平特五不中

@OnyeActiveMD

How one Toronto public health doctor is teaching the health impacts of racism and advancing equity in medicine.

Growing up in Montreal鈥檚 Nigerian and Caribbean communities, Onye Nnorom, MDCM鈥07, didn鈥檛 see a career in medicine as a possibility. 鈥淚鈥檓 not one of those people who said they always knew they wanted to be a doctor,鈥 she says.

Despite her stellar grades and keen interest in the sciences and especially biology, Nnorom couldn鈥檛 identify with the role of physician. 鈥淚 saw older male physicians in the Nigerian community, but I didn鈥檛 relate to them as career role models,鈥 says Nnorom, a public health physician, who is Black Health Theme Lead in the MD program at the University of Toronto鈥檚 Temerty Faculty of Medicine and recently became the first Equity, Diversity and Inclusion Lead in the Department of Family and Community Medicine.

Through her advocacy work as president of the Black Physicians鈥 Association of Ontario (BPAO), Nnorom has also been a leader in mentoring and promoting equitable representation of Black students and physicians in medicine provincially and nationally.

Nnorom鈥檚 perception of medicine and career aspirations changed when her mother鈥檚 endocrinologist, Dr. Eric Laryea, a 平特五不中 professor and staff physician at the Montreal General Hospital, encouraged her to enter a mentorship program he was running for young Black students. The mentors included a young Black female medical student, Ewurabena Simpson, BSc鈥01, MDCM鈥05, who is now a pediatric hematologist at CHEO (Children鈥檚 Hospital of Eastern Ontario).

鈥淢eeting and seeing Ewurabena as a young Black woman in medical school was when it clicked that I could be a physician. She鈥檚 the person who influenced me most back then,鈥 recalls Nnorom, who applied to medical school at the last minute and, with a near perfect GPA from her undergrad science studies at Concordia University, was admitted.

Mentoring and educating in the broadest sense is how Nnorom is powerfully and passionately addressing the many ways in which anti-Black racism can negatively affect health, and working to advance health equity in medicine and improve heath outcomes for the Black population in Canada.

As Black Health Theme Lead, Nnorom provides guidance to her Faculty and develops curriculum content to educate future doctors about Black population health. 鈥淲e鈥檙e teaching the students about certain health disparities from a lens where they learn how anti-Black racism is a driver of disparities in health care and health outcomes for the black population in Canada. We鈥檙e integrating this into the curriculum for all four years of medical education,鈥 she says.

In her role as Associate Program Director of the Residency Program in Public Health and Preventive Medicine at U of T鈥檚 Dalla Lana School of Public Health, Nnorom is helping to educate the next generation of public health specialists on social issues, including economic inequality and racism, that impact and are social determinants of Black community health and wellness.

鈥淧ublic health is a specialty that focuses on populations. I provide guidance in public health education on specific marginalized populations, including issues such as anti-Black and anti-Indigenous racism. As they become leaders in public health, these graduates will have a deeper understanding of how social factors and structural forms of injustice impact the health of specific populations,鈥 she says.

In her time as a medical student at 平特五不中, Nnorom discovered there was an area of medicine, the specialty of public health, where she could focus on the social issues that impact Black immigrant populations, which she knew through her own lived experience as the daughter of Nigerian and Trinidadian parents.

鈥淲hen I learned about social determinants of health in medical school, I realized that in medicine I could focus on these issues and became determined to apply into the specialty of public health, although I didn鈥檛 fully understand until much later that a major driver of disparities in health among racialized groups is systematic discrimination, oppression and injustice,鈥 she says.

Like her immigrant parents, Nnorom had volunteered in the community for years to help newcomers access services. As a 平特五不中 medical student, she volunteered for a YMCA program that helped refugees access health and social services. 鈥淭hat kind of volunteer outreach is where I came from. It was a 鈥榟obby鈥 and I didn鈥檛 recognize the connection with medicine at first. Someone asked me if I had considered community medicine as a specialty, which is essentially public health and preventive medicine. I looked it up and saw the perfect alignment with what I was doing intuitively. The key fit into the lock,鈥 she says.

After doing her family medicine training at St. Michael鈥檚 Hospital in Toronto, Nnorom obtained a Master of Public Health degree in epidemiology and completed her fellowship training in Public Health and Preventive Medicine at Dalla Lana in 2012. She practised for five years as a family physician and chronic disease prevention lead at TAIBU Community Health Centre, which serves the Black community across Toronto and a highly diverse immigrant population in the local Malvern area.

鈥淲e engaged the community with an outreach strategy and were able to increase influenza vaccination and breast cancer screening dramatically. In serving the wider Black community as a physician, I also gained a much better understanding of the experience of systemic racism and its impact on Black population health,鈥 she says.

Nnorom鈥檚 advocacy work with the Black Physicians鈥 Association of Ontario has been seminal in organizing Black physicians and increasing the representation of Black students in medical schools across the country through its mentorship, outreach and other programs. 鈥淚鈥檝e been involved in the BPAO since I was a resident. Over the years we鈥檝e tried to raise awareness about the impact of anti-Black racism in medicine and have been working with many different groups including the Quebec Black Medical Association to advocate against anti-Black racism in medicine. I鈥檓 encouraged that we鈥檙e now seeing a higher number of Black students going to medical schools across the country than ever before,鈥 she says.

But it is as an educator and mentor directly involved in effecting change in medical schools that Nnorom sees her greatest opportunity for advancing health equity in medicine and improving health outcomes for the Black population and all marginalized groups.

鈥淢entorship is key and needs to be embedded within the medical schools for sustainability,鈥 says Nnorom, who strongly supports initiatives led by U of T staff such as Ike Okafor, including听outreach programs aimed at Black high school students and the Black Student Application Program, which offers Black students a culturally safe place to apply to medical school. 鈥淭hose of us who experienced the power of mentorship know we stand on the shoulders of giants who came before us. We too want to lend our shoulders to mentoring the next generation of Black health care professionals.鈥

Nnorom believes that educating and influencing all students in medical school from increasingly diverse backgrounds on these issues offers promise and hope in overcoming the challenges that impede Black health. 鈥淔or me, the joy is in being involved with young people who are going to be leaders in health and public health, and who really have a great understanding and desire to see that the patients and the communities they serve will be treated with dignity and an understanding of the different factors that lead to better health,鈥 she says.

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