Jacob Albin Korem Alhassan, Nikisha Shally Khare, Azasma Tanvir
Background: Addressing anti-Black racism in medical education in Canada has become increasingly urgent as more Black learners enter medical institutions and bring attention to the racist harms they face. We sought to gather evidence of experiences of racism among Black medical learners and to explore the contexts within which racism is experienced by learners.
Methods: Drawing on critical race and structural violence theories, we conducted interviews with Black medical faculty, students, residents, and staff at the University of Saskatchewan College of Medicine between May and July 2022. We thematically analyzed interviews using instrumental case study methodology.
Results: Thematic analyses from 13 interviews revealed 5 central themes describing experiences of racism and the compounding nature of racist exposures as learners progressed in medicine. Medical learners experienced racism through uncomfortable encounters and microaggressions. Blatant acts of racism were instances where patients and superiors harmed students in various ways, including through use of the N-word by a superior in 1 instance. Learners also experienced curricular racism through the absence of the Black body in the curriculum and the undue pathologizing of Blackness. Medical hierarchies reinforced anti-Black racism by undermining accountability and protecting powerful perpetrators. Finally, Black women medical learners identified intersecting oppressions and misogynoir that compounded their experience of racism. We propose that experiences of racism may worsen as learners progress in medicine in part because of increases in the sources of and exposure to racism.
Interpretation: Anti-Black racism in medical education in Canada is experienced subtly through microaggressions or blatantly from different sources including medical faculty. As Black learners progress in medicine, anti-Black racism may become worse because of the compounding effects of exposures to a wider range of sources of racist behaviour.
{"title":"Variegated racism: exploring experiences of anti-Black racism and their progression in medical education.","authors":"Jacob Albin Korem Alhassan, Nikisha Shally Khare, Azasma Tanvir","doi":"10.1503/cmaj.231753","DOIUrl":"10.1503/cmaj.231753","url":null,"abstract":"<p><strong>Background: </strong>Addressing anti-Black racism in medical education in Canada has become increasingly urgent as more Black learners enter medical institutions and bring attention to the racist harms they face. We sought to gather evidence of experiences of racism among Black medical learners and to explore the contexts within which racism is experienced by learners.</p><p><strong>Methods: </strong>Drawing on critical race and structural violence theories, we conducted interviews with Black medical faculty, students, residents, and staff at the University of Saskatchewan College of Medicine between May and July 2022. We thematically analyzed interviews using instrumental case study methodology.</p><p><strong>Results: </strong>Thematic analyses from 13 interviews revealed 5 central themes describing experiences of racism and the compounding nature of racist exposures as learners progressed in medicine. Medical learners experienced racism through uncomfortable encounters and microaggressions. Blatant acts of racism were instances where patients and superiors harmed students in various ways, including through use of the N-word by a superior in 1 instance. Learners also experienced curricular racism through the absence of the Black body in the curriculum and the undue pathologizing of Blackness. Medical hierarchies reinforced anti-Black racism by undermining accountability and protecting powerful perpetrators. Finally, Black women medical learners identified intersecting oppressions and misogynoir that compounded their experience of racism. We propose that experiences of racism may worsen as learners progress in medicine in part because of increases in the sources of and exposure to racism.</p><p><strong>Interpretation: </strong>Anti-Black racism in medical education in Canada is experienced subtly through microaggressions or blatantly from different sources including medical faculty. As Black learners progress in medicine, anti-Black racism may become worse because of the compounding effects of exposures to a wider range of sources of racist behaviour.</p>","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":null,"pages":null},"PeriodicalIF":9.4,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11173657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Culturally competent and inclusive endometriosis care.","authors":"Marfy Abousifein, Nicholas Leyland","doi":"10.1503/cmaj.240278","DOIUrl":"10.1503/cmaj.240278","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":null,"pages":null},"PeriodicalIF":14.6,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11173656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Khandideh K A Williams, Aisha Lofters, Shamara Baidoobonso, Isabelle Leblanc, Jeannie Haggerty, Alayne M Adams
{"title":"Embracing Black heterogeneity: the importance of intersectionality in research on anti-Black racism and health care equity in Canada.","authors":"Khandideh K A Williams, Aisha Lofters, Shamara Baidoobonso, Isabelle Leblanc, Jeannie Haggerty, Alayne M Adams","doi":"10.1503/cmaj.230350","DOIUrl":"10.1503/cmaj.230350","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":null,"pages":null},"PeriodicalIF":14.6,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11173650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"On the hyphen.","authors":"Brett Schrewe","doi":"10.1503/cmaj.231826","DOIUrl":"10.1503/cmaj.231826","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":null,"pages":null},"PeriodicalIF":14.6,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11142035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141236315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"To eliminate cervical cancer in Canada, nationwide funding of self-sampling for human papillomavirus is needed.","authors":"Shannon Charlebois, Sarah Kean","doi":"10.1503/cmaj.240722","DOIUrl":"10.1503/cmaj.240722","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":null,"pages":null},"PeriodicalIF":14.6,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11142031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141236317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rahel T Zewude, Kenneth Croitoru, Ronit Das, Brian Goldman, Isaac I Bogoch
{"title":"Auto-brewery syndrome in a 50-year-old woman.","authors":"Rahel T Zewude, Kenneth Croitoru, Ronit Das, Brian Goldman, Isaac I Bogoch","doi":"10.1503/cmaj.231319","DOIUrl":"10.1503/cmaj.231319","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":null,"pages":null},"PeriodicalIF":9.4,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11142034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141236310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Reka E Pataky, Sara Izadi-Najafabadi, Laurie W Smith, Anna Gottschlich, Diana Ionescu, Lily Proctor, Gina S Ogilvie, Stuart Peacock
Background: To eliminate cervical cancer in Canada by 2040, defined as an annual age-standardized incidence rate (ASIR) lower than 4.0 per 100 000 women, the Canadian Partnership Against Cancer (CPAC) identified 3 priorities for action: increasing human papillomavirus (HPV) vaccine coverage, implementing HPV-based screening and increasing screening participation, and improving follow-up after abnormal screen results. Our objective was to explore the impact of these priorities on the projected time to elimination of cervical cancer in British Columbia.
Methods: We used OncoSim-Cervical, a microsimulation model led and supported by CPAC and developed by Statistics Canada that simulates HPV transmission and the natural history of cervical cancer for the Canadian population. We updated model parameters to reflect BC's historical participation rates and program design. We simulated the transition to HPV-based screening and developed scenarios to explore the additional impact of achieving 90% vaccination coverage, 95% screening recruitment, 90% ontime screening, and 95% follow-up compliance. We projected cervical cancer incidence, ASIR, and year of elimination for the population of BC for 2023-2050.
Results: HPV-based screening at current vaccination, participation, and follow-up rates can eliminate cervical cancer by 2034. Increasing on-time screening and follow-up compliance could achieve this target by 2031. Increasing vaccination coverage has a small impact over this time horizon.
Interpretation: With the implementation of HPV-based screening, cervical cancer can be eliminated in BC before 2040. Efforts to increase screening participation and follow-up through this transition could potentially accelerate this timeline, but the transition from cytology- to HPV-based screening is fundamental to achieving this goal.
{"title":"Strategies to accelerate the elimination of cervical cancer in British Columbia, Canada: a modelling study.","authors":"Reka E Pataky, Sara Izadi-Najafabadi, Laurie W Smith, Anna Gottschlich, Diana Ionescu, Lily Proctor, Gina S Ogilvie, Stuart Peacock","doi":"10.1503/cmaj.231682","DOIUrl":"10.1503/cmaj.231682","url":null,"abstract":"<p><strong>Background: </strong>To eliminate cervical cancer in Canada by 2040, defined as an annual age-standardized incidence rate (ASIR) lower than 4.0 per 100 000 women, the Canadian Partnership Against Cancer (CPAC) identified 3 priorities for action: increasing human papillomavirus (HPV) vaccine coverage, implementing HPV-based screening and increasing screening participation, and improving follow-up after abnormal screen results. Our objective was to explore the impact of these priorities on the projected time to elimination of cervical cancer in British Columbia.</p><p><strong>Methods: </strong>We used OncoSim-Cervical, a microsimulation model led and supported by CPAC and developed by Statistics Canada that simulates HPV transmission and the natural history of cervical cancer for the Canadian population. We updated model parameters to reflect BC's historical participation rates and program design. We simulated the transition to HPV-based screening and developed scenarios to explore the additional impact of achieving 90% vaccination coverage, 95% screening recruitment, 90% ontime screening, and 95% follow-up compliance. We projected cervical cancer incidence, ASIR, and year of elimination for the population of BC for 2023-2050.</p><p><strong>Results: </strong>HPV-based screening at current vaccination, participation, and follow-up rates can eliminate cervical cancer by 2034. Increasing on-time screening and follow-up compliance could achieve this target by 2031. Increasing vaccination coverage has a small impact over this time horizon.</p><p><strong>Interpretation: </strong>With the implementation of HPV-based screening, cervical cancer can be eliminated in BC before 2040. Efforts to increase screening participation and follow-up through this transition could potentially accelerate this timeline, but the transition from cytology- to HPV-based screening is fundamental to achieving this goal.</p>","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":null,"pages":null},"PeriodicalIF":14.6,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11142038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141236316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Utilisation des données des systèmes d’investigations médicolégales pour favoriser la santé communautaire et prévenir les décès prématurés au Canada.","authors":"Matt Bowes, Robert Strang, Dirk Huyer","doi":"10.1503/cmaj.231386-f","DOIUrl":"10.1503/cmaj.231386-f","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":null,"pages":null},"PeriodicalIF":14.6,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11142032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141236318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Larissa A W Jansen, Victoria Shaw, Iris J Grooten, Marjette H Koot, Caitlin R Dean, Rebecca C Painter
{"title":"Diagnostic et traitement de l’hyperémèse gravidique.","authors":"Larissa A W Jansen, Victoria Shaw, Iris J Grooten, Marjette H Koot, Caitlin R Dean, Rebecca C Painter","doi":"10.1503/cmaj.221502-f","DOIUrl":"10.1503/cmaj.221502-f","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":null,"pages":null},"PeriodicalIF":14.6,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11142033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141236314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Alopécie causée par une dermatophytie du cuir chevelu chez un garçon de 8 ans.","authors":"Wu Guo, Ge Qian, Chang'e Zhang","doi":"10.1503/cmaj.231613-f","DOIUrl":"10.1503/cmaj.231613-f","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":null,"pages":null},"PeriodicalIF":9.4,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11142037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141236308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}