DPP Preceptor Sara Duchene-Milne Leading Change in Indigenous Health

Sara Duchene-Milne has spent more than two decades advancing Indigenous health through care, education, and advocacy. When she became a Registered Dietitian (RD) in 2003, she was among fewer than ten Indigenous RDs in Canada.

A valued and long-term preceptor for the NOSM University’s Dietetic Practicum Program (DPP), Duchene-Milne recently took on two leadership roles, one nationally and one in her home community on Manitoulin Island. At Noojmowin Teg Health Centre, she has taken on a manager role as Team Lead of Diabetes Wellness and Nutrition Programs, while nationally, Duchene-Milne brings the unique needs and perspectives of Northern Ontario to the National Indigenous Diabetes Association (NIDA), where she has been elected for a two-year term as Chair.

“For me, being a leader in Indigenous health is about representation and responsibility. I feel a responsibility to use my voice and unique skill set to educate and advocate for Indigenous health in clinical and community settings,” she says.

Duchene-Milne holds a remarkable five volunteer roles in Indigenous and diabetes health, going above and beyond her professional responsibilities to make an impact with her advocacy. In addition to her roles as a DPP preceptor and Chair of NIDA, both work that she does in-kind, Duchene-Milne dedicates her time as Co-Chair for the Indigenous Science and Content Stream for Diabetes Canada/CSEM Professional Conferences, Associate Editor for Diabetes Communicator Publication, and a board member on the Mission Committee at Diabetes Canada.

A member of the Wiikwemkoong Unceded Territory, Duchene-Milne was raised in nearby Little Current. After practising clinical, hospital dietetics for many years in Sudbury, in 2021 Duchene-Milne returned to Manitoulin Island to focus on Indigenous health. A Certified Diabetes Educator and Certified Bariatric Educator, her role involves both management and clinical work for the Indigenous health centre.

“Indigenous registered dietitians have a unique ability to bridge health and nutrition knowledge from a westernized perspective—because that’s how we were trained—with a deep understanding of Indigenous culture and tradition,” she says. “Indigenous dietitians also understand the impact of colonialism on food systems and the social determinants of health.”

“This perspective allows us to approach health from a holistic perspective, supporting physical, emotional, mental, and spiritual wellness, and prioritizing cultural safety. Building trust and rapport with Indigenous patients and communities, drives better results, especially with chronic diseases such as diabetes and obesity.”

While representation has grown in the last 23 years, the number of Indigenous RDs in Canada remains low. A 2020 survey by Dietitians of Canada on the demographics of recent dietetic graduates indicated that only 1.7% identified as First Nations, Inuit, or Métis.

“There is a gap in Indigenous representation within the profession, yet the demand is high, especially for culturally safe primary care in areas like diabetes management and food sovereignty,” Duchene-Milne says.

Duchene-Milne makes an impact by delivering training to dietitians to improve patient trust, rapport, and cultural safety when conducting assessments with Indigenous patients. The training presentation, titled “Practice Pearls for Indigenous Clinical Interactions,” has been delivered twice to NOSM University DPP learners, as well as at the 2024 Diabetes Canada National Conference.

“When I became a Registered Dietitian in 2003, there were only a handful of Indigenous registered dietitians in Canada. I was very honored to be among them. Being in such a small group shaped my drive, determination, and perspective, and pushed me to want to become a better clinician, educator, and advocate for Indigenous health,” says Duchene-Milne.

Through her work as a preceptor for DPP, she is mentoring the next generation of RDs and strengthening culturally safe care throughout the North.