Structural Reporting

We acknowledge that there are structural barriers and inequities that can be found in policies, curriculum, and admissions/selections processes in medicine which have, over centuries, created privilege for some while marginalizing others within our clinical and learning environments. This has resulted in very visible underrepresentation of Indigenous, Black and Filipino people in medicine, in addition to people who experience lower socio-economic status, sexual and gender minorities, minoritized faith groups, and people with disabilities, among other groups.

We are committed to acknowledging and addressing social and medical practices that reproduce existing power structures and contribute to inequities. Examples of historically unchallenged structural practices include:

the lack of images portraying Black and Brown skin in Dermatology lectures,
the framing of race – rather than racism – as a determinant of health,
the use of male mannequins in CPR simulations without reference to performing CPR on patients with breasts or patients experiencing pregnancy,
a requirement of the controversial clinical diagnosis of Gender Dysphoria for individuals identifying as trans or non-binary to access gender-affirming care,
treating disability as a medical condition rather than as a social construct emanating from an "unaccommodating and oppressive society",
and the use of non-representative patient panels to speak to learners about patient experiences.

These are just a few examples of the ways that medical education and clinical practice risk eroding our commitment to Human Rights.

Our Temerty Faculty of Medicine Academic Strategic Plan (2018-2023) emphasizes an ecosystem of collaboration and excellence through equity. Specifically, the Faculty’s commitment to excellence through equity highlights that individuals across Temerty Medicine, regardless of how they identify, are invited to have a voice and be empowered to effect change.

The change we seek must be informed by anti-racist, anti-oppressive, and inclusivity principles and practices, which must involve a collaborative approach that is open to change, and that consistently strives to create and maintain respectful and culturally safe learning and work environments.

These principles and practices are supported by the Ontario Human Rights Code, the Faculty’s Diversity Statement, as well as by the University of Toronto’s Statement on Equity, Diversity and Excellence and the Statement on Human Rights.

If you identify a structural issue that you wish to bring to our attention, we encourage you to disclose this through some of our existing pathways including, but not limited to:

Other opportunities to report include:

Course, rotation, and teaching evaluations
“Voices” surveys

Some additional avenues are:

Program Leaders, including Academy Directors, Foundations Director, Clerkship Director, or Course Directors
Med Soc Vice Presidents of Learner Affairs; Equity, Diversity & Inclusion; Education; or Med Soc Class Presidents
Course representatives
Representatives of various committees (Foundations, Clerkship, Curriculum)
Residency and Fellowship Program Leaders, including Program Directors, Site Directors, Vice Chairs of Education, Program or Departmental Wellness Leads, Program or Departmental EDI Leads
Rotation Supervisors
Chief Residents, Senior Residents

We encourage and support all to speak up if there are ways that we can improve our environment. Only by doing so can we all belong.