The Royal College is the national professional association that oversees the medical education of specialists in Canada, accredits the residency programs at 17 universities across Canada and also accredits the learning activities that physicians pursue in their continuing professional development programs.

Indigenous Health Primer:

Key messages

• Legislation and policies related to Indigenous people in Canada were created with the intention to assimilate Indigenous people.
• The policies and laws, based entirely on race alone, resulted in cultural, social and economic disruption.
• Jurisdiction regarding health care delivery for Indigenous people is complex and often misunderstood.
• Current inequities in health and well-being experienced by Indigenous people are the result of these dismissive and oppressive policies and laws, which continue in some forms in our present day.

Understanding legislation and policies can be overwhelming but, put simply, there are two fundamental areas of legislation and policies that affect the lives of all Indigenous Peoples in Canada:

1. the set of laws and policies that were originally designed to assimilate Indigenous people, and

2. a second set of laws that dictate the level of government that is responsible for health care delivery to Indigenous people.

Indigenous Science

Indigenous science is a form of Indigenous knowledge. It refers to the science of Indigenous cultures. It is a way of seeing and knowing that is dynamic, holistic, intergenerational and time-tested. Indigenous science has existed for thousands of years, thus developing sophisticated modes of knowledge-transfer that have enabled its survivance (more than mere survival — it is a way of life that nourishes Indigenous ways of knowing).

Despite this survivance, Indigenous Science has been devalued in the past by a Eurocentric worldview and institutions that have deemed it to be simplistic or primitive. Indigenous Science is place-based and therefore dependent on a deep connection and relationship to traditional lands and the natural world.

Anishinaabe Historian Brenda Child states “In Ojibwemowin, our language, the term for medicine is mashkiki or ‘strength of the earth.’ Medicine people approached the plant and medicinal knowledge in a meticulously systematic way, according to Frances Densmore, always emphasizing experiment and study. Like artists in their work, they were masterful observers of the natural world. They knew the exact time to harvest a multiplicity of plants, many of which had the most ephemeral season…Their work sustained the Ojibwe goal of mino bimaddizi [”the philosophy of a good life]” (Densmore, 2005).

Although Indigenous Nations in what is now referred to as Canada are incredibly diverse, they all share a common, earth-centred worldview. They also share a sense of deep interconnection and relationship with the land that differs from the dominant Eurocentric understanding.

“To the settler mind, land was property, real estate, or natural resources. But to our people, it was everything: identity, our connections to our ancestors, the home of non-human kinfolk, our pharmacy, our grocery store, our library, the source of everything that sustained us. Our lands were where our responsibility to the word was enacted, sacred ground. It belonged to itself; it was a gift, not a commodity, so it could never be bought or sold” (Kimmerer, 2013

Indigenous Health Values and Principles Statement: June 21, 2019

As in the first edition, the second edition examines the values pertaining to Indigenous health and bridges these values to the CanMEDS framework with actionable principles to guide the delivery of culturally safe health care. The culturally safe physician is a complete health care practitioner who:

• embraces Indigenous knowledge/science….
• practicing with cultural humility, fostering an environment of cultural safety and proactively pursuing anti-racism interventions.
• Understands that Indigenous health is an integral component of medical research, education, training and practice, and that this research is based on evidence from empirical sources, critical appraisal of relevant material beneficial to patients, leading Indigenous and non-Indigenous practices and lifelong learning that can be adapted to serve Indigenous patients.

The culturally safe physician also embraces the following Indigenous values:

Openness: traditional Indigenous medicine reinforces the holistic approach to health and wellness embraced in Indigenous cultures. Indigenous healing practices, spiritual well-being and natural therapies are recognized by the patient, and he or she decides whether western medical practices are comprehensive, complimentary, beneficial, holistic or integrative. Evidence: health care decisions and healthy life choices are based on qualitative and quantitative information that is readily available, focused and whose limitations are clear. This includes Indigenous knowledge in traditional Indigenous medicine and its value in the education of medical students, residents and practicing physicians.

http://www.royalcollege.ca/rcsite/health-policy/initiatives/indigenous-health-e