C/O Luis Melendez
Medical students from rural backgrounds can help resolve the inequities of the Canadian healthcare system
While the Canada Health Act has always maintained that all Canadians should have equal access to healthcare, the unfortunate reality is that this ideal is far from the truth. Although many Canadian cities have sufficient doctors for their population, the same cannot be said for rural communities.
Comparatively studying the doctor-per-capita ratios between urban and rural communities exposes a harsh inequity. In fact, the country’s overall value for doctor-per-capita is one in 450 while rural areas average one doctor for every 3000 residents.
Clearly, there is a severe problem in our current healthcare system that needs to be resolved. Unfortunately, this statistic cannot be taken at face value and the snowball effect that is a result of this inequity must be studied as well.
Due to limited access to healthcare, individuals living in rural areas are more likely to have a significant disease burden. What this means is by the time someone in a rural community can see a doctor, their disease has progressed even further leading to higher rates of chronic disease and poorer mental health.
If you take a step back and really look at the problem, you notice that by allowing this population to go underserved, the Canadian healthcare system is essentially shooting itself in the foot. They are manifesting a sicker and more expensive population, in concordance with their healthcare needs.
By now, I’ve hopefully illustrated the dire need for a solution. My proposition? Increase medical school admissions for students with a rural background.
Studies have shown that when students who come from rural communities are admitted into medical schools and ultimately become physicians, they are more likely to practice in rural areas. Unsurprisingly, medical schools that have noticed and applied this phenomenon in their admissions strategies have seen benefits.
The Oregon Health & Science University School of Medicine visits undergraduate students in rural areas who have an interest in healthcare and guides them through the admissions and financial aid processes. By providing guidance to students from a rural background and linking them to residencies in rural areas, OHSU has proven successful in filling the gap.
This is especially impactful when you consider that over 50% of medical residents in the United States end up practicing in the state they trained in.
It’s undeniable that one possesses an innate connection to the community that they grow up in. This connection to serving rural communities is one that is best understood by students who have lived there and have the drive to give back to those exact areas.
The medical community should look to advance the practice of culturally competent care — care that meets the cultural and social needs of diverse communities. Where better to start than the medical schools themselves?
Other plans, such as incentivizing doctors to practice in rural areas with higher salaries have proven expensive. Rather, medical schools should commit to leveraging the passion that already exists in so many students that have a better understanding and connection with Canada’s rural areas.
By: Esther Liu, Contributor
The Silhouette: Would you have a conversation with a stranger?
David Kim: My friend once shared with me that “strangers are friends you just haven't met yet.” So, yes, I definitely would and I definitely have! Most of my friends know I’m from a small rural town in the middle of absolutely nowhere. We’re talking more cows and crops than there are people . . . It’s small, so people are friendly, right?
If you saw someone walking towards you, the normal thing to do is to ask: "Hey, how's it going?" [It’s] the whole rural hospitality thing . . . But coming to university, I’ve found that these interactions don’t happen a lot in the city. People are busy and live their lives with that trendy belief that they are the main characters of their life. People have very little time for those that are not in their immediate circle of friends – let alone strangers.
Do you have a story about a time you connected with a stranger?
I remember when I was volunteering, I was paired with this stranger. We just sat down in the cold talking for hours about our lives. I never got to see her again, I forgot her name, but I remember us just talking about what we were doing and why we do it — our stories. I think that everyone has a story that contributes to who they are.
I think we're very quick to make assumptions, but when you unfold that story, you learn more about why we do the things we do, more about their thought processes and beliefs. So, we started talking about our belief systems and our values. I remember that we even talked about the meaning of life and what we're heading to – what's the end goal, right? We were talking about our different beliefs and how she believes in a different kind of afterlife. Things like that make me think about the fact that, yeah, people are very complicated.
There’s a word I learned recently that comes to mind: sonder. [It’s] “the realization that each random passerby is living a life as vivid and complex as your own, with their own ambitions, worries, routines, wounds and victories.”
Every person I pass by on the street, every random commenter on a Facebook post, every face within the inch by inch rectangle on my Zoom call lives a unique life of their own. Basically, everyone's living their own complex lives. I think that when we think of strangers, we think of them as non-player characters. You only see a slice of their lives and that's about it. But, when you slow down, you start to appreciate others more. It’s really allowed me to learn more about empathy and the value of being quick to listen and slow to speak.
How else do you think being from a small town has changed or influenced you?
[I] remember that one lesson on the allegory of Plato’s cave: they're always like looking at a world of shadows. I don’t remember what purpose it’s actually meant to serve, but I felt like one of those people in the cave in my town: they only look at a wall of shadows and think that this is all there is, that this is the world.
Living in a small town, I kind of figured everything around me was all there was, that this is my reality for now. But moving to Hamilton, it felt like turning my head around and actually realizing there’s a whole other world that’s casting those shadows.
Entering university in the city was an absolute culture shock, even within the same province. I would say that everyone that I met in university is from the Greater Toronto Area. They have a set list of shared experiences that I don't think I normally had. I didn't realize how multicultural Hamilton could be in terms of people, places and food.
I had some amazing friends whose regular form of entertainment was introducing me to new things that were commonplace for them and seeing my reaction: noraebang, dim sum, bubble tea. I remember choking on what I thought were small rubber balls accidentally added into my drink . . . I never had a lot of different foods, never had a lot of those experiences. Even my conversations were different. My conversations about religion, about values, about ambitions. I feel like there are new colours in my life.
Would you say that you prefer the small-town life or a more urban life?
If you asked me three years ago, I would say I definitely prefer the city life even though I never fully experienced it . . . But now that I've actually experienced somewhat of a city like Hamilton — I don't know if people consider that a big city — I realize that there are great experiences but that I've just gotten used to the people back home. Right? Your hometown is a hometown for a reason: there's something about it that draws you. But, as a student right now, I'd say that I prefer the city.
I mean, this is my fourth year, it was supposed to be my year on campus. But with the unpredictability of what’s happening around us, there’s a certain sense of serenity and familiarity walking the streets I know well.
