Enhanced Skills Program: Indigenous Health

Overall Program Vision

The Indigenous Health Enhanced Skills Program strives to improve the knowledge, skills and attitudes of the trainee with respect to determinants of health, health status and concepts of health and healing specific indigenous populations. In addition, the program will allow the trainee to improve clinical and advocacy skills to prepare them to practice with, and advocate for and with Indigenous people in urban and/or rural/remote areas of Canada.

See full program rationale here.

Program and Application Eligibility 

Length of Program

Curriculum Competencies

Program Goals

To enhance the ability of Canadian family physicians to provide comprehensive care to and to be advocates of improved health for indigenous populations in Ontario and other regions of Canada in accordance with the First Nations, Inuit and Métis (Indigenous) Health core competencies for postgraduate medical education (1).

The program will look at the roles that a family practitioner can play as an advocate for and with the indigenous population.  It will also focus on the unique relationship that may be present between practitioner and patient in the indigenous community.

In order to attain enhanced competence in this area, gaining an improved understanding of the historical and cultural context of Indigenous people in Canada and of the determinants of health of this population is crucial. 

The (6 or 12 months) program will include the following goals:

• Improved skills and knowledge in direct primary/secondary care of indigenous peoples

• Improved knowledge of the history of indigenous peoples in Canada including the history of colonization, and residential schools and how this history affects current health and social conditions of indigenous peoples

• Improved knowledge and skills regarding cultural safety as it pertains to indigenous peoples

• Improved skills in mental health and addiction medicine especially as it applies to the indigenous populations, both urban and remote

• Improved skills working cross-culturally and with interpreters

• Improved skills working interprofessionally including with traditional healers

• Improved self-reflection skills that include an analysis of one’s own identity and response to the histories and contemporary environments of indigenous peoples 

The trainee will also have the opportunity to develop leadership skills with the PGY3 Leadership course.

(1) Advisory Committee on Improving the Health of First Nations, Inuit and Métis (Indigenous) Populations Through Enhancements to PGME & CME Educational Programming. Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario; Indigenous Physicians Association of Canada, Ottawa, Ontario (March 31 - April 1, 2008)

Program Objectives

The training program objectives are outlined utilizing the Can-MEDS-Family Medicine competency framework. Details of these can be found at http://cfpc.ca/uploadedFiles/Education/CanMeds FM Eng.pdf

See full program goals and objectives here.

Sample Rotation

PROGRAM CORE COMPONENTS (depending on program's length)

• Graduate course in Indigenous Health – concurrent with urban clinical time:
  • CHL 5421H – a graduate half-year course in the Dalla Lana School of Public Health, Temerty Faculty of Medicine, University of Toronto. http://www.dlsph.utoronto.ca/course/aboriginal-health/
  • Essentially an independent reading course on relevant topics in Indigenous Health.
  • To be attended concurrently with urban clinic time (September – December).
  • Evaluation: one major assignment broken up into three parts, a bibliography with critical analysis on the topic chosen due by mid-October, a term paper on the same topic due in early December, and a final 20-minute presentation on the topic in December.

•  3 - 4 months in Urban Indigenous Health, which will include longitudinal time in addiction medicine, diabetes education and mental health experiences. 
  • Urban Aboriginal Health Goals & Objectives

• 2 - 3 months in rural/remote Indigenous Health
  • Rural/remote Aboriginal Health Goals & Objectives

• 1 - 3 months selective(s) to be chosen from mental health/psychiatry (Toronto or Kenora depending on availability), Emergency Medicine or other rotations as discussed with Program Director.
  • Mental Health/Psychiatry Goals & Objectives 

• 3 months low-risk obstetrics - Rotation Goals & Objectives

• Self-reflection – 1-2 page self-reflective reports after urban experience, and also after rural/remote experience.

PROGRAM DETAILS

Application and Selection Process

Application to the enhanced skills program in Indigenous Health is open to PGY2s in family medicine who have demonstrated an interest and a commitment to working with indigenous people. ACLS will be expected and ALARM/ALSO would be beneficial.

1 resident per year will be funded at a PGY3 level. 

Applications must include:

• An up-to-date CV
• 3 letters of reference, one being from the resident's family medicine Program Director
• A personal letter outlining the applicant's learning objectives for the six or twelve-month program.

The applicant will be contacted to schedule an interview. 

Selection will be based on the application documents and on an interview. Input may also be obtained from key partner organizations or other appropriate outside individuals at the discretion of the Enhanced Skills Resident Program Committee. 

Further questions can be addressed to the Enhanced Skills Program Administration at fammed.enhanced@utoronto.ca  or to the Enhanced Skills Program Director at giovanna.sirianni@utoronto.ca

Our application is currently closed. We will begin accepting applications for the 2020-2021 academic year starting August 2019. 
 

Program Director

Acknowledgements

The Program Director would like to acknowledge the participation and input of the following people in the development of this residency program in 2008 (in alphabetical order): 

Julia Alleyne, MD, CCFP - Associate Professor - DFCM, University of Toronto

Fatima Uddin, MD, CCFP - Staff Physician, Anishnawbe Health Toronto