools of systemic racism and bias. Among 75 applicants from across North America, only 11 colleges were accepted.

DISCRIMINATION IN MEDICAL PRACTICE

The report also specifically references incidents of discrimination within the Canadian medical system.

In the fall of 2015, Indigenous women came forward to say they were coerced into having their tubes tied in Saskatoon hospitals, leading to an investigation.

In 2017, the Saskatoon Health Region issued an apology, describing the actions as racist.

Between 2015 and 2019, over 100 Indigenous women across Canada came forward to say they were forced or coerced to undergo a sterilization procedure, according to a 2021 article in the International Journal of Indigenous Health.

The human rights commission also identified the death of Samwel Uko as a case of racial discrimination in Saskatchewan health care.

Uko was a 20-year-old black man who went to the emergency room at Regina General Hospital during a mental health crisis in May 2020. Uko was removed from hospital without receiving care and was later found dead in Wascana Lake.

A subsequent inquiry into the death delivered a list of 20 recommendations for the SHA, including a requirement of cultural diversity training for health staff.

-With files from Keenan Sorokan