Building an Indigenous space in the College of Medicine

As of June 1, 2022, Tootoosis started in the role of interim vice-dean Indigenous Health. She is overseeing the creation of a new administrative body that oversees academic, research and community work in the area of Indigenous Health.

“My role is to ensure there’s an established foundation, effective operations, and leadership,” she said. “And to do the necessary groundwork to ensure the (new structure) becomes a reality.”

As a graduate of the college, Tootoosis completed the medical doctor program in 1999 and her residency in the family medicine program two years later.

After graduating, Tootoosis has taken on many roles in leadership and administration at the CoM since becoming a faculty member in 2003. These roles include becoming a clinical professor and a residency program director in North Battleford, where she is currently a family physician.

North Battleford is located approximately 50 kilometres from Tootoosis’ home community of Poundmaker First Nation.

She also has experience in governance, having been a founding member of the Saskatchewan Health Authority board of directors.

Tootoosis has the task of building a new administrative structure for Indigenous Health from scratch.

“The actual unit, whether it be a division, department, school or centre, is currently in an exploratory state," she said. Depending on the identified needs within the college, the structure of the new administrative unit may be labelled in a different way.

During her conversations with academics, researchers and community members, it became clear to Tootoosis that a division may not be large enough defined structure to address needs from an academic research and community perspective.

As a result of those conversations, she is exploring the possibility of creating a Department of Indigenous Health. By definition, a department is larger than a division and has different administrative responsibilities.

It would also be the first Department of Indigenous Health in Canada, she added.

 If a department is the administrative structure that Tootoosis and her team chooses to follow, it could potentially accommodate goals that extend beyond the college and university.

The functionalities of the new organization that the Indigenous Health Committee and leadership within the College of Medicine were hoping for, would be defined by how the new organization would be set up, she said.

“(Our) investigation is underway as to the best suited unit to achieve the overarching goals,” she added.

Establishing a Division of Indigenous Health, or an administrative home addressing Indigenous Health, is a direct response to one of the goals of the college’s current strategic plan.

In response to the Truth and Reconciliation Commission’s (TRC) Calls to Action report, establishing an administrative home within the College of Medicine helps provide a space to define and address the present and emerging health needs in Indigenous communities, which will lead to positive and improved outcomes in communities.

The new administrative home for Indigenous Health would be working alongside existing initiatives focusing on Indigenous health in the college, such as the Indigenous Health Committee (IHC).

IHC comprised of more than 30 faculty, staff and community members who are dedicated to Indigenous health.

IHC exists to strengthen culturally-based links between Indigenous world views and the medical community. The committee provides a number of services to the college, including:

• reviewing and vetting Indigenous curriculum through a community based approach
• working with Indigenous and non-Indigenous learners to provide unique experiential learning opportunities in Indigenous communities
• assistance in learning about Indigenous protocols, communities and Elders
• connecting faculty, staff and students with Indigenous communities for initiatives
• advocacy and other activities that enhance Indigenous health

As she is focused on what the new structure will look like, Tootoosis must also determine how it will serve the college and the community.

Academic and research work doesn’t happen in a silo by itself, Tootoosis said.

 A college and a university is responsible to the people and communities it serves – one of the pillars within the College of Medicine’s strategic plan.

Part of the College of Medicine’s vision and mission is to effectively serve and improve the health and well-being of the people of Saskatchewan, including Indigenous peoples. Indigenous peoples make up at least 16 per cent of the population in the province, according to Statistics Canada.

“How do we create a process for clinicians and academics to engage respectfully with the community in a standardized, structured way that is supportive to community as well as our university?” Tootoosis posed one of the outstanding questions the space is intended to answer.

Indigenous peoples face discrimination and challenges when interacting with Western healthcare systems. Indigenous Health research conducted at the College of Medicine ranges from making interactions with the health care system more culturally responsive and accessible, to working in direct consultation with Indigenous communities to identify how research can effectively address needs.

“There is good work happening already in Indigenous research,” Tootoosis said. “Modelling and scaling that (on a college level) is important. Highlighting individual discoveries (in research) is also important in this process.”

“At the end of the day, identifying what’s working well and supporting it, that’s important,” she added.

The new administrative home will need to meet a series of requirements in academia and research, and as defined by needs of the community.

“It’s very clear what academia needs are,” Tootoosis said. “It’s pretty clear from faculty, whether they’re clinical or academic, or both.”

“What the community wants, or needs, out of this (structure), that’s a little more challenging to create this concise picture,” she added. “It’s more challenging than on the university side, but still attainable.”

While new structure won’t solve every systemic problem regarding Indigenous health in the near future, Tootoosis hopes it will serve as a space for interdisciplinary research teams can work collaboratively to approach these discussions.

“Clinicians and academics, and faculty who are part of both groups, will be guided by an Advisory council of community members, representatives of the Indigenous communities of Saskatchewan,” Tootoosis said.

“The goal is ultimately creating a safe space for the good work of university faculty and community to thrive,” she added.

Tootoosis is aiming to have the new structure for Indigenous Health in the College of Medicine approved and operational by Spring 2023.

“I think any (administrative) unit needs to benefit the academics and the community, and I honestly believe (the new structure) can absolutely do both,” Tootoosis said.