1. Agree @kimkellymd, equity, diversity and inclusion cannot be achieved without deliberate sponsorship and mentorship. Although I can’t speak to the experience of identifying as a woman, I can speak to my own experience as an Indigenous physician. Beginning of a thread.
2. My ancestry is Anishinaabe, Cree, Metis and Polynesian. My extended family survived residential school and the sixties scoop. I was the first person in my family to consider medicine as a career.
3. My Dad did a Masters in educational administration and has been in management or training roles most of his life. My Mom worked at home full-time. My family didn’t have a lot growing up. We always had enough, but that often meant my parents went without.
4. Looking back as a parent now, I can see what they saw; big dreams for their five kids. Sacrifice that would one day bring opportunity.
5. I was labelled as developmentally delayed with a speech impediment when I was in early grade school. The principal told my parents I’d never graduate high school and to make plans to take care of me as an adult.
6. My parents were crushed but tried their best to hide it from me. I have clear memories of my Mom holding me, rocking me back and forth telling me that I wasn’t broken.

Those years were hard on my parents and me, particularly my Mom.
7. #EDI lesson 1: I’ve grown to think about lack of equity, diversity and inclusion as disempowerment. This disempowerment can be deliberate or passive. In my case, I was literally told that I’d amount to very little. Those who cared for me were told the same.
8. Disempowerment is a part of medical culture, shaping what we expect from each other. Stats-wise, we should absolutely have female candidates. If we don’t see this an issue, we can’t address #EDI. Achieving #EDI and changing our expectations go hand in hand. #medtwitter
9. My Dad spent the next few years consumed with a mission to help me. My Mom pulled me from school and began to homeschool me, along with my two younger siblings. They both spent thousands of hours developing skills and putting in time with me over the next few years.
10. Remember this was homeschool in the late 80’s and early 90’s. There was no curriculum, so we went through any workbooks my parents could find. We watched a lot of @BillNye the Science Guy. I began to read voraciously. #turningpoint
11. When I was 12, my Mom enrolled me in summer school Grade 10 science. I excelled and she volun-told the school board I’d be in Grade 10 the following year. Doing a mix of adult distance learning and in person classes I finished high school early, now labelled as gifted.
12. #EDI Lesson 2: Mentorship and sponsorship works, but it takes consistency and investment. Disempowerment doesn’t become empowerment overnight. In the same way however, it also doesn’t take decades to change things. We need to invest more in #EDI to have the results we want.
13. You’ll know if mentorship and sponsorship are effective based on the interest you spark within the disempowered. I began to see myself differently. Closer to how my parents saw me.
14. When I was accepted to medical school, I was the only Indigenous medical student in all four years. There was the early beginnings of an Indigenous student support program, but I didn’t see anyone who looked, talked, or could connect with my lived experience.
15. My first exam was in histology. Didn’t do as well as I'd wanted. Booked time with the professor to asked for tutoring.

Professor responded that I shouldn’t worry. Repeating 1st year wasn't the end of the world.

I walked out of that office feeling broken, trying not to cry.
16. Val Arnault-Pelltier, who ran the Indigenous support program, saw me walk by. She noticed I didn't look okay and stopped me. She listened.

I spoke every week with Val. Eventually those conversations included Dr. Albritton, our Dean.

Every week. For four years.
17. Val and Dr. Albritton are why I didn't drop out that days. They're the reason why I pushed through those next four years. Just like my parents, they saw me differently than I saw myself. I wouldn't be a physician today if not for Val and Dr. Albritton.
18. #EDI Lesson 3: You never really shed systemic disempowerment. The layers of confidence and competence you wrap around yourself can be torn away by what may be perceived as a passing, benign comment.

#medtwitter
19. That doesn’t mean the vulnerable are weak. Its not easy to shake off and leave behind what you’ve learned over your lifetime.

You walk with those memories and learnings your entire life. You push through them, not around them. You want to let go, but they don't let go.
20. #EDI Lesson 4: Having those in positions of power and authority connect with the disempowered is a necessary part of any #EDI strategy. I still remember the advice Val and Dr. Albritton gave me. The voices of everyone who shaped me remain in my head.
21. #EDI Summary:

We can’t create effective strategies for #EDI if we don’t recognize the disempowerment which exists in medical culture; disempowerment and expectations go hand in hand.

Mentorship and sponsorship work.
22. The greater the disempowerment, the more time and effort it takes to create empowerment.

The disempowered never forget how disempowerment feels. We need to be reminded about what we can be if we fall back into those memories. But that's also a strength; we see and empathize
23. Leadership to support #EDI by those in power and authority has an exponential impact. This impact can resonate for a very long time. We are all the sum of our lived experiences.

Lean in to #EDI, it will make you a fuller person. Disempowerment is a shared human experience.
24. Closing Thoughts: The impacts of exclusion happen early. They’re messages we take throughout our lives. It’s not anyone’s fault for what the school system said to me and my parents. I’m not asking for anyone to own that trauma.
25. I do reflect however on where I’d be if the mentorship, time investment, recognition of how my life experiences impacted my success, space given to me by decision-makers, didn’t happen after. What would I have become?
26. The end point of #EDI is not shame and blame.

It’s a process through which we unlock potential and encourage individuals to grow into who they were meant to be. #medtwitter
27. @KimKellyMD, until reality meets expectations our work in #EDI is far from done. Great candidates, but would have been better to have an inclusive set of candidates.

Would love to join #equityinmedicine for a fireside chat to discuss further if there was interest.

--END

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More from @AlikaMD

4 Jul
1/ Beginning of a long thread.

Yesterday a CBC report noted that myself and a surgical colleague reported the hanging of a noose in June 2016. Thank you to everyone who has sent me supportive messages and phone calls since the story was published. It means a lot.
2/ I have spoken out about racism, discrimination and bias for almost 20 years. There are many within AHS that have championed this message, including our CEO who amplified this message (and me) both when she was over PPIH and in her current role.

cbc.ca/player/play/24…
3/ I want to share with you the conversation I had with my 12 year old daughter last night. In it I shared my truths, and together she helped me arrive at some worthwhile insights. As she told me, “Dad you’ve always said things clearly to people. Why stop?” She’s right of course.
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