Dr. Bolu Ogunyemi was the first Black student from Newfoundland and Labrador to train at Memorial University of Newfoundland (MUN). Now, he’s leading change to make medicine more reflective of, and accountable to, Canada’s diverse populations. He spoke with the CMA ahead of Black History Month.
You were the inaugural assistant dean of social accountability at MUN. What does social accountability mean to you?
It means every aspect of medicine— research, workplace culture, education, clinical practice— reflects the communities we serve, with a particular focus on underserved communities. That includes the pipeline to the field, of course. A lot of medical schools have been making diversity a priority. At Memorial, we have programs introducing Indigenous and rural students to the health sciences, including medicine, nursing, and other allied fields, at an early stage. I’ve given some of these talks. For young people, just seeing themselves reflected in the physician workforce is important. I’m an immigrant. I understand first-hand some of the barriers to training in medicine in Canada. I was the first black person in the Newfoundland and Labrador pool to train at Memorial.
What about patients?
Another big part of social accountability is helping people access health care in a way that considers their cultural context. This may include resources and translations in their mother tongue. For example, Indigenous people have high rates of severe dermatitis, so we are in the process of translating patient handouts about skin conditions to Innu-aimun, the traditional language of the Innu First Nation in present day Newfoundland and Labrador. I was also the lead author on a policy paper by Canadian Doctors for Medicare that discusses how we can leverage virtual care to improve health inequities faced by patients living in rural and remote settings.
Why is diversity in medicine so important to improving health outcomes?
Folks bring different lenses and perspectives to the classroom, to their teaching, to the way they practice— even where they practice. There’s evidence that physicians from underserved backgrounds are more likely to work in areas with people from their own or other underserved backgrounds. Part of the reason I do outreach work with Indigenous communities is because I have an understanding of racism in health care and how important cultural sensitivity can be.
For example, many of our dermatology textbooks were written at a time when there was very little diversity, and they’re based on white skin. Doctors have been taught to look for red skin as a sign of skin inflammation. But people with richly pigmented skin can have very subtle changes in hue, and still have significant eczema. They may have very itchy skin or skin that is warmer than usual.
I chose dermatology because I wanted to advocate for revisions in dermatology education to reflect the entire spectrum and diversity of skin and hair types in folks of all ethnic backgrounds.
You recently spoke out against racism faced by an Egyptian doctor in a Newfoundland town, noting that these types of incidents occur across the country. How can the medical community better support physicians of colour, especially in rural and remote settings?
In health care right now, we need all hands on deck, especially in rural and remote areas where access to health care is most dire. The provinces of Newfoundland and Labrador, Saskatchewan and others have relied heavily on internationally trained physicians. Many are minorities in the communities they are practicing in. It’s important for people to feel welcome, to feel part of the community, to feel that they can bring their authentic selves to work.
As a medical community, we can help by making sure people practicing in a new cultural environment have connections to others, formally or informally, who understand their challenges and can support them. I'm part of Black Physicians of Canada and the Canadian Association of Nigerian Physicians and Dentists. Through these groups, I have helped folks navigate the world of medical education and practice as a racialized immigrant.
Still, there’s data that shows that folks from underrepresented groups are less likely to have a willing mentor. I think we need to be more intentional in our inclusion efforts.
What about supporting trainees who experience racism or other forms of discrimination?
We're seeing more and more recognition that when doctors aren’t well, we can’t take care of our patients. And wellness includes cultural safety. But many physicians have learned in a culture that told them, “You have to develop thick skin to work in this healthcare system.” Physicians, including those who supervise learners, aren’t taught how to manage discrimination or microaggressions at work.
To teach physicians about these scenarios before they face them, I created case studies for professionalism modules for teaching faculty at Memorial. One was based on a case I had been made aware of involving a racialized resident, training under a white physician, who experienced racism from a patient. That puts the supervisor in a difficult position. When you're the senior staff doctor, it's your job to take care of the whole team working under you as well as the patient. It’s important for to really listen to the resident in this situation, ask what they need in the moment, and offer them a chance to step away. They may need a short break. In some instances, another physician may need to take over their role for some time.
There's a push for more integrated, national health workforce planning. Where does—or should— diversity fit in?
Here’s an example of how factoring diversity into workforce planning can be critical: Partly because of the history of racism in health care, many Black folks in Ontario were hesitant to get COVID-19 vaccines, and the pandemic took a higher toll on them. Black health care providers could see the need to bring information about the importance of COVID vaccines to culturally safe spaces in the community. The Black Health Vaccine Initiative they created resulted in a significant increase in vaccinations, preventing COVID and preventing long-COVID.
Leadership tables benefit not just when there is diversity of backgrounds but diversity of thought. We all have our biases, but when we have varied perspectives, including those that have been historically shut out, we can have more rich, nuanced conversations. This was a central theme of a TEDx talk I gave a few years back. When we’re intentional about empowering people from underrepresented backgrounds, that's when we can get the best solutions to our problems.
This interview has been edited and condensed.