SuperMori or SuperDoctor future indigenous medical graduates Papaarangi

Super-Māori or Super-Doctor - future indigenous medical graduates Papaarangi Reid LIME Connection II September 2007

Super-Māori or Super-Doctor When we envisage future indigenous doctors, who do we see?

Super-Māori or Super-Doctor When we envisage future indigenous doctors, who do we see? Super-Doctor or Super-Māori?

Super-Māori or Super-Doctor When we envisage future indigenous doctors, who do we see? Super-Doctor or Super-Māori? Or do we expect them to be both?

Super-Māori or Super-Doctor When we envisage future indigenous doctors, who do we see? Super-Doctor or Super-Māori? Or do we expect them to be both? Who qualifies as indigenous in our affirmative action admissions programmes?

Super-Māori or Super-Doctor When we envisage future indigenous doctors, who do we see? Super-Doctor or Super-Māori? Or do we expect them to be both? Who qualifies as indigenous in our affirmative action admissions programmes? Are the pathways into our programmes decolonised or liberated from our baggage?

Super-Māori or Super-Doctor When we envisage future indigenous doctors, who do we see? clinically safe

Super-Māori or Super-Doctor What do we mean by clinically safe? Do grades matter? “C”s get degrees Grades and engagement What do our communities need/deserve? Practice or practise.

Super-Māori or Super-Doctor When we envisage future indigenous doctors, who do we see? clinically safe culturally safe

Super-Māori or Super-Doctor What do we mean by culturally safe? • Noted a variety of words used • Noted a variety of definitions • How are we going to move forward? • Cultural safety from kawa whakaruruhau

Super-Māori or Super-Doctor What do we mean by culturally safe? • Recognises cultures – including the medical or nursing culture • Acknowledges who has power • Therefore who is the “agent of change” • What needs to change? • “Negotiate a space for the indigenous patient to heal or die peacefully” • Communicate with patient, establish relationship, ask, listen, negotiate.

Super-Māori or Super-Doctor What do we mean by culturally safe? • “Negotiate a space where the indigenous patient can heal or die peacefully” • Communicate with patient, establish relationship, ask, listen, negotiate, act • Depends on mature sense of self, understanding of power & professionalism • Depends on ability to be reflexive

Super-Māori or Super-Doctor However in a system • An agent of change is perceived as very powerful and potentially very dangerous • Especially one working to reduce systemic inequalities acting out on indigenous peoples • That is, a health worker who intentionally intervenes in the accrual of white privilege

Super-Māori or Super-Doctor Therefore a system that is designed and finely tuned to create and maintain white privilege, will not welcome cultural safety. Understandably cultural safety is being colonised and sanitised by health systems [including those we work for] to neutralise its ability to shift power. Colonised by name [competence, sensitivity], nature [self-reflexive] and intent

Super-Māori or Super-Doctor Therefore it remains important to hold fast to the vision of cultural safety and • define only what our institution can cope with • [rather than re-defining cultural safety] • And ….

Super-Māori or Super-Doctor And …. . train graduates to • Negotiate a space for their indigenous patients to heal or die peacefully • Communicate with patient, establish relationship, ask, listen, negotiate, act • Develop a mature sense of self, an understanding of power & professionalism • Develop the ability to be reflexive

Super-Māori or Super-Doctor When we envisage future indigenous doctors, who do we see? clinically safe culturally safe Cultural competency has raised the expectation that indigenous doctors be capable of leading and responding appropriately in a variety of indigenous cultural settings. Is this reasonable?

Super-Māori or Super-Doctor It will be difficult to achieve: 1. Student pathways into medical science 2. Difficult to do a conjoint degree Is there evidence of better health outcomes? [warm fuzzies are not enough]

Super-Māori or Super-Doctor Why do we want this outcome? - are we credentialing? - is it a hang-up from “real-Māori” racism? - are we being romantic – time-warped? Try to understand individual histories within colonial histories, judge the histories not individuals, promote rights and provide supportive pathways to re-engage Changing entry criteria at FMHS Uo. A

Super-Māori or Super-Doctor Finally • Indigenous graduate, or • Indigenous graduates Thinking beyond [super] individuals to cohorts of indigenous graduates who will have travelled important roads together, who will network through different regions and different specialities. Differences will be good.

Super-Māori or Super-Doctor So – of course it’s both [if possible] Otherwise a committed indigenous person who is fascinated with science, passionate about learning, engaged with their community and their own personal development, can reflect constructively on colonial events [macro and micro] and cope with stress. Commitment not involvement.