Canadian Medical Association

Equity is about recognizing and accommodating people’s differences to ensure that every individual has what they need to thrive. In the background to its policy on equity and diversity in medicine, the CMA says equity is achieved when “every person has the opportunity, with their own identity, culture, and characteristics, to create and sustain a career as, or receive care from, a medical professional without discrimination or any other cultural or characteristic-related negative bias or barrier.”

What are the issues?

While there are ongoing efforts throughout the medical profession to increase the representation of marginalized groups, bias and discrimination continue to be issues.

These create individual and systemic barriers to the advancement, health and livelihood of many people.

Professionally, people from ethnic/racial minority backgrounds consistently earn less than their white counterparts, and those who identify with more than one determinant of diversity often face compounded challenges.

In terms of caring for people from ethnic and racial minority backgrounds, a study from BMC Health Services Research revealed health care professionals generally believed they had the ability and cultural knowledge to treat minority patients. However, many lacked specific training and failed to identify larger systemic issues such as racism, power imbalances, entrenched majority culture biases and awareness of their own prejudices.

Gender bias in the medical profession

Gender bias is another facet of equity, one that continues to be a significant issue facing women in medicine. The CMA has found that women physicians in primary care earn an average of 16% less annually than their male colleagues. The gap in specialties is even higher at 37%.

These issues persist despite growing numbers of women in the field. Today, there is an almost even split between male and female medical students. By 2030, half of all practising physicians in Canada will be female. As a result, if the health care system does not establish appropriate equity and diversity practices, half the workforce will be at risk of gender bias — and its associated poor health outcomes.

Recent research has shown that women physicians have higher rates of burnout and suicide ideation, and are screened more often for depression. An article in Human Resources for Health also found that women physicians report higher levels of sleep disorders.

Addressing gender bias in medicine will help women physicians experience greater career satisfaction and improve their health and wellness. It will also foster a greater sense of solidarity among physicians and lead to improved patient care and a more responsive, adaptable health care system.

The opportunity

Physicians are affected by many complex, intersecting elements of identity and other personal characteristics, culture and historical legacy. As the Canadian population becomes more diverse, the medical profession must accommodate and reflect this diversity. 

To achieve this, the profession must minimize inequitable treatment of people from diverse backgrounds to broaden their acceptance during initial recruitment, training, specialty selection, placement and retention. This will increase opportunities for all groups to enter the profession and realize their full potential within it — with benefits for patient care, physician health and wellness, and the very fabric of medicine.

Inclusion strategies

Developing and implementing programs and resources to support marginalized and under-represented groups requires great commitment from organizations and institutions. This section provides resources to help you develop practices or programs that encourage the participation of diverse individuals, and to integrate and value their perspectives in organizational structures and decision-making processes. 

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