This is the first in an eight-part series on The Gordon Foundation's Jane Glassco Fellowship Program.
In 2017, there was a 35 percent shortage of general practitioner physicians in the Northwest Territories (NWT), a shortage that's led to nearly half of the territory’s population lacking regular access to a medical doctor. Remote Indigenous communities are disproportionately impacted.
Unlike other small Canadian jurisdictions – such as the Yukon or Prince Edward Island – the NWT does not have programs encouraging students to study medicine elsewhere before returning home to practice. Instead, remote communities in the Northwest Territories are forced to hire locum physicians (temporary, travelling doctors) or rely on telephone-medicine.
A policy paper from Thomsen D’Hont, an alumni of the Jane Glassco Fellowship Program, explores what programming options could exist in the NWT to facilitate the training and recruitment of Indigenous doctors. The paper, published in May 2017, challenges the Territorial government to take bold steps to address the current crisis.
The Northwest Territories population is among the youngest in Canada. And among that population is a new generation of aspiring doctors eager to practice medicine. D’Hont is one of them. He is a Metis medical student from Yellowknife studying at the University of British Columbia’s Northern Medical Program in Prince George, BC. And after graduating, he plans to return home to practice.
“Addressing the Need for Indigenous Physicians in the Northwest Territories,” D'Hont's paper on the NWT's Indigenous doctor shortage, combines personal experience with detailed policy analysis and research.
As if to prove his point, while D'Hont was drafting the paper, only one Indigenous doctor was working in the NWT despite the fact that half of the Territory's population is Indigenous. Both the 1996 Royal Commission on Aboriginal Peoples and the 2015 Truth and Reconciliation Commission’s Calls to Action recommend training and hiring more Indigenous healthcare workers.
Addressing the shortage
D’Hont identifies 12 cost-effective and easy-to-implement policy solutions that could encourage more Indigenous youth to practice medicine in the Northwest Territories.
But perhaps most importantly, young people need to be inspired to go to medical school. Having just one Indigenous doctor in a territory twice the size of Texas means that students lack role models within the profession.
From 2006-2011, the NWT guaranteed Indigenous students the opportunity to study medicine. The Territorial government partnered with the universities of Alberta and Calgary to reserve spaces within their medical programs for qualified applicants. The Yukon runs a similar partnership with Memorial University in Newfoundland. Restoring the short-lived NWT program would go a long way towards ensuring that qualified, Indigenous students from the territory receive the opportunity to study medicine.
British Columbia, meanwhile, boosts Indigenous medical enrolment by running workshops to help students prepare their applications and admission tests, an approach D’Hont recommends the Territorial government pursue as well.
Medical students in the NWT also need expanded financial support. The current financial assistance model focuses on undergraduate studies by providing 12 semesters of grants, beyond which students are no longer eligible and must rely on loans. This increases the financial burden on aspiring doctors.
Both the NWT and Yukon operate a “return-for-service” incentive that turns student loans into grants for doctors who practice medicine in the North. D’Hont suggests the NWT synchronize the values rewarded within their program with those offered in the Yukon.
But perhaps most importantly, young people need to be inspired to go to medical school. Having just one Indigenous doctor in a territory twice the size of Texas means that students lack role models within the profession. Physician shadowing is one of many chances to encourage would-be doctors to better understand the calling and its challenges, D'Hont notes, but so too would clinical rotations in the NWT for Indigenous medical trainees, targeted high-school outreach and establishing a territorial family residency.
“Implementing any selection of [these] options." he writes, "will make a difference for aspiring doctors in the NWT."
To read Thomsen D’Hont’s policy paper – including all 12 of his recommendations with detailed costing and timelines – as well as other policy work from the Jane Glassco Northern Fellows, please visit The Gordon Foundation's website.
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