Have you met ... Nicole Cardinal?

Nicole Cardinal, ’12 MD, has always been a strong advocate for Indigenous health, and for improving the physical and emotional health of her community. While working as a physician in Saddle Lake First Nation, Cardinal is also actively involved in the community as a board member of the Indigenous Alternative Relationship Plan, which aims to improve health-care service delivery on reserves.

Cardinal is also a clinical assistant professor in the University of Alberta’s Department of Family Medicine, bringing her passion for Indigenous health to medical education. Now, Cardinal has stepped into a new role as clinician lead for education in the Indigenous Health Initiatives Program (IHIP), a position she hopes will open the door for more students to learn about Indigenous health issues.


What brought you to the U of A?
I've been connected to the U of A in some capacity ever since I graduated from the MD program in 2012, mostly involved in education as a mentor or preceptor for students interested in Indigenous and rural medicine. When this job posting came up for clinical lead for education, I realized it was something I was already working with students on and that I was interested in medical education, specifically in Indigenous health, so that’s what drew me in.

What made you decide to take on this new role?
I was a graduate through the Indigenous Health Initiatives Program (IHIP), and I feel I owe something to the program. When I first applied to medical school, I honestly didn't think I would get in because I had a lot of obstacles—I come from a small Indigenous community and I'm an Indigenous person. But IHIP opened the door and I'm appreciative. It not only helped my community, it also helped me provide for my children and give them some security. So I want to give back to the program.

At the same time, when I was a medical student, there was more emphasis on Indigenous health in our undergraduate curriculum. It seems like that emphasis has slowly gone away. So when I applied to this position, the emphasis on the importance of having a dedicated Indigenous health program was something that I wanted to bring back.

Why do you think it is important for students to gain experience treating Indigenous patients?
It's the history that is important, which brings in colonization and the effects that it has had on Indigenous people. These topics impact our health today, which is why it's important for physicians in any discipline to learn about how to approach an Indigenous patient from the lens of an Indigenous person.

When students spend time learning with me, I get them to know the community. I get them to see the community dynamics and I try to show them the beauty and the resilience of my people, despite everything that has happened historically. When we look at each individual patient, we look at their background and the bigger picture—more than just asking the questions. We try to understand where the patient is in their lives in order to be able to provide them adequate care. I try to teach students that the social part of our lives plays into our health and that impacts how we manage patients.

What are you hoping to accomplish in your new role?
There are a couple of things. My end goal is focused on “how does this change the care that Indigenous people receive?” There are different ways that we can affect patient care: from the top, as an education institution, all the way down to the individual level of the students. I hope our students learn ways to interact with Indigenous people in a culturally safe manner, or ways that they can incorporate some of this knowledge into their practice because that will change patient care.

At the institution level, I want to make Indigenous health a learning priority, realizing the importance it plays in patient care. So when I choose projects, it always comes down to what can make the biggest impact, even if it's at the individual level. If I can make a positive impact on the care Indigenous people receive, then I’ll know I've done a good job.

What are you most excited about?
The thing that excites me is sharing the knowledge that I have and my passion for my own people. Just the prospect of raising this topic, which is important to me, and sharing it with others is exciting. What makes me happy about holding this position is being able to help with the curriculum in guiding and educating my colleagues, which will hopefully impact the students as well.

Why do you think it is important to have programs like IHIP at the U of A?
For me, it was such a positive experience in my life. IHIP opened many doors for me and I'm glad it was there.

I think when we look at what is happening in the media, and the emphasis on the Truth and Reconciliation Commission of Canada: Calls to Action and what that means in health and for health-care professionals, this program is very important. One of the TRC calls to action (Number 24) is that medical and nursing schools educate students on Indigenous health, including the history and legacy of residential schools and IHIP is a way to help bring back Indigenous health into our education. I'm happy that we are trying to uphold that and we are trying to make our own path for reconciliation within the faculty.

Why do you think this role, in particular, is important to have in the faculty?
It's been so interesting; sometimes I feel like I'm learning more from what other programs are doing than I feel like I'm contributing. I'm finding my role is to support programs and help guide their approaches within an Indigenous context.

I've been working with different programs, such as the emergency medicine program and the undergraduate program, and their needs are different for what they want to teach their students. Their goals for residency training are also different. So I find I'm in more of a support role for them, helping to guide them through questions that come up. There are some topics that I'm still learning about myself, like the Sixties Scoop or Indian hospitals, for example. So through this position I'm able to continue to learn, share and expand my knowledge along with everybody else.