Leadership for Equity: Expanding Inclusive Medical Culture
Leadership has a measurable impact on the wellness and satisfaction of teams. So, too, does a physician’s knowledge and practice of equity and inclusion. Doctors Manitoba and the University of Manitoba, Office of Leadership Education for Rady Faculty of Health Sciences, are continuing their Joint Leadership Education Series to support physician leadership pathways.
Leadership for Equity: Expanding Inclusive Medical Cultureis a multi-part series that will feature speakers with expertise and lived experience in anti-oppression fundamentals, racism, decolonization and Indigenous health, 2SLGBTQIA+ health and advocacy, and ableism. This series will cultivate knowledge and tools for ongoing integration of anti-oppression in practice.
This series is offered with generous support from the Canadian Medical Association. The Doctors Manitoba and Rady Office of Leadership Education Joint Leadership Education Series is a self-approved group learning activity (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada.
Accessibility: Closed captioning available for virtual sessions.
Session 1 (Completed): Intent, Harm and Action: Understanding Bias, Discrimination and Racism in Healthcare
March 20, 2023 | 6:30PM — 8:00PMCST
Dr. Sharda’s presentation explores the concept of bias and implicit bias. It challenges the notion that physicians are ‘neutral’ and ‘objective.’ She will provide definitions of bias, racism and colonialism and explain how power (personal and social) is needed to create and maintain systems of oppression. She will delineate systems vs interpersonal discrimination and how they feed into each other. Dr. Sharda will speak about intent vs impact (and harm) and provide examples from the healthcare context about how this harm can manifest to patients, physicians, and learners. She will introduce the ideas of privilege and oppression via the Coin Model of Privilege. Dr. Sharda’s presentation offers an approach for students, doctors and medical professionals to start their journey of learning and unlearning — drawing on the concepts of Miller’s Pyramid, narrative humility and critical allyship and provides guided opportunities to self-reflect on the concepts presented. A certificate of attendance will be provided to participants.
Define concepts of bias and discrimination including racism
Describe how bias and discrimination affect healthcare outcomes and physician wellness
Describe the concepts of cultural humility and critical allyship as tools to combat discrimination
Dr. Saroo Sharda MBChB, MMEd, FRCPC is an anesthesiologist, medical educator, writer and trained creative writing coach. She identifies as a woman of colour of North Indian descent, who has the privilege of being cis-gender, straight, able-bodied and economically privileged.
She is an advocate for physician wellness, equity and anti-racism, and has written and spoken widely about these topics, including publications in the Canadian Medical Association Journal, British Medical Journal, The Globe and Mail and Today’s Parent.
Dr. Sharda is the Associate Dean of Equity and Inclusion for the Faculty of Health Sciences at McMaster University and the inaugural Equity, Diversity and Inclusion Lead at the College of Physicians and Surgeons of Ontario, where she works as a Medical Advisor.
When not writing or working she works hard to avoid stepping on lego pieces strewn around the house by her 5 year-old and 8 year-old sons.
Session 2 (Completed): 2SLGBTQ+ Health: What’s the Same, What’s Different?
Dr. Chronopoulos’ talk focuses on how to make health spaces more queer-friendly. This involves an overview of terminology in the 2SLGBTQ+ community, as well as approaches to challenging our cisheteromonogamous norms that are the foundation of medical teaching. The session will provide ideas on changing language, documentation and health spaces to make them more inclusive. Finally, the session will speak to the medical care of the queer community, focusing on screening, monitoring, documentation and treatments.
To be able to practice in a way that is inclusive of folks of all genders and sexual orientations
To do so fluidly, without awareness of someone’s gender or sexual identity
To be able to take a history inclusive of gender and sexually diverse people
To be able to perform appropriate physical exam adaptations for sexually and gender diverse folks
To be able to adapt screening practices to sexually and gender diverse people
To be aware of specialized medications and monitoring that may be used by sexually and gender diverse people
Having completed her Residency training in Family Medicine at the University of Calgary in 2008, Dr. Julia Chronopoulos settled at the Royal Alexandra Family Medicine Center in 2009, and subsequently the MacEwan University Health Center in 2018. She enjoys serving a diverse population, with a special interest in mental health, as well as sexual and gender diversity. She currently coordinates the Rainbow Health Clinic at MacEwan University Health Center where she additionally acts as the Medical Director. Watch the recording.
Session 3 (Completed): Ableism 101: Learning to Diagnose and Treat Often-Fatal Ableism in Canada’s Healthcare System
May 23, 2023 | 6:30PM — 8:00PMCST
This session will introduce learners to the concept of ableism, that is disability prejudice and discrimination, as endemic to society as a whole, and to healthcare in particular. It will then introduce learners to Disability Ethics as an alternative to conventional bioethics in that it is a rights-based approach which aims to ensure that the perspectives of people with lived experience of disability are central to discussions and debates about ethical issues involving disability and people with disabilities. Given that the ever-expanding eligibility for Medical Assistance in Dying (MAiD) in Canada is a current public and ethical debate that has huge ramifications for both physicians and people with disabilities, learners will be invited to use a disability ethics lens to analyze some recent cases in which people with disabilities who did not want to die were nonetheless compelled to end their lives via MAiD because they could not get adequate supports to live. Finally, this session will provide physicians with some practical Best Practices to help them implement a Disability Ethics approach in order to diagnose and treat ableism in their own clinical practice as well as in the broader healthcare system.
Understand the interconnection between a deficit-based, biomedical view of disability and Medicine’s proneness to ableism.
Identify fundamental differences between a conventional clinical ethics approach to treatment, and an approach that is informed by disability ethics.
Critique conventional biomedical notions of Quality of Life using a disability ethics lens.
Identify and implement Best Practices for de-ableizing their own clinical practice, and incorporating a disability-ethics based approach.
Speaker Bio: Heidi Janz, Ph.D. (She/Her/Hers) is a Core Faculty Member and Associate Adjunct Professor with the John Dossetor Health Ethics Centre at the University of Alberta. Her areas of specialization include Disability Ethics, Critical Disability Studies, and Research-Based Drama. She is also an active disability-rights advocate at the national level. In her “other life,” she is a writer/playwright and filmmaker. Her creative work focuses on making the experiences of people with disabilities accessible to audiences made up of both people with disabilities and people who are temporarily able-bodied. Heidi Janz also has cerebral palsy.
Session 4 (Completed): Leadership &2SLGBTQIA+ Health Panel Discussion
June 9 | 12:00 – 12:50PMCST
With panelists, Dr. Blair Peters, Dr. Robert Obara & Jules Perez
Please join us for a panel discussion focused on Leadership &2SLGBTQIA+ Health. Co-moderators Dr. Joss Reimer and Callum Barnes will lead a conversation with members of the 2SLGBTQIA+ Community who will speak from the roles of physician and medical learner. This panel discussion is a follow-up to Dr. Chronopolous’ session (view the recording here) and will build on the information in her talk.
Panelists are Dr. Blair Peters, one of the world’s first surgeons to complete a formal academic fellowship training in advanced gender-affirming surgery, Jules Perez, a medical learner who has held multiple EDI-related leadership positions, and Dr. Robert Obara, a family physician with a special interest in transgender health and passion for 2SLGBTQIA+ advocacy.
At the time of registration, there is an opportunity to submit questions you would like the panel to address related to medical leadership at the individual and system level. Moderators will develop panelist questions based on themes that emerge from the submissions.
Dr. Joss Reimer (she/her) has been voted the next President-elect of the Canadian Medical Association, Dr. Joss Reimer is an expert in physician leadership and public health. Currently, Dr. Reimer is the Chief Medical Officer for the Winnipeg Regional Health Authority. Before taking on the role of CMO for Winnipeg, Dr. Reimer is best known as the Medical Lead and Official Spokesperson for Manitoba’s Provincial COVID-19 Vaccine Taskforce. Prior to the pandemic, Dr. Reimer worked as the Medical Director of Public Health for Winnipeg and she also developed and directed the 4‑year Population Health course still used today to train all future physicians studying at the University of Manitoba.
In addition to her public health and medical leadership roles, Dr. Reimer maintains a clinical practice in Women’s health where you might find her catching babies in the middle of the night.
Callum Barnes (He/They) is a queer medical student who is inspired to centre advocacy and activism in their developing medical career. Within the Max Rady College of Medicine, Callum has held various leadership roles such as being a member of the executive committees for the Surgery and 2SLGBTQIA+ Health Interest Groups, the Local Officer for Reproductive and Sexual Health Sr., a member of the 2SLGBTQIA+ EDI working group and nationally as the Manitoba representative on the Steering Committee for the Canadian Queer Medical Students Association (CQMSA). Prior to medicine, Callum worked in makeup and continues to express his creativity through the art form. They also are a proud parent to two cats.
Dr. Blair Peters (he/they) is a double fellowship-trained board certified plastic and reconstructive surgeon who specializes in gender-affirming surgery and peripheral nerve surgery. They completed their residency training in Plastic and Reconstructive Surgery at the University of Manitoba, was one of the first surgeons in North America to complete an additional fellowship in comprehensive gender-affirming surgery at OHSU and is an Assistant Professor in both the Division of Plastic and Reconstructive Surgery and the Department of Urology at Oregon Health & Science University.
He is a member of and a recognized advocate for the LGBTQIA+ community and frequently speaks on panels, creates educational materials, and advocates for policy change and the broader rights of all queer people. He strives to be a strong queer voice in medicine and surgery and focuses on shifting the culture of medicine and mentoring future generations of gender-affirming surgeons.
Jules Perez (they/them) is a queer, nonbinary medical student with a background in psychology prior to medical school. Jules’ passion for social justice, advocacy and activism is informed by their lived experiences. They hold various leadership positions locally and in the Canadian Federation of Medical Students (CFMS), including 2SLGBTQIA+ EDI working group point person, founder of the Accessibility EDI working group, and Wellness Advocacy File Co-Lead, and were co-National Officer of Reproductive and Sexual Health (2021−2022). Outside of medicine, Jules enjoys spending time with their family and pets, and engaging in their creative hobbies.
Dr. Robert Obara(he/him) completed his medical training at Trinity College Dublin and coming to Canada as an international medical graduate, Dr. Obara is now a full-scope family physician in Manitoba with a special interest in transgender health. He strives to provide comprehensive care and encourages general health and wellness among his patients.
With a passion for advocacy, he has worked on various initiatives related to women’s reproductive rights and health training, and on 2SLGBTQIA+ wellness and health promotion; he has also served on the Manitoba College of Family Physicians’ board. In his spare time, he enjoys playing volleyball.
Session 5 (Completed): Unraveling the Threads of Colonization and Racism in Manitoba’s Healthcare
September 28, 2023 | 6:30PM — 8:00PMCST
This presentation aims to empower physicians with a deeper comprehension of the intricate intersections between historical legacies, healthcare delivery, and the imperative for transformative change in support of health equity for Indigenous populations in Manitoba. It will explore the historical underpinnings of colonization and Indigenous-specific racism within the healthcare system, highlighting their enduring influence on the health of Indigenous communities. The session will emphasize the importance of physicians, as leaders in the healthcare system, learning to recognize the subtle yet impactful manifestations of these issues in healthcare and carrying this into application of practical strategies for fostering anti-racist and decolonizing practices.
Learning Objectives: 1. Gain insight into the historical background of colonization and racism within Manitoba’s healthcare system and how this continues to impact the health of Indigenous peoples. 2. Develop the ability to identify and understand how colonization and racism manifest in healthcare practices. 3. Acquire strategies to promote anti-racist and decolonizing approaches as leaders in healthcare settings.
Dr. Linda Diffey is a member of the Peepeekisis Cree Nation in the Treaty 4 region and Indigenous Scholar in the Department of Community Health Sciences and Ongomiizwin Indigenous Institute of Health and Healing at the University of Manitoba. She co-led the development and implementation of the Indigenous Health curriculum in undergraduate medical education at the Max Rady College of Medicine and served as a co-editor of the national undergraduate medicine curricular framework for Indigenous health that was developed by the Indigenous Physicians Association of Canada and the Association of Faculties of Medicine of Canada. In 2022 she launched the BRAID Network, a project within the Rady Faculty of Health Sciences that supports faculty development in the areas of anti-racism and Indigenous health. Her current research focuses on the experiences of physician instructors during the implementation of anti-colonial, anti-racist pedagogy in medical education. Other areas of interest include examining systemic colonial oppression within health-related institutions and the application of Indigenous resurgence as a theoretical foundation within Indigenous research methodology.
Session 6 (Completed): Dealing with Patient and Caregiver Bias: Recommendations for Physicians, Healthcare Providers & Medical Centres
October 24, 2023 | 6:30PM — 8:00PMCST
with Kimani Paul-Emile, Ph.D.
A patient or caregiver’s refusal of care based on the physician’s race or ethnic background can raise thorny ethical, legal, and clinical issues — and can be painful and confusing for healthcare learners and providers. This session will address the roles and responsibilities bystanders, learners, physicians, and healthcare leaders play when preparing for and confronting these situations.
Learning Objectives: 1. The ethical and legal considerations for healthcare leaders, learners, providers, and health centres when dealing with patients who discriminate against healthcare team members or request reassignment based on their healthcare team member’s race or ethnicity; 2. How to effectively balance patients’ and caregivers’ interests, healthcare learners’ or personnels’ employment rights, and healthcare centres’ duty to treat patients under these circumstances; and 3. The factors to consider when drafting or reviewing an organizational policy to address patient’s and caregiver’s biased behavior toward healthcare workers.
Debrief to follow led by Valerie Williams, CPHR, CCIP, Director Office of Equity, Access & Participation, Rady Faculty of Health Sciences.
Closed captioning is available. Contact us for any other accessibility needs.
Kimani Paul-Emile is a Professor of Law and the Robert L. Levine Distinguished Research Scholar at Fordham Law School. She is also Associate Director of Fordham Law School’s Center on Race, Law & Justice, and faculty co-director of the Fordham Law School Stein Center for Law & Ethics. Dr. Paul-Emile specializes in the areas of law & biomedical ethics, health law, anti-discrimination law, and race and the law, and law and society.
Dr. Paul-Emile’s award-winning scholarship has been published widely in such journals as the Virginia Law Review, Georgetown Law Journal, UCLA Law Review, George Washington Law Review, New England Journal of Medicine, Journal of the American Medical Association, and Annals of Internal Medicine, among others. Her co-authored article, “Patient and Trainee Experiences with Patient Bias,” won the American Board of Internal Medicine Foundation’s 2019 John Benson Professionalism Article Prize. For her article, “Blackness as Disability?,” Dr. Paul-Emile received the Law and Society Association’s 2019 John Hope Franklin Prize, awarded for “exceptional scholarship in the field of Race, Racism and the Law.” Her co-authored article, “Dealing with Racist Patients,” has been viewed over 153,000 times, placing it in the 99th percentile of articles published in the New England Journal of Medicine, and 99th percentile of all medical journals. Dr. Paul-Emile’s scholarship has appeared in or been covered by national and international news organizations and other outlets, including the New York Times, Wall Street Journal, Washington Post, National Public Radio, CBS News, MSNBC, CNN, Newsweek, and The Guardian.
In 2022, Dr. Paul-Emile was awarded an honorary doctorate from Drew University. In 2020, she was selected to serve as a Law and Public Affairs (LAPA) Fellow at Princeton University for the 2020 – 2021 academic year. Dr. Paul-Emile is also currently a member of the Committee on Science, Technology, and Law of the National Academies of Sciences, Engineering and Medicine. In 2017, Dr. Paul-Emile was awarded a Making a Difference in Real World Bioethics Dilemmas Grant by the Greenwall Foundation for 2017 – 2019; and in 2013, the foundation chose her to receive a Faculty Scholars Award in Bioethics: an award intended to enable outstanding junior faculty members to conduct original research to help resolve important policy and clinical dilemmas at the intersection of ethics and the life sciences. In 2012, she was awarded a Public Health Law Research Grant from the Robert Wood Johnson Foundation, the nation’s leading philanthropy on health and health care.
Prior to pursuing her doctoral degree, Dr. Paul-Emile served as associate counsel at the Brennan Center for Justice at New York University School of Law, and practiced civil rights law at the Center for Constitutional Rights, where she was a National Association for Public Interest Law (now Equal Justice Works) Fellow and later the William Moses Kunstler Fellow for Racial Justice. She also served as senior faculty development consultant at the New York University Center for Teaching Excellence. Dr. Paul-Emile holds an A.B. degree in Political Science and in American Civilization, with honors, from Brown University; a J.D. from Georgetown University Law Center; and a Ph.D. in American Studies from New York University.