In this series, some of Canada’s most active physician advocates talk about their vision for a better future of health and what motivates them to step into public conversations.
Dr. Onye Nnorom — a Toronto-based family doctor and public health specialist — uses her voice to combat anti-Black racism and address health inequities. Among her numerous roles, she is currently president of the Black Physicians’ Association of Ontario (BPAO) and hosts the podcast Race, Health and Happiness.
Black physicians can face barriers even before applying to medical school. Can you talk about your own experience?
I’m not sure if people realize that anti-Black racism in our educational systems, health care system and the labour market can have a direct impact on our journeys to medicine.
My father was a maintenance worker and my mother was a personal support worker. How would I know how a doctor thinks? Applicants might not have the money for MCAT courses or the time to volunteer in the ways traditionally valued for admission.
I was fortunate enough to be part of a mentorship program for Black students that helped develop that lens for medical interviews. Even then, as a Black medical student, once you are in you are one of the few, so you feel the stress of representing a whole community. You are at once both hyper-visible and invisible.
About 4.7% of Ontario’s population is Black, according to the 2016 census. But Black physicians account for only 2.3% of the province’s doctors.
How did those experiences affect your early career?
When physicians come from a community underrepresented in medicine, they end up doing outreach or mentorship in addition to school or residency. While your colleagues are just studying or doing research, your extra equity-driven work — a concept called a “minority tax” — isn’t rewarded by the medical establishment.
Meanwhile, you might have a patient who doesn’t want to be examined by a Black doctor or who asks for your credentials because they can’t fathom you are qualified. Or you are harassed while trying to do your job.
We also face guilt if we don’t feel we are succeeding in an environment that may be riddled with bias, because we recognize so many people invested in us to get us where we are.
There are myriad ways these things compound to create greater stress for Black physicians.
Last year, the BPAO received a grant of $1 million through a collaboration between the CMA, Scotiabank and MD Financial Management. How will that help address Black physician wellness?
The core work of the BPAO includes mentorship, outreach, increasing our numbers, hosting Black health events and advocating in the community. We want to increase the number of Black physicians in Canada and improve health in Black communities. There is no great equalizer except social justice and removing oppression. When there is a Black doctor, that physician is less likely to hold racist biases and will have a stronger therapeutic bond with the patient.
Health care is supposed to benefit a diverse population. We need more voices at the table.
The BPAO's 13th annual health symposium will take place virtually on Feb. 26, at 9 a.m. ET. Learn more.
Black communities have been disproportionately affected by COVID-19. How has your advocacy work helped move that needle?
There has been distrust of government, researchers and public health institutions that have been promoting the vaccine. Prior to the pandemic, these institutions made little or no effort to demonstrate that they truly valued Black lives. The distrust is warranted, but we recognize as Black physicians that vaccines are our best defence against the virus.
The BPAO established the Black Health Vaccine Initiative in April 2021 to provide culturally safe vaccine clinics to Black and other racialized communities in Ontario. We work closely with the Black Scientists’ Task Force on Vaccine Equity in Toronto, which helped get Black vaccinators on the ground in neighbourhoods with a high Black population density. The task force also organized virtual town halls to answer questions from the public and promote vaccine confidence. We have administered over 50,000 doses to date in Black and racialized communities.
What are the some of the challenges you face working in this advocacy space?
There is a gap in race-related health data in Canada. And while the collection of this data is necessary, it can be used to stigmatize and highlight differences instead of prompting action on systemic and structural issues. Race-based data need to be collected in a way that is respectful and in partnership with Black communities. For example, the collection of race-based data during COVID-19 has been instrumental in advocating for resources for Black communities and other communities disproportionately affected by COVID-19.
What is your favourite part of being a physician?
The patients. I love the idea of being with someone on their journey toward better health. I love reducing medications from their list.
I also really love educating young people, including medical students — to inspire them and to learn their fresh take on things. Together, we can reimagine what health care will look like.
This interview has been edited and condensed for clarity.
Black physician trailblazers: Other stories of advocacy
Racism in medicine and the impact on physician wellness
“We’ve often been stalled by the fact that medicine is painted as this altruistic, noble, honourable profession, forgetting that medicine is built on such heinous acts of racial violence that we don't often acknowledge.” – Dr. Joseph Mpalirwa
Overcoming imposter syndrome in medical school
“I owe a large part of my strength to my mentors. These Black female physicians took me under their wing and have been a support system for me ever since.” — Dr. Chika Stacy Oriuwa
Using virtual town halls to build community trust in vaccines
“People appreciate open conversations that aren’t dismissive or condescending.” — Dr. Isaac Odame
Defending public health funding in Quebec
“I really had the opportunity to see how health is not so much about individual behaviours as it is about the social determinants of health.” — Dr. Ak’ingabe Guyon
Five organizations to watch across Canada
Along with the BPAO, Dr. Nnorom highlights other Black advocacy organizations helping to transform health care in Canada.
Black Physicians of Canada
This organization supports and celebrates Black physicians and medical learners to make sure Black Canadians are equitably represented in medicine and racialized health disparities are eliminated across the country. It also advocates for Black patients and the Black community at large.
Health Association of African Canadians
This Nova Scotia-based association is made up of volunteers and researchers from academic, community, public policy and clinical agencies interested in advancing the health of Black women and their families. Its work includes community mobilization, development and research.
Black Medical Students’ Association of Canada
This collaborative network of Black medical students across Canada advocates for equitable representation of Black students in medical schools and more inclusive medical training.
Black Health Alliance
This organization brings together a range of partners to develop innovative support for Black health and well-being.
Quebec Black Medical Association
This association funds projects that contribute to public education, enhance services for disadvantaged communities and support Black students pursuing medicine.