Facing hard truths: Medical education's reckoning with settler colonialism in an era of reconciliation.

Abstract

Introduction: Medical schools are responsible for embedding Indigenous health education across the training continuum. Central to this work is recognising settler colonialism as an ongoing structure that privileges non-Indigenous peoples while producing and sustaining inequities for Indigenous communities. This paper explores key learning moments as non-Indigenous medical learners and faculty reflect on their experiences within systems that promote reconciliation yet remain largely rooted in colonial logic.

Methods: Data collection and analysis were informed by the principles of narrative inquiry. Five non-Indigenous medical students, a health research graduate student and 10 medical educators (MD and PhD) consented to participate in a narrative interview about how they positioned themselves and supported others engagement in ongoing reconciliatory efforts within their institution. Data were gathered over 2020-2022.

Results: Participants acknowledged their privileged position and aimed to leverage it to address educational or health disparities affecting Indigenous peoples. Yet intervening when they witnessed unfairness proved challenging. Although many attempted to adopt a proactive stance and advocate for systemic change, the prevailing tendency in such situations was to avoid disrupting the status quo due to perceived gaps in their knowledge or apprehension about professional backlash.

Conclusion: Non-Indigenous medical learners and faculty struggle to navigate a system calling for transformation yet rife with historical and institutional barriers. This struggle often arises from the discomfort stemming from their privilege and a sense of limited influence within the medical hierarchy.