Many Saskatchewan physicians have felt pain and frustration from discrimination their entire lives, or have had their medical skills questioned or second-guessed based on the colour of their skin.

Delegates to the Saskatchewan Medical Association’s (SMA) 2021 Fall Representative Assembly heard moving stories from five Saskatchewan physicians who have experienced racism and discrimination in the health system — either because they are Indigenous or from another country.

While each expressed optimism that positive change is possible and offered concrete suggestions for creating a cultural revolution, their deeply personal accounts are powerful evidence that racism is a problem in this province’s medical community. Their experiences were presented at the RA by Lorelei Nickel, who teaches strategy, ethics, and leadership at the University of Saskatchewan, Edwards School of Business. She is an equity, diversity, and inclusion (EDI) champion at USask, a founding member of Edwards’ EDI Collective, and board chair of Global Gathering Place, a newcomer settlement agency in Saskatoon. She shared what the five told her during lengthy interviews and presented recommendations to the RA.

Growing up with racism

Nickel told the RA that the physicians talked about feeling the sting of racism early in life, and how over time they came to understand what racism is. Said one: “When you grow up, you just know what you’re being taught. You don’t know any different. I witnessed a lot of racism against my mom, and there was racism against me, but I didn’t know that’s what it was. I remember being invited by my friend to come play at her house. When I got there, her mom opened the door, she looked surprised, and she wouldn’t let me come into the house. She gave me ice cream and said I should go home.”

Another talked about growing up in South Africa: “Having been treated racially and separately, I didn’t see myself at any particular disadvantage within my group objectively. We were disadvantaged in terms of schooling, housing, and education, but you see what you go through. You don’t know the difference until you know for sure what the other side looks like.”

One doctor said she’s been racialized her entire life: “There was always bias. It was always there. Kids were openly mean because of my appearance and where I came from. If I did well in school, teachers questioned how I knew things and they thought I cheated. I just wanted to be lost in a crowd and escape.”

Two groups face racism in Sask. medical profession

Nickel said two forms of racism are present in the medical community, according to the physicians: one that targets Indigenous physicians and patients, and another that discriminates against immigrants.

One of the doctors, who grew up in South Africa, said it took some time to realize Canada has its own version of apartheid: “Coming to Canada was a breath of fresh air — to leave an apartheid era there, come see a different country and come to work in a different place and kind of be recognized as equals with others. It seemed to me at that time, that race was less of a factor in Canada. But the way I see it now is, in Canada you have the Indigenous people. Then you have the old immigrants and the new immigrants. There’s a lot of racism against the Indigenous people in Canada, which is very much like the racism we had in South Africa … separate areas and disadvantages, socially and educationally. In South Africa, you had the Homeland system. In Canada, you have the reserve system. I honestly can’t say that I felt the racism like I felt in South Africa. But the xenophobia is something we feel.”

One doctor talked about the uneven playing field faced by some physicians in this province: “I don’t want to play the racism card because every time you play that card, you’re a baby crying, so you just toughen up. I’m not sure if what I went through would have been different if I was from a different race, but I’m sure it might’ve been — because I’ve witnessed other people whose path is just smooth. And you have to go up and down. And even if you are on top, they put you down, so you can go up again.”

Hope and optimism for moving forward

The physicians Nickel interviewed said if the province’s medical community is to move from “us and them” to “we,” building relationships and sharing stories are critical. For too long, said one, people have kept their experiences to themselves: “The only path forward is for people to tell their stories and that will encourage other people to tell their stories. And finally, people will say, what the heck, why are we living this way? It makes no sense. And eventually change will happen.”

The first step is admitting there is a problem, one physician told Nickel: “Acknowledging racism and xenophobia is a starting point. Having more meaningful conversations, fellowship with colleagues, building bridges, rather than living and working in silos – this should all be done for the improvement of the system forever, and for everyone.”

It’s not enough, said another, to simply go through the motions of being inclusive: “Don’t just invite us to the party. Actually dance with us.” Another noted it will be difficult – but crucial – for some physicians to take a hard look in the mirror: “People need to acknowledge their unconscious bias. Why is this person not valued highly enough in your eyes to be worthy of a conversation or relationship? If we can’t even go for coffee, we can’t engage.”

Despite their experiences, the physicians suggested a way forward is not complicated. Said one: “People are desperate to be heard and to be treated in a good way. It’s so powerful when you do just simple things. It’s quite amazing, actually. Stay strong. Keep doing the right thing. Keep going back to community, keep building relationships, and over time it does work.”

The Saskatchewan Medical Association appreciates funding from Scotiabank, MD Financial and the Canadian Medical Association as part of their Physician Wellness+ Initiative to address the urgent, ongoing health and wellness needs of our medical community. This article was made possible by the Physician Wellness+ Initiative.