Black Representation in Canadian Health Care — Dr. Chika Stacy Oriuwa

Avis Favaro

COVID exposed a deep racial divide. Black communities and people of colour in Canada were among the hardest hit by the virus and the least likely to be protected by initial public health measures.

But the problems go far deeper. Studies show there’s been long-standing discrimination in the health system fed into by racism, ignorance and a sad history overlooking Black Canadians and their health needs.

On today’s episode, the story of a remarkable young woman, Dr. Chika Oriuwa, a physician, psychiatrist-in-training, mother and advocate. Born in Canada to parents from Nigeria, Dr. Oriuwa has become a powerful up-and-coming voice for Black health equity after butting her head against some hurtful messages from a very white medical world.

Chika Oriuwa

Literally on the very first day of my medical school journey being reminded that no, no, no, we notice and we wonder if you actually deserve to be here. And so that was, that was a very painful poignant reminder of the situation that I found myself.

Avis Favaro

Data shows Black people in parts of Canada make up almost 5 percent of the population but account for just over 2 percent of physicians. Dr. Oriuwa is trying to change that.

Chika Oriuwa

Diversity, not only in medicine, but in all areas, has repeatedly shown to improve the outcome of the work that is being done.

Avis Favaro

Hello, and welcome to the Canadian Health Information Podcast. We call it the CHIP for short. I’m Avis Favaro, the host of this conversation. The opinions expressed here don’t necessarily reflect those of CIHI, but it is a free and open discussion and this show is about Black health care in Canada as seen through the eyes of a doctor trying to help heal the system.

I just want to welcome you Dr. Oriuwa. Thank you for joining us. And I noted your necklace there; it says mama. And behind you, you have a very adorable baby. Number one, what’s his name?

Chika Oriuwa

His name is [Azema].

Avis Favaro

Wonderful. And you have a second one coming.

Chika Oriuwa

I do. A little girl.

Avis Favaro

Wonderful. When’s she due?

Chika Oriuwa

June.

Avis Favaro

June. So the first thing that struck me is you’re not even 30 and you have an amazing trajectory from being a physician, training as a psychiatrist, public speaker, the poetry that you’ve been successful with, and you’re such a powerful advocate.

Guess where I want to start is do you feel like it’s your mission to uncover the suffering that’s been occurring among Black Canadians in the health care system? Or is that your mission to fix it?

Chika Oriuwa

I would definitely say it’s both. I think that for individuals who have been involved in this kind of advocacy work, so much of the evidence is almost there. So, really, my advocacy work is more about shining a light on what for many has already been, has already been well understood, and certainly trying to ameliorate that. And I think I do the work of mitigating these issues in my role as a physician. And then in my role as an advocate, that’s really where I’m raising awareness, educating and trying to bring more of this into the light.

Avis Favaro

One of the interviews I heard, you decided you wanted to be a doctor when you were 4.

Chika Oriuwa

Yes.

Avis Favaro

How is that possible? How did you know? Where did that come from? Do you recall?

Chika Oriuwa

It’s kind of a funny story. So my mom’s brother is a physician in the States. All I knew is that he took care of babies. So he was a neonatologist for a long time before he switched to practising in general pediatrics, and I knew that he took care of like newborn babies. And when I was very small, I was obsessed with babies. And I still am, clearly. So all I knew at that point was that my uncle spent his days taking care of babies and I wanted to do the same thing. And so I just declared to the world that I’m going to be a doctor and I’m going to take care of babies.

And, of course, at 4 years old, I didn’t quite have the appreciation of the arduous route to and through medicine, and so I would consider myself extremely fortunate that the goal that I declared as a little girl at 4 years old really manifested through my love that I eventually found through arts and science and math and biology. I just loved it so much. And so being able to have a natural skill set that aligned with an early ambition and aspiration of mine, I consider to be just a stroke of luck.

Avis Favaro

What was the jet fuel that kept you going? Because when you reach your teenage years and you’re in high school, there’s many distractions.

Chika Oriuwa

Yes. Absolutely. You know, for me, I think that once I recognized in elementary school that I was just fascinated by the human body and that nothing else really captivated my interest in the same way, I was just incredibly steadfast. Like I’ve known my entire life that I wanted to be a doctor. And I also recognized, as I was going through elementary school and high school, that there really weren’t that many physicians that looked like me. But then, at the same time, that also kind of pushed me even more because I knew that there needed to be Black women in medicine and that I knew I was capable of becoming a doctor even though I didn’t see a representative in the field. And so it was a driving force.

Avis Favaro

When did it hit you I am different, I have a platform?

Chika Oriuwa

Yeah. I would say that I guess I first started to notice a pattern with respect to a lack of diversity in the STEM fields in general, certainly in high school when I was going through my calculus classes and my advanced functions and my university-level biology and chemistry and physics and just recognizing that there was only a few Black individuals in my class, men or women, and sometimes I’d be the only one, even though I went to a very diverse high school in Brampton. And so I had a lot of Black peers. However, when it came to entering into these very niche scientific spaces, there would only be a handful of us. And that’s when it really started to dawn on me that okay, there is an issue here that I think is more so systemic as opposed to individual issues with the individuals in my school, with the Black individuals in my school.

Avis Favaro

Why did you say that?

Chika Oriuwa

I definitely actually believe that there was a lot of ambition amongst most, if not all, of the Black students that I went to school with. However, it became clear to me Black students are treated differently throughout the educational system that steers them away from STEM and steers them away from courses that you would need to take in high school in order to go on to university, in order to go on to medical school.

And so I noticed that even as early as elementary school that a lot of my friends were being told, oh you know what? It’s probably best if you don’t do these academic courses. You should do more of the applied courses and steer yourself towards college. And these were conversations that we were having with 12- and 13-year-olds. And even at that time I thought it was interesting that most of my Black friends in my class in elementary school, or some of them, were being told you would be more fitting for college. And then there’s only a couple of us who they deemed would be appropriate for university.

Avis Favaro

Did they ever try to pull you back? Did you ever get the suggestion nah, maybe college?

Chika Oriuwa

Interestingly enough, in the first few years of elementary school, so Grades 1 to 3, I actually remember being told that I was not necessarily a bad student, but that I was struggling in certain areas and that a lot of people would be surprised to learn that I was actually a C student, B, Cs and like a few As from Grades like 1 to 3. But this teacher just — it felt almost like they had an innate issue with me. They weren’t very warm towards me, weren’t very effusive. Anytime that I tried to ask for help, it seemed that it was always a problem. I was also one of 2 Black girls in my class. I just felt that she had a lot less patience for me than other students.

Luckily, my parents pulled me out of that school and then from Grade 4 onwards, I was an A, A+ student ever since. And so really it was interesting because I think that had I stayed in that school, my trajectory might have been very, very different. And when I went to my elementary school, which is Saint Marguerite Bourgeoys in Brampton, I had an incredible, incredible teacher who was my teacher from Grades 4 through 6, so she just kind of held on to me for all of those years and she changed the way in which I saw myself. She changed my self-esteem. She really allowed me to feel empowered.

That same teacher actually came to my wedding this past summer and I owe so much of my resilience and academic perseverance to her.

Avis Favaro

It must make you worry though about other children that don’t have parents that lift them out and give them a better opportunity.

Chika Oriuwa

Absolutely. Especially because since we know that the research shows, particularly for racialized students, that they do face this undue burden of sometimes being labelled as having behavioural issues, being streamed in different academic streams that are below their capability, being more harshly reprimanded if they have any kind of misstep in school.

And now being a mother to a 14-month-old baby boy and then welcoming a baby girl soon, that is something that I’m so incredibly sensitive to and attuned to and know that I will advocate for my children in that space because it’s so easy for them to fall into these pitfalls.

Avis Favaro

So let’s move that forward to when you actually got to medical school and you were the only one of 250 white students. Correct?

Chika Oriuwa

Yes. I was the only Black student out of 259 students.

Avis Favaro

When did it hit you that there’s something going on here, too?

Chika Oriuwa

I would say it hit me during stethoscope ceremony, which is the first day of orientation week. Sometimes it’s known as the white coat ceremony, but at U of T, we do the stethoscope. And I recognized right at that moment when all of the students were crossing the stage to get donned with their stethoscopes that I was the only Black one. And that was a real point of disillusionment because I had been in my undergraduate at McMaster University in the health sciences program where I was also the only Black student in my year. And so I was very much looking forward to having a change in narrative, a change in identity in a sense, and that was, unfortunately, continued into medical school.

Avis Favaro

And did you ever think, okay, I’m not going to be part of this? Did you ever think of walking away?

Chika Oriuwa

So the University of Toronto was always my dream medical school. I knew that I had won the lottery in a certain way by getting into the medical school and that I had worked so hard and that was my dream.

There were points where I had wished that I’d gone to a medical school where I wasn’t going to be the only Black medical student. But I had also learned that the other medical schools I had gotten into either didn’t have any Black medical students in the same year and so it was more than likely that I was also going to be in that position irrespective of where I went.

Avis Favaro

Tell me a little bit about that. Because people of white and European backgrounds, we don’t see it. We don’t necessarily see it. What were the hidden or not subtle aggressions or messages that you weren’t wanted? What got thrown at you?

Chika Oriuwa

I will definitely share, I would say, a few examples. Something that I try very intentionally not to do is to go into the nitty-gritty granularity of the racism and the trauma because I often feel that I get asked to do that a lot and it’s often re-traumatizing without a lot of support afterwards. And so I’ll share more of like a surface-level experiences.

So, for example, on my first day of medical school, so the same day as the stethoscope ceremony, just hours before the stethoscope ceremony, when we were picking up our medical school backpacks, like all the different colours, I was asked by a student whether they had made it easier for me to get into the medical school because I was the only Black student and whether they lowered the criteria. And obviously, that carries with it the implication that I’m not as maybe qualified as other individuals to be in the medical school. And so certainly that planted the seeds of imposter syndrome and really just amplified them tenfold that I truly did not belong or that I wasn’t smart enough.

Avis Favaro

How did that feel?

Chika Oriuwa

It was definitely painful and othering and jarring I think because I had almost convinced myself that — I almost honestly deluded myself into thinking that maybe I’m the only one that notices, maybe I’m making more of a big deal of it than it actually is. But literally, on the very first day of my medical school journey, being reminded that no, no, no, we notice and we wonder if you actually deserve to be here. And so that was a very painful poignant reminder of the situation that I found myself.

Avis Favaro

There was another one that you talked about in an article written about you, where someone asked you to clean the vomit off the floor.

Chika Oriuwa

So that was in my clerkship year of medical school, so my third year of medical school, where I was going through the emergency department and I was wearing my scrubs and my stethoscope and I had my clipboard and my pager and all the things I would say that the typical physician would look like running around the emergency department. And as I was running from one room to the other room, going to see and assess another patient, I had a patient tug on my scrubs or tap on my scrubs and ask me or tell me, you know, you forgot to clean the vomit off the floor over there. And it was clear that they had mistaken me for custodial staff. And this is not at all to denigrate the importance of custodial staff who really are the backbone of the hospitals, but to simply say that that’s not the training that I had received to be there; this must be someone who’s doing custodial work.

I talk about these experiences at length actually in my memoir. And so I do consider it to be a form of self-preservation to not continuously delve into the various forms of trauma that I faced in medical school, of which there are innumerable examples and experiences of racism, micro-aggressions, macro-aggressions that I faced in medical school. And so what I’ve decided to do, as a means of healing and protection, is to actually write about it at length in the memoir that I have coming out soon and where I do go into the details of most, if not all, of the experiences that I faced in medical school, good and bad.

Avis Favaro

Let’s talk a little bit about the suffering of Black patients in the health care system. Did your family experience this? Were you ever a patient and you noticed that you got less-than-optimal care?

Chika Oriuwa

See that’s interesting because growing up, I had an experience once with my family doctor, who is an incredible, incredible family doctor. But when I was growing up, I needed to have some dermatological treatments when I was like maybe 14, 15. And they had prescribed me a medication that should not, I would say, have been prescribed for a Black patient, and it ended up actually bleaching my skin and blotting my skin. And when I went back and said, I have literal blotches of white marks on my face, that’s when they had referred me to a dermatologist and I received the appropriate care.

And it’s interesting because looking back in retrospect, when I went through medical school and then when I went through the dermatology lectures, so much of it, the default was learning about white patients. We are learning how to treat a diverse population and so it’s imperative that that is built into the infrastructure of the medical school and that this isn’t information that needs to be sought out, like when I was in medical school, having to ask every preceptor, okay, but what would you do if this was a Black patient? How would you treat this on darker skin? How would you assess this on darker skin?

Avis Favaro

Is that what you had to do because —

Chika Oriuwa

Oh yes.

Avis Favaro

— you could see it wasn’t there?

Chika Oriuwa

Yeah. I did this multiple times actually.

Avis Favaro

I was surprised there’s almost no data on Black — divvying up the results in terms of the racial background.

Chika Oriuwa

Yeah. It was my second or third week of medical school and there was a case that was about burns and the different degrees of burns and how to assess them and how to treat them and how to diagnose them and the whole gamut. And I remember asking how would you be able to identify this specific dermatologic presentation on a Black patient that presents to the ER? And the staff had said, well that’s your problem, that’s not my problem. Yeah.

And then the whole group just went silent and I remember like literally gasping in shock that that was said. And then the preceptor tried to laugh it off and said it was a joke and then ultimately said that they didn’t know and that that would need to be independent learning for me to go back and do.

Avis Favaro

What did that teach you? What did that tell you?

Chika Oriuwa

Well it was really frustrating to know that A, this is critical information because someone like myself, or my family members, what if they experienced this particular health care issue and they went into the hospital and they did not receive the care that was adequate because the physician never learned how to identify this particular issue in someone of a darker skin tone. And then the implication that that needed to be independent learning as opposed to learning for everyone to know was really was really frustrating, because I might be the only Black doctor-in-training in my medical school class, but I’m certainly not the only one who’s going to be treating Black patients. And luckily I am really happy to say that the University of Toronto has made many strides since I was in medical school. And I started 7 years ago, which is very wild for me to even think about, but incredible, incredible strides have been made in the interim.

Avis Favaro

So you bring up an interesting point here. Because I think COVID, unlike any other illness, has been a slap in the face, in the sense that it’s made it very clear that there are racialized components to disease. Like we’ve discovered that COVID had a much greater effect on Black people living in certain communities and now, there’s a realization that we have to collect data. So Canadian Institute for Health Information have made an effort to start collecting the data. Can you explain why data on different racial groups is important?

Chika Oriuwa

Absolutely. So collecting data on different racial groups really enables us to quantify the issue. With a lack of evidence, it will be hard to quantify it. And if you can’t quantify it, then you can’t address it. And if you can’t quantify it, you also can’t assess different measures of change and improvement, and therein lies the ability to have accountability.

So if you are able to measure something, this is my starting point. Okay. We now know that in 2 years, we want to improve — this is very general — but we want to improve the care for diabetes within the Black community in West Toronto. Okay. How is it that we can actually assess this? How can we track this? And how can we hold certain individuals, bodies, organizations accountable to ensure that this is actually happening? So data collection is really at the core of advocacy because if you can’t measure something, you can’t quantify it, you can’t address it, you can’t achieve the end goal of equity. And so it’s a critical, critical step.

Avis Favaro

Why has it taken so long in Canada to collect the data? To even start collecting the data?

Chika Oriuwa

We like to look at our neighbours to the south and say, well we don’t have the same violent racist history towards certain groups as the U.S. does when, in fact, we know that that’s not true. We know that there is an incredibly violent racist history, especially towards Indigenous population and populations, and that extends towards other racialized populations including the Black population.

And so I think that once we recognize that we needed to shed that part of our Canadian identity where it is too taboo to talk about race and actually have these conversations and say no, no, there are individuals in our health care system who are treated differently, we need to address that. And this needs to be addressed, particularly through research, because research enables policy. It enables and affects change within institutions. It affects how even we as doctors practice, right. And so being able to start with the data, move into the research, move into the policy, have translational research into actually how it is that we practice as doctors, that’s kind of the entire arc of how things need to be built out.

Avis Favaro

You’re working now in psychiatry. Do you see this quiet racism when you’re at work in a hospital or a clinic?

Chika Oriuwa

So I’m actually still in my residency, so I’m technically not independently practising but I am certainly a physician that’s being trained in psychiatry and so I’m doing all of the things that are imperative to my training. And it’s interesting that we call it quiet racism because I think that the entire spectrum of racism can be seen. Certainly, there are implicit biases that come out.

Avis Favaro

Can you just give some examples? Just so people understand. Like trying to understand what the heck is going on?

Chika Oriuwa

Yeah. So I mean it’s very it’s very interesting because sometimes it can be incredibly subtle and it can be so subtle that you might not even feel comfortable calling it out or really putting a label or a face to it. And that could even be say, for example, how certain patients are described during rounds when they’re not even in the room. And you might see how certain words, certain adjectives, certain descriptors are used more frequently for certain patient populations and —

Avis Favaro

Like?

Chika Oriuwa

For example, for an Indigenous population, and I’ve certainly heard individuals describing certain Indigenous populations in such a way that I felt was inappropriate or played into certain tropes about Indigenous populations such as alcohol use and things of that nature and drug use and seeing it as more of an individual problem as opposed to the direct outcome of colonialism, of racism against the Indigenous population.

And so I think that it’s important to be able to spot the language that at first glance might not seem problematic, but if you’re in tune to it, you recognize that, actually, this kind of language upholds racist rhetoric and we need to reframe the ways in which we talk about certain groups.

Avis Favaro

Do you call them out if you hear it? Your colleagues?

Chika Oriuwa

I wouldn’t necessarily say it’s in the form of calling it out. But I would say, as we often use in psychiatry, redirecting or reframing. And then I would say that like experiences that I’ve had where I’ve been the recipient of racism, and I talk about this in my memoir where I discuss that I was one day working in the emergency room at CAMH, so the Centre for Addiction and Mental Health, and I had a patient actually come up to me and say you’re not a real doctor, you’re a phony, you’re a fake, I’ll never take medicine from you.

They had actually went home and googled me. They looked me up and they had seen a lot of the advocacy work that I had done.

This person was quite unwell. They were in the throes of psychosis, but they still came in with this fix idea that I was a fraud, that I was infiltrating the medical field. I’m not cut out to be in medicine, that people would never want me to treat their children. So it was really quite painful being in that position where I was fully qualified to do the work of a physician as a psychiatry resident and still being told that I was somehow infiltrating the medical system and that I was a fake and that I was a fraud.

Avis Favaro

How do you cope with it?

Chika Oriuwa

I journal. I do a lot of journaling. I mean I’m a poet, I’m a writer. The most natural way for me to process my feelings absolutely is through journaling, is through writing.

I’m a human at the end of the day, so I think having an appropriate emotional response to traumatic situations is something that I’ve also experienced. And so, of course, there are moments where I’m tearful, there are moments where I feel I’m weak and downtrodden, but I’m very fortunate to have an incredible support system.

My husband is fantastic. He’s an incredible, incredible ally and really supports me through the hardest moments.

Avis Favaro

But it is, seems to me, quite a burden. It’s like a big burden to carry and you’re not yet 30.

Chika Oriuwa

Yeah it is a big burden. I would say almost this onus to do this advocacy work, but it also comes extrinsically and I would say that there is certainly a minority tax. In certain spaces, I’m expected to do this work because I’m a Black woman. Feeling as though I have to do this work, even when it comes to an expense of myself, is actually the narrative of racism that I have to be of servitude as a Black individual to non-Black individuals in order to educate them, in order to do a number of things which is why throughout this interview with you, I’ve been very intentional about setting boundaries around describing at length the suffering and the trauma that I have felt because that is something that I volunteered so freely for so many years on this journey and I felt that it was corrosive to me, to my wellness.

And so moving forward, and in order to actually live up to this idea of anti-racism and the work that I do believe is so important, I give information and I allow myself a certain degree of vulnerability. But I really set boundaries so that I’m able to self-preserve.

Avis Favaro

I’m going to play devil’s advocate. Why do we need more Black doctors? There were some people who I mentioned I was doing this interview and they go, well, a doctor is a doctor is a doctor and a patient is a patient and skin colour shouldn’t matter.

Chika Oriuwa

You know, would we ask ourselves why would we need female doctors? We understand that women in medicine have undoubtedly advanced medicine in a number of ways. And I think that the same rings true for having a more racialized or having more diversity when it comes to race in medicine because research has shown that Black physicians are more likely to go back and practice in medically underserved areas, particularly for other communities of colour and, of course, also enriching the educational environment for the other medical learners.

And it also allows us to advocate for the needs of Black health, which is often done by Black physicians. And so this improves public health of society and it improves the quality of all physicians that are being trained.

So to that person that questions a doctor is a doctor is a doctor, well I wouldn’t necessarily say that that’s the case, and that diversity, not only in medicine but in all areas, has repeatedly shown to improve the outcome of the work that is being done.

Avis Favaro

Does it also not help people of different groups trust their physician?

Chika Oriuwa

Of course. And so the research has also shown that Black patients felt as though that the quality of the care that they received when being treated by a Black physician is higher. I can say this from personal anecdotal experience that many of the Black patients that I have personally treated throughout medical school and into residency have echoed the very same sentiments.

Many of them have become very emotional when they saw me. They felt as though they can be more honest. They brought forward medical concerns that they had never felt they would be able to discuss in the presence of a white physician. And so it’s imperative. I think it’s actually hazardous to try and approach medicine from a colorblind fashion. It shouldn’t be done in that manner.

Avis Favaro

Do you think that some Black Canadians are just not even getting medical care because they don’t feel comfortable?

Chika Oriuwa

Oh absolutely. There’s a deep distrust and a deserved, I would say, distrust when it comes to the history of anti-Black racism because of how Black individuals have been marginalized, mistreated and exploited within medicine that it’s very reasonable to see why there is this distrust where you might not want to go to the doctor because you don’t trust the medications that they’re giving you, they might not trust the vaccines. And that’s why it’s even more important to have Black physicians in the space, so that we can begin to heal the schism that is between medicine, especially within psychiatry and the Black community, so that there is a real healing that can be done.

Avis Favaro

Why psychiatry? What drew you there? You wanted to take care of babies when you were young.

Chika Oriuwa

Yeah. It’s a pivot. And I really still love babies and I definitely toyed with the idea of pediatrics, but I think that when it came to psychiatry, it was just really an extension of my advocacy.

There is such great need for Black physicians in the mental health space, and I’ve also been an absolute passionate lover of the brain. I’m fascinated by neuroscience. I want to do a fellowship in neuropsychiatry because I’m just so fascinated by the intersection between neurology and psychiatry and I just want to know everything I can know about the brain, brain medicine, behavioural medicine, neuroscience. It’s everything that I care about and so psychiatry was just the right fit for me.

Avis Favaro

That’s a lot. That’s a big life mission for you to be looking at. I want to kind of move a little bit positive to solutions for the back end. One of the dolls that I played with as a child was a very tall white Barbie doll. And you have played with Barbie dolls too.

Chika Oriuwa

Oh yeah. I had so many.

Avis Favaro

Oh really? I only had one. How many did you have?

Chika Oriuwa

Well, I remember my fifth birthday party that all of my friends got me Barbies and so I ended up having several. And my mom would only let me play with a couple of them at a time because there were just too many and I would open up all the boxes and just have Barbies everywhere.

All the Barbies were white. They were all blonde or brunette and had pin straight hair and they did not look anything like me. They also were not physicians. They were usually just — they actually weren’t even — I don’t even know at that time if they even had careers but they were just —

Avis Favaro

I don’t think so. You just dressed them up nice, right? So one of the many things that you started to help change is the dolls. So you have a Barbie doll that looks like you.

Chika Oriuwa

I do. I do.

Avis Favaro

Did they approach you? Mattel? Or did —

Chika Oriuwa

Yes. Yes, they came to me.

Avis Favaro

When you got the email or the phone call, what was your very first reaction?

Chika Oriuwa

I was like, Barbie? I was just shocked. It felt so surreal. It was a pinch-me moment. So many women from all ages can identify with knowing what a Barbie is. And so for me it just felt so surreal. And then for them to say that we want to make a Barbie in your image was just shocking and was such an honour, was such a privilege. And, of course, I wanted to do it justice by ensuring that my Barbie had an afro very similar to what I’m wearing today, had the appropriate skin tone, such as myself, had Afrocentric features that I have and so.

Avis Favaro

She looks like you. Do they call her Barbie? Or do they call her Chika?

Chika Oriuwa

I think it was like the Dr. Oriuwa Barbie. I don’t know what her official title is.

Avis Favaro

I’m assuming you have a few at home.

Chika Oriuwa

So it’s actually just one Barbie. It’s a one-of-a-kind Barbie. And I do have the Barbie, she’s sitting just over there. But yeah, I have her and it’s very exciting because I have always imagined that my little kids will grow up and see the Barbie sitting there. And if my son can play with it without ripping its head off, I’ll give it to him to play with. And my daughter as well, if she can play with it and try and preserve it because there’s only one. I’ll certainly — you know, it’s just such an incredible thing to have in my home. But then, of course, having done so much media and publicity work to be that representation in the public eye is also incredible.

Avis Favaro

You became an ambassador for Black medical students at the University of Toronto.

Chika Oriuwa

Yeah, for the Black Student Application Program. Yeah.

Avis Favaro

I understand that since you were there, the graduating classes now have 14 and 15 Black medical students.

Chika Oriuwa

Yeah, the numbers have gone up.

Avis Favaro

The numbers have gone up of other Black students following in your footsteps.

Chika Oriuwa

I’ve met quite a few of them. I actually this past summer went to the kind of social for Black medical students at the University of Toronto who were coming in, so the Class of — and so I haven’t had a chance to meet every single Black medical student because there are now so many, but I’ve definitely had the opportunity to meet quite a few of them and, well, I can say firsthand.

Avis Favaro

Did any of them thank you for paving the way?

Chika Oriuwa

I would say almost everyone that I’ve had the chance of meeting has thanked me in some capacity or has recognized the work that I’ve done, and I’m just so grateful. I feel honoured to even be a small part of the legacy that is at the University of Toronto. And so it’s a privilege.

Avis Favaro

Let’s talk about your goals, big goals. So what do you want in your medical career to see changed in health care in Canada?

Chika Oriuwa

I think so much of what we’ve already talked about is really creating a space that is safe for Black patients and Black doctors. I want those spaces to become even safer. I want to be able to facilitate that to support that in a way that isn’t unduly burdensome to myself.

Avis Favaro

What do we need to do at the school system to make sure that there are more kids of all colours that do feel more comfortable becoming doctors?

Chika Oriuwa

Right. I think we need to really, on a foundational level, systemically address the biases, the racism that can be present within teachers, within educators, social workers, guidance counsellors. So much of this unlearning needs to happen at the systemic level and really just ensuring that there are structures in place for mentorship to enrich and empower Black students from a very, very young age so that they recognize that they will go through this and they will be supported, they will be uplifted and that they won’t face undue barriers and challenges.

Avis Favaro

What worries you the most?

Chika Oriuwa

You know, I would say what worries me is that there’s always the potential of regression when it comes to talking about race, when it comes to collecting data around it. It takes a long time, and I don’t know if I’ll see it in my generation or even in the next generation, to really undo that foundation of racism that’s at the systemic level. And there are always going to be individuals that challenge it along the way. And so I think that’s always something that’s worrisome for me, but I hold on to the hope that the best is yet to come.

Avis Favaro

Good. What excites you the most?

Chika Oriuwa

I think seeing the newest generation of a more diverse medical class, of seeing more racialized physicians, seeing more physicians from different backgrounds who have originally faced marginalization and under-representation within medicine, and just seeing the tides change not only at the University of Toronto but at other medical schools as well.

Avis Favaro

Okay. Last question, political aspirations. Have you been asked? Approached? Is that something you might think of?

Chika Oriuwa

I get asked all the time if I want to go into politics and, you know, I don’t know. I would never say never, but I think that I’m very happy with the kind of advocacy work that I’m doing at this time.

Avis Favaro

Just like a politician.

Chika Oriuwa

[laughs] Exactly.

Avis Favaro

You’re practising. You’re practising with your answers.

Chika Oriuwa

Exactly.

Avis Favaro

Anyways, it has been an absolute pleasure talking to you. Thank you so much for explaining things, and I hope it helps Canadians understand what Black Canadians have been up against in the health system.

Chika Oriuwa

Thank you so much. And it’s been an absolute pleasure and honour speaking with you as well.

Avis Favaro

As mentioned in our interview, CIHI is now collecting and producing data on racial components in Canada’s health system because, as Dr. Oriuwa said, if you can’t see it and count it and compare the outcomes, you can’t fix it.

Thank you for joining our discussion.

Our executive producer is Jonathan Kuehlein. Special thanks to Ieashia Minott and Alya Niang, the host of our French CIHI podcast.

If you want to learn more about the Canadian Institute for Health Information, please go to cihi.ca, that’s C-I-H-I dot C-A and subscribe to the CHIP wherever you get your podcast.

I’m Avis Favaro. Talk to you next time.