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Addressing the Gaps, Alumni Stories, Gallery, In the Spotlight

NOSM-acquired Skills Help Fill a Gap in Care for Underserved Populations   

Gallery

Dr. Andrea Haner (MD Class of 2010) is applying the skills she learned at NOSM to treat diverse, underserved populations. She is the only GP Oncologist treating gynecological cancer in the Southwest Alberta region.

“The population I work with is very underserved. If I didn’t do this work, women would have to commute to Calgary—a two-and-a-half-hour drive into the cancer centre for most,” says Dr. Haner. “Instead, they can come to Lethbridge for chemotherapy treatment.”

The skills Dr. Haner learned at NOSM, with a focus on the personal side of medicine, helped prepare her for the subspecialties she’s taken on, including serving a diverse populations in family medicine with the Medical Assistance in Dying (MAiD) team, on-call with the hospital sexual assault team, and in her family practice at Lethbridge College and as a GP Oncologist. In her family practice location, Dr. Haner works with diverse populations, she sees college students for mental health concerns and hormone therapy for transgender students, as well as other populations outside of the college including Hutterites, Mexican Mennonites, local and surrounding Indigenous communities.

“While at the Northern Ontario School of Medicine, I found I spent a lot of time helping patients with social problems and navigating the health-care system. An important part of my work is helping people with really, really difficult aspects of their lives. At NOSM, I learned how to be compassionate and really get to know patients and it’s very satisfying,” says Dr. Haner.

She says she didn’t anticipate moving west, however, Dr. Haner’s passion for cancer care led her to BC Cancer’s general practitioners in oncology program, then subsequently to Alberta when the local cancer centre was seeking someone with her skills.

“I’m very proud of my training in the North. The NOSM education was very broad-based, which is its strength. I was exposed to patients very early on and to preceptors who offered tips and hints from breaking bad news to patients, to navigating the system, and working with language interpreters. It all ends up being so important in everyday work life,” says Dr. Haner.

These days, her varied practice in Lethbridge also includes serving the 50 per cent rural population via telephone and telehealth, and helping coordinate and guide people in smaller centres—another skill she learned at NOSM.

“Medical students from larger cities don’t realize the limitations of smaller centres, for instance offering guidance for CT scanners or what rural family doctors are able to do with very limited resources. I gained a really good understanding of those challenges,” says Dr. Haner.

“It just so happened that I found my way in Alberta. NOSM set me up to bring my skill set anywhere and I am providing important care to underserved populations. When you go into medicine you don’t have to be pigeon-holed to one location or type of practice, you can diversify as you grow in your career.”

Dr. Haner encourages wellness, diversity and inclusion to also be considered as choices in medical practice. For her, working in rural health is where she always wanted to be. “Think about how your skills can help any underserved population. That is the most valuable service,” says Dr. Haner.

Alumni Stories, In the Spotlight

Striving for Inclusion

As the active anti-racism movement continues to ripple across multiple professions and communities in Canada, medical schools are among those taking a closer look at their institutional systemic practices to make active improvements in diversity and inclusion.

Joby Quiambao is a Registered Dietitian, alumna of the Northern Ontario Dietetic Internship Program (NODIP) at NOSM, and works full-time with the Maamwesying North Shore Community Health Service. She’s also a member of the inaugural Canadian chapter of Diversify Dietetics— a group working to increase ethnic and racial diversity in the dietetic profession.

“With the amplified awareness of racial injustice in the news and the ongoing anti-racism protests, it has given voice to the lack of diversity in many professions. Westernized and colonial roots are being revealed and confronted,” Quiambao says.

“Early in my undergraduate university experience I didn’t realize how important knowing my own native language and cultural history was at first. It provides me an enriched perspective and understanding of the work that I do today as a dietitian. I believe a large part is due to the fact that it is instilled in our systemic and institutionalized societies to think in a standardized way.”

Quiambao emphasizes that “racism is present in Canada and continues to stem from colonial roots, from defining what food we should eat, to who gets to become part of the dietetic profession.”

However, change is happening in communities and there is a growing, diverse population across Northern Ontario. Quiambao sees it and says she feels part of it, “I am very grateful I got into NODIP and that I secured my career in the North.”

“However, throughout my journey toward becoming a dietitian, there was a blatant lack of racial diversity both during my undergrad at Western University and later at NOSM’s Northern Ontario Dietetic Internship Program-I was the only person of colour within my NODIP cohort.”

She says she would like to see more diversity across all nutrition and dietetics education programs, where learning institutions provide sustainable opportunities that are inclusive and accessible for underrepresented applicants of various cultures, ethnicities, and socioeconomic status.

Currently, Quiambao is working on a project that looks at the demographic data of applicants to nutrition and dietetic programs. She hopes the project will offer valuable evidence to improve the intake process and contribute to diversifying the profession. She describes this work as “a start.”

Much of Quiambao’s self-identity and self-exploration began while working with and among Indigenous communities both in Toronto, and in the North. It was advice from her former colleague, traditional healer, Kenn Pitawanakwat from Wikwemikong Unceded First Nation, who encouraged her to explore her own culture and its connection to her own career path and wellness.

“I’ve learned that traditional teaching is cultural sharing. Also, that nutrition, Indigenous health and the environment all intersect and are interconnected, and I see that clearly as a dietitian.”

Quiambao says it would’ve been powerful to see someone else, like herself, a person of colour, in the program or represented in the promotion of dietetics education.

“It brings a lot of hope when you see someone relatable being represented in roles you aspire to fulfil. It adds a whole new perspective on whether one can hope to be, or strive to become, part of that profession.

“Seeing someone like you in a career you hope to have someday sends the message that there are opportunities for you that are available and accessible.”

Resources and further reading on this topic: 

NODIP’s related research work:

The Scope, page 12
Published paper in Canadian Journal of Dietetic Practice and Research

Other dietetic health promotion work of interest:

Diversify Dietetics
Towards Decolonizing Canadian Dietetic Practice

Alumni Stories, In the Spotlight

New NOSM Graduate Receives CMA Advocacy Award 

Dr. Niharika Shahi (MD Class of 2020) received the Canadian Medical Award (CMA) for Young Leaders (Student) for her outstanding advocacy efforts on unique Northern Health issues including, Indigenous youth mental health support in high school, public education around opioid overdose  and Naloxone administration, and raising awareness about the signs of local human trafficking.

The award honours one student “in recognition of their exemplary creativity, initiative and commitment to making a difference at the local, provincial and national level.

Dr. Shahi was surprised to that she was the recipient of the award, and she doesn’t know who nominated her.

“I was in my fourth year of medical school and it was a very big surprise,” says Dr. Shahi. “It’s not only a success for me, but also for the teams I worked with on these projects. In the North, work is often being done on a smaller scale and when a national award happens, suddenly these important health-care initiatives start to be talked about across the country. On Twitter, I see physicians from Ottawa becoming interested and discussing these projects in Northern Ontario. To me, that is the biggest success,” she says.

She credits the NOSM social accountability mandate for fueling her interest in unique Northern health initiatives that go beyond the mandatory MD curriculum.

“I was always interested in providing better health care to Northern communities and that was a big reason why I chose to attend medical school in the North. I have a responsibility as a future health-care provider, so I took it upon myself to recognize the different issues being faced by our communities,” says Dr. Shahi.

During a NOSM rural placement in Kenora, she spent time talking to youth and visiting nearby First Nations communities. Indigenous youth shared challenges of travelling to attend high school in Thunder Bay. She recalls recognizing the mental health challenges associated with an entire population of teenagers who are separated from their families to gain higher education, and in many cases only visiting home twice a year.

“I was able to partner with local psychiatrists through Compass North (NOSM’s student-led outreach clinic) and we structured workshops for high-school staff who are working with Indigenous youth to provide them with the resources needed to support better mental health for their students,” says Dr. Shahi.

She also reached out to a local needle exchange program she recognized the prevalent opioid crisis in the North and lack of training in opioid overdose management She started working with the program to offer training around the safe and recommended ways to administer Naloxone. The workshop was initially only offered to medical students, however with Compass North’s advocacy, is now widely attended as a public workshop.

In her first year of medical school, Dr. Shahi joined a new volunteer group called Canadian Association of Medical Students Against Human Trafficking.

“It was an inaugural year for this group. They were looking for a representative from each medical school. I realized this is something that is happening in Northern Ontario that is not talked about in our medical school curriculum, nor even mentioned,” says Dr. Shahi. “So I took on the role of campus representative. I got in touch with the local police and asked them if they would provide some information to NOSM medical students through a workshop.”

The topic was added to the agenda of a women and children’s health night at NOSM. The workshop included advice on how physicians can recognize the signs of human trafficking and how to differentiate treatments for victims.

“It was an eye opener for everyone who attended because it’s an issue that is not openly discussed , for example, we talked about what to do if a patient comes in who is a victim of human trafficking,” she says.

She continued to work with Compass North throughout her medical education and later became the Director of the Clinical and Social Service Committee of the clinic.

“Compass North was initially set up to offer health care services outside of clinic hours to improve access to care for the public. The clinic would offer limited basic services like health promotion workshops and flu vaccines,” says Dr. Shahi. “It was a great learning experience, because as early as my first  year of medical education I was able to interact with patients, and I was able ask for consent and and gain clinical skills before moving into clerkship.”

“Experiences like Compass North, and partnering with different organizations locally, provided me an opportunity to work with different teams and learn to provide better health care in the North. That was the biggest driver for me, and I would love to continue working on some of these projects with NOSM students, and help them gain better education.”

Dr. Shahi recently started a radiology residency at McMaster University in Hamilton. She plans to return to Thunder Bay to provide care to her home community in future.

NOSM University