EDI Topics and Resources

Ally

Equity Quest

Incorporating equity and diversity principles into the search and selection process is imperative. A diverse workforce (students/residents/faculty) improves residency culture, teaches inclusion, fosters innovation, and optimizes patient outcomes.

Some residency programs at the University of Alberta have implemented EDI initiatives into their CaRMS selection process, but not all program directors know where to start. As such, Dr. Lindsay Bridgland and Dr. Tehseen Ladha have developed an educational video, Equity Quest, in collaboration with the University of Alberta's Learning Design Studio, to help raise awareness of unconscious bias and incorporate equity into the CaRMS search and selection process.

The video is educational and engaging with the hope that it will stimulate self-reflection and inspire further learning. This video may also be used for other search and selection committees within the FoMD.

by Dr. Lindsay Bridgland

On Being an Ally

Being an ally requires commitment and work. To be an ally is to acknowledge one’s privilege and to advocate for those with less privilege. The goal is to break down systems that challenge the values of equity, diversity, inclusion, and anti-racism. Allyship is not passive — it is an active process that involves intentional learning, unlearning, and re-evaluation. It is the recognition of social and cultural injustice and the active pursuit of social justice.

Being an ally can be uncomfortable. An ally will surely make mistakes, but they acknowledge their mistakes, apologize, and vow to do better next time. Allies promote their colleagues, foster trust, and seek out ways to transfer their power and privilege to those who lack it.

Dr. Aimee Bouka says it best: to be an ally is to “look for the most oppressed and marginalized in the room. Guaranteeing their voice and freedom benefits everyone.”

by Dr. Lindsay Bridgland 

Bias

Colonization

Racism

Terminology

Long live the chief lead

You may wonder why the term "chief resident" has now been changed to "lead resident" at the University of Alberta, as well as at several other institutions across Canada.  The term "chief" carries colonial connotations that cannot be overlooked. Historically, colonial powers imposed this term in a reductive or dismissive manner, simplifying complex Indigenous leadership structures into a framework that discounted other leaders in a tribe/community, especially women.  The term "chief" was implemented to identify the person in charge and discounted other traditional leadership roles such as council, elders, traditional healers, and spiritual leaders.  This not only misrepresented the leaders' actual status and role(s), but imposed a foreign hierarchical structure onto Indigenous communities.

In a medical context, the title "chief" (resident/site, etc.) may inadvertently perpetuate these hierarchical and colonial underpinnings, potentially alienating groups with a history of colonial subjugation. At times, it has been used to "other" Indigenous colleagues.  Though professionally established, the term can evoke negative connotations, undermining the principles of equality and respect that are crucial in healthcare. As such, re-evaluating and adapting our professional language to be more inclusive and culturally sensitive is a step towards healing historical wounds and fostering an environment of mutual respect and understanding. It’s a recognition of the power of language to either perpetuate or dismantle historical inequities.  

by Dr. Majid Sikosana

What is Intersectionality?

Intersectionality is a term that was coined by Professor Kimberlé Crenshaw in 1989 to explain how race, gender, sexual orientation, disabilities, class, et cetera intersect to produce different barriers in a compounding and interlocking way based on power, privilege, and systemic inequalities.

An individual's lived experiences cannot be fully understood by prioritizing any one single social identity. Racism, classism, sexism, and ableism are always operating at the same time. As such, a racialized woman will experience discrimination based on gender and race at different times in different social contexts. Similarly, a disabled, gay white male will experience discrimination due to his disability and sexual orientation depending on his social location.

Intersectionality can best understood using this analogy:

Intersectionality is an important concept to consider in our goal of creating a more inclusive and diverse workplace. We need to see a world where we see everybody.

by Dr. Lindsay Bridgland

What are Land Acknowledgments?

Land acknowledgments are often done at the beginning of lectures or public events to insert awareness of Indigenous presence and land rights. To avoid tokenism, land acknowledgments need to be carefully constructed as a reminder of all of the privileges settlers enjoy today as a result of colonialism and the ongoing violence and trauma experienced by Indigenous people. Land acknowledgments demonstrate respect, understanding and appreciation for the land and culture of Indigenous peoples that was erased and forever altered by colonialism. A useful resource for identifying Indigenous lands/territories can be found at https://native-land.ca/.

Below is an example of a well thought-out land acknowledgment from The Law Society of Alberta:

We acknowledge Treaty 6 territory — the traditional and ancestral territory of the Cree, Dene, Blackfoot, Salteaux and Nakota Sioux. We acknowledge that this territory is home to the Métis settlements and the Métis Nation of Alberta, Regions 2, 3 and 4 within the historical Northwest Métis Homeland. We acknowledge the many First Nations, Métis and Inuit who have lived in and cared for these lands for generations. We are grateful for the traditional Knowledge Keepers and elders who are still with us today and those who have gone before us. We make this acknowledgement as an act of reconciliation and gratitude to those whose territory we reside on or are visiting.

by Dr. Lindsay Bridgland 

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Workplace

The Myth of Meritocracy

Meritocracy is the idea that the "best" individual will be selected for a position strictly based on hard work, dedication, and intelligence. It is the belief that who you are, what your skin colour is, or where you were born will not affect your opportunity for success. On the surface, hiring, promoting, or selecting leaders based on merit sounds like a great idea. But, in reality, privilege and bias play a role, leaving women, Indigenous peoples, and people of colour behind.

Who defines merit? Who determines what the "best" is? These decisions are often made using proxies for aptitude and those proxies are inherently biased. For example, in 2014, a study of urology program directors in the United States investigated factors that gave applicants special consideration (Urology. 2015 Apr; 85(4): 731-736). Forty-seven percent of urology program directors gave special consideration to applicants who were a child of an academic urologist. This is not merit.

Food for thought: There is no one "best fit" in medicine. As physicians, we serve a diverse group of patients who all have different backgrounds and different needs. Let's consider that our selection processes and hiring/promotion practices may need to evolve to meet the needs of our current population as meritocracy is flawed and inherently biased.

by Dr. Lindsay Bridgland

Parity for Women in Medicine — Still a Work in Progress

According to a recent CMA study, currently over 54% of Canadian physicians under age 40 are women. It is estimated that by 2030, half of all Canadian physicians will be women. Despite this, only 25% of leadership positions in medicine are held by women, with very few being held by women of colour. More women are stepping into leadership roles to bring different perspectives to the way medical care is delivered and taught, yet an overwhelming majority continue to report weekly microaggressions based on gender.

Medicine is a profession that is built on pre-existing culture and hierarchical ideas. Ongoing wage gaps, discrimination toward parental leave, lack of consideration of family/work balance, and unequal access to mentorship all contribute to disengagement and burnout amongst women in leadership. Women are effective systemic disruptors, with fresh ideas to challenge the norm, and have known positive outcomes with patient care, both in treatment and prevention.

Below are a few examples of situations demonstrating the lack of parity that still exists in medicine today. Let's try to even the playing field by being an ally to all women physician colleagues!

Example 1: Women physicians are often addressed by their first names, even when being introduced to speak at international conferences or in important meetings. Men are regularly addressed as "Dr. X."
Solution: Equity in acknowledgment.

Example 2: Women in leadership are often not offered an administrative assistant as a standard. Assumptions are made that women can handle it all, and thus administrative help is reserved for male colleagues.
Solution: Standardizing leadership contracts and terms for the role.

Example 3: Women in medical leadership are less likely to negotiate higher wages and stipends than their male counterparts for fear of being labelled as difficult.
Solution: Reducing barriers for negotiation and providing space with allies to discuss difficult, but necessary details.

by Dr. Neeja Bakshi

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White Immunity — A different take on white privilege

The phrase "white privilege" can evoke a variety of emotions and opinions, including defensiveness. When this term is used, responses often include, "How am I privileged?" or "I worked extremely hard to get where I am. I earned it." But white privilege is NOT the suggestion that everything a White person has accomplished wasn't earned, or that White people haven't struggled throughout their lives. The problem with "white privilege" is that it centres around the individual and centres around whiteness rather than focusing on the markedly different experiences that people of colour endure.

"White immunity" is a different way to understand white privilege, one that evokes empathy and understanding. White people receive social inoculation from racial oppression. The term "white immunity" looks holistically at society to examine how the most marginalized individuals are being treated and asks the question, "How is my experience different from that of people of colour?" Racism isn't about an individual; rather it is a system of advantage based upon race in which white people are immune to historically racist systemic and structural barriers.

by Dr. Lindsay Bridgland