We learn in medical training that factors big and small have an influence on health. Broader social, economic, political, and environmental forces play an important role in determining who experiences good health, and who does not.

In this episode, host Sandra and Dr. Yipeng Ge, a family doctor and public health practitioner, drill down into the details of the structural determinants of health. What are they? How do we recognize their influence in our patients? As medical learners and trainees, what can we do about them?

Check out this episode to hear Dr. Ge’s insights on these questions, which draw on his current practice here on Turtle Island, as well as his work in Palestine.

Resources:

- Learn more about the concept of social prescribing from the Canadian Institute for Social Prescribing.

- Read up on the advocacy work of the Canadian Federation of Medical Students (CFMS) and the UBC Medical Undergraduate Society’s Political Advocacy Committee.

- Listen to this recent episode of Just Medicine for more on the Truth and Reconciliation Commission of Canada’s 94 Calls to Action. 

Credits:

Additional music by AmsleyBeats, used under the ⁠Pixabay content license⁠.

Welcome back to Just Medicine! In this episode, we explore the often overlooked vulnerabilities in pediatric health care with our excellent guest, Dr. Amarens Matthiesen, a Certified Child Life Specialist. She discusses the importance of including children in healthcare decision-making and how this looks in practice. Please tune in for a thought-provoking conversation on equity and agency in the pediatric care setting.

Welcome back to Just Medicine! In this episode, I spoke with Dr. Michael Etowa, a post-doctoral research fellow at the Daphne Cockwell School of Nursing at Toronto Metropolitan University and an associate scientist at the HIV Treatment Network in Ontario. Dr. Etowa's research on HIV vulnerability and resilience in the black community fueled a truly enriching discussion about the social determinants of health, health literacy, and community-based interventions for marginalized populations. Conversations such as this serve as a reminder of the importance of taking an active role in healthcare to serve those who are often underserved, overlooked, and ultimately more vulnerable to poorer outcomes.

We are back again with another episode! I had the pleasure of speaking with Dr. Victoria Weaver, one of the only dual infectious diseases and addictions medicine specialists in Canada. She shares her insights on the treatment of infectious diseases in patients with concurrent substance use. In particular, we discussed the challenges that arise in ID treatment, disease severity and continuity of care. Additionally, we delved into the ethical dilemmas that often arise in this line of work and the importance of multidisciplinary healthcare teams to this specific population.

Welcome back, everyone! This week's episode focuses on Refugee Health by highlighting a remarkable medical student-led initiative called the Refugee Health Initiative (RHI).

I had the pleasure of speaking with Nikola Deretic, a third-year medical student at the University of British Columbia and the current co-president of the Refugee Health Initiative. Nikola delves into the RHI's work to engage and support refugee families in Greater Vancouver with the aid of medical students, language interpreters, and other community organizations.

It was truly a meaningful conversation about advocacy and dismantling barriers in health care.

To explore the details of the initiative and learn more about Refugee care in BC, check out these websites:https://globalhealth.med.ubc.ca/service/student-groups/refugee-health-initiati

https://bcrefugeehub.ca/

We are back again with another episode! I had the pleasure of speaking with Dr. Mary Kestler, an infectious diseases specialist with particular expertise in HIV, TB, Global Health and Tropical Medicine. She shares her insights on HIV care in urban settings, amidst their unique challenges and opportunities. We also delve into the intersection of HIV care with substance use, gender, and sexual orientation, as well as the social stigmatization that can affect these marginalized groups.

We're back! This week's episode explores the unique mental health challenges faced by youth with chronic illnesses, focusing on inflammatory bowel disease (IBD) with expert Dr. Astrid Williams.

Adolescence and young adulthood are already full of psychosocial and physical changes. Add to this a lifelong illness, and it can lead to feelings of hopelessness and isolation. Listen in on an important conversation on body image struggles, how to navigate a smooth transition from paediatric to adult healthcare, and healthy coping strategies that are youth-friendly.

All resources discussed in the episode are linked below!

1. Headspace: https://www.headspace.com/mental-health?origin=navigation

2. Crohn's & Colitis Canada: https://crohnsandcolitis.ca

3. Crohn's & Colitis Canada Youth Wellness Series: https://crohnsandcolitis.ca/Support-for-You/Youth-Education-Series

We’re back again with another episode! This week, dive into the world of genetic testing and the genomic divide with expert guest speakers Dr. Wyeth Wasserman and Dr. Anna Lehman:

Did you know that when it comes to genetic testing, you can’t simply use the same reference data for everybody? Different populations of people share different background variations in their genes, so we need good reference data from diverse populations in order for genetic testing to be applicable and useful for each individual. As you may have guessed, this has some pretty big implications for diagnosis and treatment when it comes to those who are poorly represented in large genetic databases. 

Listen in on my conversation with not one, but TWO amazing guest speakers who are doing some pretty game-changing work on the Silent Genomes Project, which aims to reduce healthcare disparities and improve diagnostic success for children with genetic diseases from Indigenous populations. 

We are back with another episode! I had the pleasure of chatting with Dr Tribesty Nguyen who is a public health resident physician. He has many years of experience in social justice, health equity, health policy, and political advocacy, particularly with 2SLGBTQ+, refugee, and racialized communities. He is here with us to share about the nuances of providing care for GBTQ+ men and how to take a sexual history for this population.

If you have any questions, want to suggest a topic for us to cover, or know of any experts in a particular field, please email us at justmedicinepod@gmail.com

We are back with another episode! I had the pleasure of chatting with Dr Alec Yu who is an internal medicine resident physician working at St Paul's Hospital in inner city downtown Vancouver. He shares us his insights working on the frontlines and resources we can directly connect our patients to.

If you have any questions, want to suggest a topic for us to cover, or know of any experts in a particular field, please email us at justmedicinepod@gmail.com

We are back with another episode! I had the pleasure of chatting with Dr Fraser Black and Ashley Mollison who are experts on the complexities of delivering palliative care for a vulnerable population. In this episode, we also discuss what drew Dr Black and Ashley to this line of work and why it is so rewarding.

For details on PORT, refer to: https://www.equityinpalliativecare.com/port

For details on research about PORT as well as the ways in which approaches to palliative care are defined, understood, provided, received, and supported, refer to https://palliativeapproaches.uvic.ca

If you have any questions, want to suggest a topic for us to cover, or know of any experts in a particular field, please email us at justmedicinepod@gmail.com

In this second episode, I provide a primer on the medical aspects of pediatric gender affirming care. I provide you with the context of taking a history, treatment plans offered, considerations when providing this type of care and the transition from pediatric to adult settings.

In this episode, our host Sandra chats with Derek K. Thompson – Čaabať Bookwilla | Suhiltun, a member of the diitiidʔaaʔtx̣ – Ditidaht First Nation and Director of Indigenous Engagement at the University of British Columbia’s Faculty of Medicine. They discuss the role of non-Indigenous medical learners and trainees in realizing the Truth and Reconciliation Commission of Canada’s 94 Calls to Action, and especially those that relate to health. 

Through stories, history, and insights from his personal and professional experiences, Derek offers listeners practical strategies for honouring the Calls to Action in their work within the health care system. He discusses using trauma-informed approaches to care, creating space for knowledge systems about wellness and healing that go beyond the biomedical, and making an emotional commitment to kindness and understanding.

Tune in as we explore the Truth and Reconciliation Commission of Canada’s Calls to Action, and the unique part that you, as medical learners and trainees, play in advancing them. 

Resources:

• Read the Truth and Reconciliation Commission of Canada’s 94 Calls to Action.

• Check out the report, First Nations Population Health and Wellness Agenda: First Interim Update, 2024, mentioned in this episode.

• Derek will be leading the online event, “To Bear Witness: A Meaningful Conversation with my Mom on Belonging and Perseverance”, on 23 April 2025: Learn more or register now.

Credits:

Additional music by Denis Pavlov, used under the Pixabay content license.

In this first solo episode, I introduce you to the concept of pediatric gender affirming care. I cover the services offered for youth in British Columbia, which providers provide this care, and the steps required to access this type of care for patients.

Many Canadians may not realize that the apples in their fruit basket or the flowers brought home to family may be there because of the contributions of a migrant farm worker (MFW) to the nation. Despite having such a significant impact on the Canadian agricultural landscape, MFWs face inequities in health care access and delivery across the country. In this two-part series, Sebastian Lopez Steven, (UBC MSI 2) engages with healthcare workers that provide care to these individuals in British Columbia. Join us for enlightening conversations regarding the major health issues for MFWs and how to bring care to these individuals in a culturally competent manner.

Episode 2 features a chat with Dr. Mary Kozial, a family doctor in Vancouver’s Lower Mainland who provides care for MFWs. We start off with a bit of background on Sebastian’s more informal thoughts on working with this population and then jump into the chat with our physician expert. While continuing to centre MFWs in this discussion, this episode also uses the topic as a jumping off point to chat more about broader equity practices in medicine – come for chats about MFW rights and health and stay to learn about the roles of cultural competent care and myoactivation (now that’s a name)!

 

Resources for the listener:

1. For information about cultural brokers: Brar-Josan, N., & Yohani, S. C. (2019). Cultural brokers’ role in facilitating informal and formal mental health supports for refugee youth in school and community context: a Canadian case study. British Journal of Guidance & Counselling, 47(4), 512–523. https://doi.org/10.1080/03069885.2017.1403010

2.    For information about anti-oppression as an emerging competency within the Royal College: Thoma, B., Snell, L., Anderson, R., Frank, J., Tourian, L., Fowler, N., Gomez Garibello, C., Hall, A. K., Constantin, E., Atkinson, A., Chan, T. M., Giuliani, M., Waters, H., Labine, N., Samson, L., Karwowska, A., & Van Melle, E. (2023). Emerging concepts in the CanMEDS physician competency framework . Canadian Medical Education Journal, 14(1), 4–12. https://doi.org/10.36834/cmej.75591

3.    For information about myoactivation: Lauder, G., West, N., & Siren, G. (2019). myoActivation: A Structured Process for Chronic Pain Resolution. IntechOpen. doi: 10.5772/intechopen.84377

Many Canadians may not realize that the apples in their fruit basket or the flowers brought home to family may be there because of the contributions of a migrant farm worker (MFW) to the nation. Despite having such a significant impact on the Canadian agricultural landscape, MFWs face inequities in health care access and delivery across the country. In this two part series, Sebastian Lopez Steven, (UBC MSI 2) engages with healthcare workers that provide care to these individuals in British Columbia. Join us for enlightening conversations regarding the major health issues for MFWs and how to bring care to these individuals in a culturally competent manner.

Episode 1 focuses on a chat with Christelle Kuenzig, a nurse practitioner who provides care for MFWs in the Lower Mainland of British Columbia. We chat with Christelle about a general approach to healthcare provision in this population and what needs to change to ensure equity for MFWs across the province and the country.

Resources for the listener

1. Overview of the Seasonal Agricultural Worker Program (SAWP) as part of the temporary foreign worker framework in Canada: https://www.canada.ca/en/employment-social-development/services/foreign-workers/agricultural/seasonal-agricultural.html

2. Salami, B., Meharali, S., & Salami, A. (2015). The health of temporary foreign workers in Canada: A scoping review. Canadian Journal of Public Health, 106(8), e546–e554. https://doi.org/10.17269/CJPH.106.5182

3. Istiko, S. N., Durham, J., & Elliott, L. (2022). (Not That) Essential: A Scoping Review of Migrant Workers’ Access to Health Services and Social Protection during the COVID-19 Pandemic in Australia, Canada, and New Zealand. International Journal of Environmental Research and Public Health, 19(5). https://doi.org/10.3390/ijerph19052981

We’re back baby! For part three of our Reproductive Health series, I had the pleasure of chatting with Dr. Sheila Curran on the complexities of rural pregnancy care. 

While pregnancy itself isn’t exactly a “walk in the park,” navigating pregnancy for those who live in rural locations comes with its own particular challenges. In this episode, we address both the practical (ex. financial) implications of rural pregnancy, as well as more nuanced topics such as the cultural implications of travelling for healthcare.

If you have any questions, want to suggest a topic for us to cover, or know of any experts in a particular field, please email us at justmedicinepod@gmail.com 

We are BACK with an exciting new conversation!! 

Did you know that cervical cancer is a preventable disease? In this episode, Dr. Lauren Adolph and I discuss the importance of prevention and screening when it comes to cervical cancer, as well as why certain populations are disproportionately impacted by this condition. Tune in to learn more about this unique disease, the actionable barriers standing in the way of its eradication, and exciting new screening programs being implemented in Canada.

If you have any questions, want to suggest a topic for us to cover, or know of any experts in a particular field, please email us at justmedicinepod@gmail.com 

In this final episode of a 2-part series on Medical Assistance in Dying (MAiD) for mental health, I had a conversation with Dr. Derryck Smith where we explored the positive outcomes anticipated from this legislation.

Join us as Dr. Smith shares his personal encounters with MAiD and why he believes this reform is pivotal in restoring human rights and empowering individuals suffering from treatment refractory psychiatric conditions.

For more information on MAiD in Canada, check out the link below: ⁠https://www.justice.gc.ca/eng/cj-jp/ad-am/bk-di.html⁠

We're back again! As the first episode of a multi-part series on women's health, this month's episode addresses Access to Contraceptives in Canada.

Listen in as expert guest speaker Dr. Yuyang Wang brings his enthusiasm, expertise and knowledge to the table. We've got a jam-packed episode ready for you, as we dive into topics including cost barriers, rural-specific factors, the importance of education, and other special considerations that can impact the accessibility of contraceptives.

If you have any questions, want to suggest a topic for us to cover, or know of any experts in a particular field, please email us at justmedicinepod@gmail.com

"Sex & U" - Resource for sexual and reproductive health (by the Society of Obstetricians and Gynaecologists of Canada):

https://www.sexandu.ca/

Global Contraception Policy Atlas (2023 version):

https://www.srhrpolicyhub.org/region/?region=can

In this first episode of a 2-part series on Medical Assistance in Dying (MAiD) for mental health, I chatted with Dr. Diane McIntosh on the equity considerations that follow the legalization of MAiD for psychiatric conditions.

Listen in as Dr. McIntosh shares her expertise and perspective on this issue, discussing the disproportionate impact MAiD might have on vulnerable populations, how a lack of access to care might drive individuals to seek MAiD, and some of the health equity concerns that are raised by the law.

For more information on MAiD in Canada, check out the link below: https://www.justice.gc.ca/eng/cj-jp/ad-am/bk-di.html

We're back with another episode and this month we're focusing on one of the most important skills we learn in medicine, history taking! Specifically in this episode we focus on taking a good substance use history while remaining sensitive and providing patient-centred care. Please see below for the terms we discussed in episodes. Enjoy!

Terminology (Terms can change over time and they are usually regionally specific, so this list is most specific to the West Coast)

Substance names

1. Up = Stimulants (Usually cocaine, in powder or crack form)
2. Down = Opioids (Not specific to a single opioid, but usually in BC refers to fentanyl)
3. Side = crystal methamphetamine (or crystal)
4. Combinations:

• Speedball = cocaine and opioids
• Goofball = Crystal meth and opioids

Quantity of substance

• A Point = 0.1 gram
• 8 ball/a ball = 1/8 of an ounce = 3.5 g

Route of Injection

• Smashing = inject in any form (IV, IM, SC)
• Muscling = intramuscular injections
• Skin popping = subcutaneous injections
• Jugging = injection directly into the jugular vein

We are BACK! In this episode, I sat down with Dr. Maria Hubinette to chat about Trauma-Informed Care. Many of our patients have faced many forms of trauma and even had traumatic experiences in healthcare settings. It's important to recognize that health systems and healthcare workers can contribute to trauma and how we can alleviate some of the damage that can happen in health encounters through TIC.

In the final episode of this four-part series, Kennedy reconnects with Jessie Newman, an Indigenous health dietitian, to bring together the key themes of diet, food access, and the gut microbiome in the context of Indigenous health. Building on earlier discussions, Jessie shares insights into the initiatives she’s spearheaded to promote food sovereignty and improve health outcomes in Indigenous communities.

Here, we discuss actionable strategies for addressing food insecurity, fostering cultural connection through traditional food systems, and supporting systemic change. Jessie emphasizes the importance of empowering communities to reclaim their food systems, and highlights how listeners—whether healthcare professionals, students, or advocates—can contribute to these efforts.

This episode is both a reflection on the complex intersections of food, culture, and health and a call to action for listeners to engage with equity in healthcare. If you’re ready to explore how understanding and advocacy can drive meaningful change, this episode is for you.

Tune in to learn how you can make a difference in advancing food sovereignty, supporting Indigenous health, and creating a more equitable future.

In this month's episode, we're continuing our panel discussion with our 3 special guests. We delve deeper into what transitioning means and what are the different components of it. All of the resources mentioned in the podcast are as always listed in the show notes below. We highly recommend looking through Trans Care BC for any extra information! If you have any questions, want to suggest a topic for us to cover, or know of any experts in a particular field, please email us at justmedicinepod@gmail.com. Resources and References: Trans Care BC Primary Care Toolkit (Updated March 2023): http://www.phsa.ca/transcarebc/Documents/HealthProf/Primary-Care-Toolkit.pdf Trans Care BC Testosterone Consent: http://www.phsa.ca/transcarebc/Documents/HealthProf/pctoolkit-testosterone-consent.pdf Trans Care BC Estrogen/Testosterone Blocker Consent: http://www.phsa.ca/transcarebc/Documents/HealthProf/pctoolkit-estrogen-testosterone-blocker-consent.pdf

In the first episode of this special multi-part series on Gender Affirming Care, I chatted with 3 special guests who are advocates for inclusive trans care. Rae, Lucas, and Dr. Thompson all bring their own experiences and perspectives in how medical trainees can engender (pun intended) change in medical education with respective to gender affirming care.

If you have any questions, want to suggest a topic for us to cover, or know of any experts in a particular field, please email us at justmedicinepod@gmail.com. 

Resources and References: 

1. Trans activist leaving Canada https://www.cbc.ca/news/canada/london/sorrenti-trans-activist-leaving-canada-1.6559289
2. WHO definition of Gender Affirming Care https://www.who.int/standards/classifications/frequently-asked-questions/gender-incongruence-and-transgender-health-in-the-icd
3. Trevor Project Youth Mental Health Survey https://www.thetrevorproject.org/survey-2020/?section=Introduction
4. Mental Health Disparities Among Canadian transgender youth https://pubmed.ncbi.nlm.nih.gov/28007056/
5. Transgender Noninclusive Healthcare and Delaying Care Because of Fear: Connections to General Health and Mental Health Among Transgender Adults: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5436369/
6. Dr. Thompson’s article in Perspectives on Medical Education about teaching a Gender Affirming Care Framework https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8600495/
7. Broken Arm Syndrome https://pubmed.ncbi.nlm.nih.gov/36736052/
8. Injustice at Every Turn: A Report of the National Transgender Discrimination Survey https://transequality.org/sites/default/files/docs/resources/NTDS_Report.pdf
9. Trans-misogyny https://www.juliaserano.com/av/TransmisogynyPrimer-Serano.pdf
10. Racialized Equity Labor: https://academic.oup.com/socpro/article-abstract/67/2/286/5488730?redirectedFrom=fulltext

Music by Lesfm from Pixabay.

Enjoy this bonus episode discussing some introductory terms and concepts to be familiar with as we kick off the Gender Affirming Care series! In the next few months, we will be exploring different facets of gender inclusive care with a variety guests from different backgrounds and lived experiences.

Producer's note: the accompanying episode will be released on Thursday, Mar 9. 

If you have any questions, want to suggest a topic for us to cover, or know of any experts in a particular field, please email us at justmedicinepod@gmail.com.

Music by Lesfm from Pixabay.

Producer’s note: The audio for this episode is a bit unstable at times, so apologies for that in advance.

In this episode, I chatted with Dr. Katarina Wind, a recent Family Medicine graduate and a weight-inclusive practitioner about weight and fatphobia in healthcare. We talked about the history and application of BMI to medicine, her personal journey with weight perception, and how to approach discussions around weight with patients. The sources from the introduction are included below.

If you have any questions, want to suggest a topic for us to cover, or know of any experts in a particular field, please email us at justmedicinepod@gmail.com

Sources

References

1. Rathbone, JA, Cruwys, T, Jetten, J, Barlow, FK. When stigma is the norm: How weight and social norms influence the healthcare we receive. J Appl Soc Psychol. 2020; 00: 1– 17. https://doi.org/10.1111/jasp.12689
2. Mann T, Tomiyama AJ, Westling E, Lew AM, Samuels B, Chatman J. Medicare's search for effective obesity treatments: diets are not the answer. Am Psychol. 2007 Apr;62(3):220-33. doi: 10.1037/0003-066X.62.3.220. PMID: 17469900.
3. Loveman E, Frampton GK, Shepherd J, Picot J, Cooper K, Bryant J, Welch K, Clegg A. The clinical effectiveness and cost-effectiveness of long-term weight management schemes for adults: a systematic review. Health Technol Assess. 2011 Jan;15(2):1-182. doi: 10.3310/hta15020. PMID: 21247515; PMCID: PMC4781196.
4. Lee JA, Pausé CJ. Stigma in Practice: Barriers to Health for Fat Women. Front Psychol. 2016 Dec 30;7:2063. doi: 10.3389/fpsyg.2016.02063. PMID: 28090202; PMCID: PMC5201160.
5. McPhail D, Orsini M. Fat acceptance as social justice. CMAJ. 2021 Sep 7;193(35):E1398-E1399. doi: 10.1503/cmaj.210772. PMID: 34493569; PMCID: PMC8443289.
6. https://www.brown.edu/news/2016-12-12/famine
7. https://www.huffingtonpost.co.uk/entry/south-asian-health-colonial-history_uk_620e74fee4b055057aac0e9f
8. https://obesitycanada.ca/guidelines/weightbias/
9. https://thischangedmypractice.com/why-i-no-longer-prescribe-weight-loss/
10. https://www.nytimes.com/2013/06/19/business/ama-recognizes-obesity-as-a-disease.html

Music by Lesfm from Pixabay.

In this episode, I chatted with Dr. Marcus Greatheart, a family physician and social worker, who works with a large population of patients with mental health and substance use issues. We talk about the importance of recognizing our privilege and how we can walk alongside our patients. 

If you have any questions or want us to cover a specific topic, email us at justmedicinepod@gmail.com. 

Dr. Greatheart’s resources

1. Trans Pulse Study: https://www.cmajopen.ca/content/9/4/E1213.short
2. Serious Illness Conversation Guide (Ariadne Lab): http://www.bccancer.bc.ca/new-patients-site/Documents/SeriousIllnessConversationGuideCard.pdf
3. Compassionomics: The Revolutionary Scientific Evidence that Caring Makes a Difference by Stephen Trzeciak and Anthony Mazzarelli
4. Cleveland Clinic R.E.D.E to Communicate model of communication in Healthcarre: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513605/

Introduction References

1. https://news.gov.bc.ca/releases/2022PSSG0010-000188
2. https://vancouver-fraser.cmha.bc.ca/facts-and-figures/

Welcome to Just Medicine! Here, we mean “just” in the fairness capacity and not in the “only” sense. In fact, this podcast is not “just” about medicine but how medicine is applied and adapted to the real-world conditions of our patients. This is a student-led podcast created by medical students for medical trainees. We will be bringing episodes to you monthly, where we sit down and chat with a guest about a social justice topic that they are passionate about.

If you have any questions, want to suggest a topic for us to cover, or know of any experts in a particular field, please email us at justmedicinepod@gmail.com

We’re back!

This is the third episode of our podcast series on Food Security and the Gut Microbiome where we continue to discuss the critical overlap of healthcare, community, and connection. We’re grateful to speak with Dr. Morgan Lindsay, a dedicated family physician practicing in British Columbia. 

In this interview, we examine the perspective of both providers and patients that have been historically underserved. Dr. Lindsay shares valuable insights on the importance of maintaining representation of Indigenous people within the healthcare system, as care providers. We also ask deeper questions about why a patient might be considered ‘vulnerable,’ and look beyond the exam room to understand how addressing the social determinants of health can guide more effective advocacy within systems that often perpetuate these inequities.

Finally, we revisit the important topic of food and diet, with a focus on the power of connection. Dr. Lindsay discusses how colonization has disrupted Indigenous peoples’ relationships with their traditional lands and communities, leading to numerous health challenges, and how restoring these connections is key to healing.

If you haven't listened to our other two episodes yet and you’re interested to learn more, I highly recommend you go check them out!

Welcome back to Just Medicine! 

This week, we continue a podcast series that explores the intersections of diet, food security and the gut microbiome, especially for Indigenous folks. 

In our previous episode of the series, we established a fantastic background on the importance of foods and food systems in Indigenous communities, as well as how diets are changing through time. We also discussed some of the adverse health and social outcomes that have disproportionately affected Indigenous communities through generations since colonization. 

In this episode, we’re having a conversation with Dr. Estello Nap Hill, a gastroenterology fellow who attended UBC medical school, with specific expertise in the gut microbiome. He speaks to the composition and factors that shape the gut microbiome, how the gut microbiome impacts health, and how microbes in more traditional hunter/gatherer diets differ from Westernized diets. He shares his clinical and research expertise on the topics to emphasize the importance of food to overall health and wellbeing from a medical standpoint.

Welcome back to Just Medicine!

This week, we begin a podcast series that explores the intersections of diet, food security, and the gut microbiome, especially for Indigenous folks.

In this four part series, Kennedy Graham (UBC MSI 1) speaks to experts to call attention to how colonialism has impacted diet in many Indigenous communities; explore diet’s role in creating and influencing the gut microbiome; highlight existing advocacy projects and approaches that address issues created by colonial practices; and share actionable steps for listeners, towards health equity and cultural preservation in the context of food and land systems for Indigenous communities. 

In this first episode, we are honoured to be joined by Jessie Newman, an Indigenous Health Dietician doing both systems and community work on Vancouver Island. We discuss her journey to becoming an Indigenous Health Dietician, as well as systemic and historical causes of food insecurity among Indigenous populations. We address barriers to food sovereignty such as geographic isolation, colonial policy that disrupts intergenerational knowledge transfer on land and food practices, and lack of access to traditional foods. Jessie also speaks to two projects she created, related to diabetes support and knowledge sharing. 

We are back with another episode! In this podcast, I spoke with Bryan Becker, who is presently working in peer support at the RAAC clinic at St.Pauls Hospital. RAAC stands for rapid access addiction clinic: this service provides addiction medicine assessments for any substance use issue, including alcohol. It serves to maximize treatment support for clients, provide training and distribution of Take Home Naloxone, offer harm reduction services and to facilitate referrals to substance use services. Support Workers like Bryan are individuals with lived experience of mental illness or substance use who have graduated from a Peer Support Worker Training Program. These individuals work on a contracted basis under the supervision of Rehabilitation staff with clients who access Vancouver Mental Health and Substance Use programs and services. On his own time, Bryan enjoys BMX, the beach, 3rd Beach drum circle, movies, reading and helping others.

I am so honoured to have had the chance to speak with Bryan, and I hope everyone listening takes away as much as I did from the stories and advice that he shares.

We're back! In this episode, I had the pleasure of speaking with Dr. Althea Hayden, a medical health officer, Ranjit Lehal, a family nurse practitioner, and Dr. Mei-ling Wiedmeyer, a clinician scientist. From navigating cultural barriers to understanding specific health needs, this week's inspiring guests share their insights and experiences in providing and developing accessible health care for refugee patients. Tune in as we explore community resources and the importance of advocacy in delivering equitable health care for refugee patients.

We are back with another episode! I had the pleasure of speaking with Dr. Elise Jackson, who recently completed her Addictions Medicine Fellowship following an internal medicine residency at UBC. We speak about the protocols surrounding substance use while in hospital, as well as how the importance of hospitalization as a touchpoint for future care coordination. We also delve into the personal difficulties physicians and other HCP can face while caring for populations with complex needs.

The success of a treatment plan can depend heavily on social factors – for example, income, housing status, or whether or not someone has drug coverage. The social history is where we, as medical learners, trainees and practitioners, are meant to gather that information so that we can apply it in our care.

For this episode, host Sandra spoke to Dr. Ritika Goel, a family doctor and activist based in Toronto, about how to make the most of that part of our conversation with patients. What's important to ask about? And what can we do with the answers?

Resources:

- Download the ⁠IFITHELPS tool⁠ for taking and actioning a social history.

- Explore 211, a database of information for government and community-based, non-clinical health and social services across Canada, at ⁠211.ca⁠.

- Familiarize yourself with the ⁠Canada Disability Benefit⁠, a new program to supplement the incomes of working-age folks living with disabilities. Applicants must be approved for the Disability Tax Credit, which requires certification by a medical practitioner.

- Learn more about social accountability in this article series in Canadian Family Physician: Buchman S, Woollard, R., Meili R, Goel R. Practising social accountability: From theory to action. Can Fam Physician. 2016 Jan;62(1):15-8. PMID: 26796826; PMCID: PMC4721832 .⁠https://pmc.ncbi.nlm.nih.gov/articles/PMC4721832/⁠

- Have a listen to relevant past episodes, eg. ⁠on the structural determinants of health⁠, ⁠providing trauma-informed care⁠, and ⁠taking a good substance use history⁠.

Credits:

Additional music by ⁠kontraa⁠, used under the ⁠Pixabay content license⁠.

Survey:

To help us make the best possible podcast, please consider filling out ⁠this short, anonymous survey⁠ after listening.

Climate change is presenting a big problem for health, with significant implications for equity. As medical trainees, when it comes to addressing the health impacts of climate change in our patients, it can be hard to know where to even start. 

In this episode, our guest Dr. Melissa Lem – a family physician, environmental advocate, and the president of the Canadian Association of Physicians for the Environment (CAPE) – shares ideas on how to integrate considerations about planetary health into medical practice.

Resources:

- Ready to get involved in climate action? Check out CAPE, the Canadian Coalition for Green Health Care, and EnviroMed at the University of British Columbia's Faculty of Medicine.

- Dive into some of the health research and recommendations around time spent in nature at the website of PaRx⁠, Canada’s evidence-based nature prescription initiative.

- Consult inhalerguide.ca (or BCinhalers.ca for folks practicing in BC) to learn more about the carbon footprint of and coverage for different asthma and COPD inhalers.

Credits:

Additional music by ⁠LP-Studio-music, used under the ⁠⁠Pixabay content license⁠⁠.

In this episode, Dr. Kona Williams, a Cree and Mohawk forensic pathologist and coroner based in Sudbury, Ontario, talks to host Sandra about what forensic pathology is (and isn’t). They also discuss death investigation systems, why some communities in so-called Canada are left waiting years for answers about their loved ones’ deaths, and what needs to happen to ensure health care is more equitable for all – including those who are no longer living.

Resources:

- Watch Dr. Williams’ TedX talk entitled “Investigating Indigenous deaths: Looking beyond the pathological diagnosis”, on how the social, structural, and colonial determinants of health factor into her work in death investigation.

- For additional context on Murdered and Missing Indigenous Women and Girls (MMIWG), read the final report of the National Inquiry, and this news story: McCue, D. (2019, Jun 10). MMIWG report missed chance to change how deaths are investigated, says Indigenous forensic pathologist. CBC News. https://www.cbc.ca/radio/checkup/mmiwg-report-missed-chance-to-change-how-deaths-are-investigated-says-indigenous-forensic-pathologist-1.5167987

- Read about the Goudge Inquiry, mentioned by Dr. Williams, which prompted a change in death investigation systems in Canada: Eggerston, L. (2008, Nov 4). Goudge: “Systemic failings” in Ontario coroner’s office. CMAJ, 179(10), 995. https://www.cmaj.ca/content/179/10/995

- Learn more about the Canadian Association of Forensic Medicine on their website, and familiarize yourself with what’s happening at the Centre of Forensic Sciences in North York, Ontario.

- Have a listen to relevant past episodes, eg. ⁠⁠⁠on the structural determinants of health⁠⁠⁠, trauma-informed care, and ⁠realizing the Truth and Reconciliation Commission’s health-related calls to action⁠.

Credits:

Additional music by Aleksey Voronin⁠, used under the ⁠⁠⁠⁠Pixabay content license⁠⁠⁠⁠.

Survey:

To help us make the best possible podcast, please consider filling out ⁠⁠⁠⁠this short, anonymous survey⁠⁠⁠⁠ after listening.

In this episode, host Sandra speaks to Dr. Eric Cattoni, a family physician and Medical Director at the Families In Recovery (FIR) Unit at BC Women’s Hospital. They discuss what’s unique about providing substance use care to people who are pregnant and postpartum and their families, as well as the elements of perinatal substance use care, like compassion and a trauma‑informed approach, that are relevant to any area of medicine — especially in the context of the toxic drug crisis.

Resources:

- Read more about “rooming in” and the evidence behind it in the BC Women’s Hospital Rooming-In Guideline (2020), in Abrahams et al. 2007 and Abrahams et al. 2010, and in the 2025 Canadian Pediatric Society statement referenced in the episode.

- Learn the basics of treatment for opioid use disorder during the perinatal period in the BC Centre on Substance Use’s 2017 Guideline Supplement and this toolkit on Mothering and Opioids from the Centre of Excellence for Women’s Health (CEWH).

- Dive deeper into the FIR model of care here: BC Women’s Hospital + Health Centre. (2020). FIR model of care. 

⁠- Consult the BC Government’s announcement on ending birth alerts: Government of British Columbia. (2019, September 16). Minister’s statement on ending ‘birth alerts’.⁠ Ministry of Children and Family Development. https://news.gov.bc.ca/releases/2019CFD0090-001775

- Brush up on Trauma-Informed Principles with this discussion guide from CEWH, and our past episode on ⁠⁠providing trauma-informed care⁠⁠.

Credits:

Additional music by Susana Cipriano, used under the ⁠⁠⁠Pixabay content license⁠⁠⁠.

Survey:

To help us make the best possible podcast, please consider filling out ⁠⁠⁠this short, anonymous survey⁠⁠⁠ after listening.

In this episode, host Sandra speaks to Dr. Gbolahan (GB) Olarewaju, a public health resident physician, academic activist, and past and inaugural chair of the Black Medical Students’ Association of Canada. They discuss how decades of discriminatory policies and practices have thrown up obstacles to the medical profession for Black folks – and how the efforts of Black learners and trainees and their allies are righting these wrongs.

Tune in as we delve into the history of medical violence against Black communities, and the role we all play in dismantling structural barriers to health and the health professions. 

Resources:

• Learn more about the history of medical violence against Black communities in Harriet A. Washington’s 2008 book, Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present.

• Familiarize yourself with the concept of race correction with this primer from the Canada-US Coalition to End "Race Correction" in Health Care and in Vyas, D. A., Eisenstein, L. G., and Jones, D. S. (2020). Hidden in plain sight — Reconsidering the use of race correction in clinical algorithms. NEJM, 383. 874-882.

• Review some papers about the health impacts of a demographically diverse health care workforce:

• Marrast, L. M., Zallman, L., Woolhandler, S. et al. (2014). Minority physicians’ role in the care of underserved patients. JAMA Internal Medicine, 174(2). 289-291.

• Greenwood, B. N., Hardeman, R. R., Huang, L., and Sojourner, A. (2020). Physician-patient racial concordance and disparities in birthing mortality. PNAS, 117(35), 21194-21200.

• Snyder, J. E., Upton, R. D., Hassett, T. C. et al. (2023). Black representation in the primary care physician workforce and its association with population life expectancy and mortality rates in the US. JAMA Network Open, 6(4). E236687.

• Watch Dr. GB’s keynote, “Progress and Protection: Intersectional Vigilance and Justice in Research and Advocacy”, given at 2024’s The Summit Conference.

• Read ‘The End of Diversity’ (2019) by Rinaldo Walcott, a critique of the language often used around equity and diversity, and a meditation on what true transformative change and structural justice could look like.

• Check out this list of Canadian anti-racism resources.

• Have a listen to relevant past episodes, eg. ⁠⁠on the structural determinants of health⁠⁠, and realizing the Truth and Reconciliation Commission’s health-related calls to action.

Credits:

Additional music by ScovinieBeatz, used under the ⁠⁠Pixabay content license⁠⁠.

Survey:

To help us make the best possible podcast, please consider filling out ⁠⁠this short, anonymous survey⁠⁠ after listening.