Anti-racism: listening, learning, and taking action

Dear Colleagues,

Since the tragic deaths of Joyce Echaquan and George Floyd, the pandemic has accentuated the realities, injustices, and discrimination faced by racialized groups. The CFPC leadership and staff acknowledge the social privilege associated with the predominant White or settler status and the profoundly negative impact of colonization, residential schools, and slavery for Indigenous and Black peoples. This results in systemic racism and oppression, most often based on race, religion, immigration status, sex, sexual orientation, gender identity, and physical or mental ability. Systemic and interpersonal racism and other forms of discrimination must be addressed at all levels. To this end, the CFPC’s refreshed strategic plan includes 2 specific targeted actions:

• ensure the integration of Indigenous health (IH) and cultural safety into family medicine residency training standards and promote use of the CanMEDS–Family Medicine (CanMEDS-FM) IH supplement¹; and

• develop a plan of action engaging and supporting leadership from racialized groups to address systemic racism where the CFPC has responsibility and influence.

We are committed to being an anti-oppression organization, embracing our diversity and need for advocacy and anti-racism. It is important to reaffirm CFPC’s role as a member-based organization, standard setter, and employer, as this provides context for the positive impact we hope to achieve. The following draft principles will guide our work:

• prioritize the voices of those with cultural perspectives, knowledge, and lived experience while respecting and honouring the time, intensity, and cost of involvement;

• approach this work with humility, listening and learning as an organization;

• understand the need for historical contexts and decolonization as part of an anti-oppression strategy;

• respect that identity, privilege, and discrimination are layered and multidimensional, and for any individual or group there may be similar, different, or combined experiences or impacts related to gender, race, religion, etc.

The CFPC engages with our partners, demonstrating commitment to allyship—eg, we collaborate with the Royal College to develop accreditation standards and policy requirements that address racism in the learning environment and the accreditation process, including the training of surveyors. Work is already under way with formation of the Accreditation Working Group on Anti-Black Racism. We are also following up on actions from the CanMEDS-FM IH supplement, such as development of supporting documents, tools, and activities. Notably, the CFPC is a partner of the National Consortium for Indigenous Medical Education (NCIME), an important Indigenous-led initiative that will expand IH curricula, support Indigenous trainees and faculty and their wellness, and promote cultural safety and antiracism in medical schools (ncime.ca/vision). While the work of the CFPC IH committee aligns with this, we are looking for a Clinician Educator in IH to help advance the efforts of the NCIME, support the roll-out of the CanMEDS-FM IH supplement, and help develop a plan and resources for our strategic plan goals related to IH education.

We will also consider how the CFPC examination can better test physician competence with respect to the delivery of culturally safe and trauma-informed care, and will assess and address any systemic barriers and discrimination in the eligibility for and delivery of examinations, including examiner training. In addition, we must create a safe space for listening and dialogue, respecting the knowledge and lived experiences of physicians, trainees, and staff from marginalized groups, and we must include their perspectives and voices. We need to facilitate educational opportunities for CFPC leadership, members, and staff to foster critical shifts in perspective and behaviour, and promote a culture of allyship. We will also continue to collaborate with other medical organizations in transforming medical education and health care to address systemic racism and foster a climate of cultural humility and safety.

We are grateful to the CFPC IH committee for their diligent efforts, feedback, and guidance. In light of recent discoveries of unmarked graves of Indigenous children near residential school sites, CFPC members are encouraged to participate in professional development activities focused on Indigenous history, health, and social issues. September 30 is the first National Day for Truth and Reconciliation, when we will remember and support residential school survivors and their families and communities. With all Canadians, we will reflect and renew our commitment to reconciliation by listening, learning, and taking action.

• Copyright© 2021 the College of Family Physicians of Canada