From language troubles to the female body, foreign doctors training in Canada can face challenges: study

2016/05/17 Leave a comment

Good overview of some of the challenges and discussion of whether better to be handled individually or through an orientation course (or both).

My experience during my various cancer treatments, dealing with a variety of  new Canadian doctors, was that language was sometimes an issue, manner generally less so:

It was one striking example of a culture clash the Alberta study suggests is common for graduates of foreign medical schools who do two-year family-medicine residencies here.

Some balk at being taught by female doctors, struggle with the nuances of English, use inappropriate body language, are uncomfortable with the mentally ill — or unfamiliar even with the concept of patient confidentiality, the researchers found.

Many of the “international medical graduates” (IMGs) also are highly educated, have rich cultural perspectives and strong characters, reported colleagues who were surveyed for the study.

But the authors say residency programs — whose on-the-job training is required to become a licensed doctor — should recognize the transition difficulties and incorporate “medico-cultural” education into their curriculums.

“In some countries, males look after males and females look after females,” said Olga Szafran, associate research director in the University of Alberta’s family-medicine department and the study’s lead author.

“(But) we can’t be selective in the kind of patients that our physicians end up treating. If you’re not familiar with the anatomy of the opposite sex, it’s very difficult to end up in the delivery room and deliver a baby.”

Canada relies heavily on IMGs, with graduates from medical schools outside North America making up about a quarter of practising physicians.

Universities here typically reserve a set number of residency spots for those foreign doctors, with the Edmonton faculty training about a dozen in family medicine a year, said Szafran.

Her study does not specify countries of origin, but the top five sources of IMGs countrywide in 2012 were South Africa, India, Libya, the U.S. and Pakistan, according to a Canadian Medical Association report.

The Alberta team admit their research was “qualitative,” not an empirical study with statistically significant results. They conducted interviews or held focus groups with the doctors who supervise family medicine trainees, with nurses and other health professionals who work alongside them and with both Canadian and international residents.

IMGs are an important part of the system, not least because they help serve an increasingly multicultural patient population, said Szafran. But she said the study subjects were consistent in outlining an array of challenges they face.

The combination of thick accents and difficulties with the subtleties of English can undermine communication with patients, which “makes life difficult and diagnosis difficult and affects everything,” one physician-trainer told the researchers.

The linguistic barrier can be exacerbated by different types of body language — like refusing to make eye contact with patients, or invading their personal space.

Some have a more direct style of talking to patients. A Canadian resident recalled a foreign colleague telling someone: “ ‘You’re fat, that’s why your joints suck,’ and the patient started to cry because nobody says that stuff here.”

Participants in the study reported IMGs unfamiliar with common mental-health conditions like depression, addiction, anxiety and panic attacks — problems that patients never sought medical help for in their home countries.

The mix of genders is also an issue, with some foreign graduates refusing to shake hands with patients of the opposite sex, or recognizing that a female doctor could have authority over them, the paper noted. “They tend to walk over you a bit, and you have to stand your ground and push back and just remind them about gender equality,” one female physician told the researchers.

Foreign graduates often make “stellar” doctors, but some of the Alberta study’s findings do sound familiar, said the head of Canada’s biggest family-medicine program.

Dr. David White, interim chair of the University of Toronto’s department, recalled a highly motivated, hard-working and likeable male medical graduate from southwest Asia — who had never treated women or children.

It left him with “knowledge gaps you could drive a truck through,” but White said such shortcomings can be relatively easily fixed by, for instance, teaching how to conduct a pelvic exam.

More difficult, he said, is to unlearn the mindset of a different medical culture. White cited a resident from a central Asian republic who had the doctor-knows-best attitude long since discouraged in Canada, and “a very reserved approach that did not come across as very empathic or warm.”

But White questioned whether formal cross-cultural training is necessary. So long as teachers understand the challenges faced by IMGs, such issues can be addressed on an individual basis, he argued.

Source: From language troubles to the female body, foreign doctors training in Canada can face challenges: study | National Post

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In Homogeneous South Korea, A Multicultural Village Hints At Change

2016/05/17 Leave a comment

Interesting article on change in South Korea:

“There is real immigration going on that is supported, facilitated, advocated by the South Korean government,” says Katharine Moon, the SK Korea Chair at the Brookings Institution. Her research focuses on the impact of a changing Korean population.

Immigration is a fairly new concept in South Korea, where foreigners make up only about 3 percent of the population. Bars and restaurants can ban non-Koreans from entry because no anti-discrimination laws exist. Foreign workers in Korea are subjected to mandatory HIV testing.

“It has been a homogeneous society linguistically, culturally, for so long. It has prided itself on the purity of the bloodline, the so-called bloodline,” Moon says. But because the birthrate has fallen to such low levels — South Korea has the lowest fertility rate among developed nations — immigration policies are changing. Government figures show the number of foreign residents living in South Korea climbed by about 50 percent between 2009 and 2014. Moon says attitudes will take a little longer to adjust.

“Right now, [integration] is about fitting into the Korean context, learning Korean language and not teaching your kids Vietnamese or Tagalog or some other foreign language,” Moon says. “True multiculturalism would involve mixing and blending and fusing of different languages, cultures, customs. We don’t see much of that — except in places like Wongok Village.”

A food stall in South Korea's Wongok Village sells Chinese flatbreads and other snacks popular in China. Two-thirds of Wongok's residents are not ethnically Korean, and many of them are from China.i

A food stall in South Korea’s Wongok Village sells Chinese flatbreads and other snacks popular in China. Two-thirds of Wongok’s residents are not ethnically Korean, and many of them are from China. Elise Hu/NPR

Outside, on what’s known as “Multicultural Street,” people from different backgrounds mix. In front of the banks, there are signs in four or five different languages. Food stalls sell a lot of Chinese food, and there are Chinese markets and Chinese karaoke joints. You can hear Vietnamese as you walk up and down the streets.

“[There are] job opportunities here because there’s a lot of factories. And you know, in every place where there’s electricity, there’s work opportunity,” says Eugene Okoye, who came to Wongok four years ago from Nigeria to run a clothing export business.

As more people like Okoye seek opportunities in Wongok, their kids fill the classrooms of teachers like Kim. She says the children have taught her about dropping prejudices.

“Multicultural people are people that Koreans have to work together with to make Korea into a better country,” she says. “Wongok Village is what Korea will look like in the future.”

Source: In Homogeneous South Korea, A Multicultural Village Hints At Change : Parallels : NPR

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U.K. girls learn about female genital mutilation before danger of ‘cutting season’ 

2016/05/17 Leave a comment

Likely an issue in Canada as well:

She teaches the types of FGM, how children can contact international organizations for help, and how to avoid getting on a plane to leave the country if they suspect they’re going for FGM.

“There’s one trick, called spoon-in-knickers,” Wardere says. “You can put something metal in your underwear when you’re going to the airport and [the detector] will sound. Everyone working in the airport is trained that if with an underage child, the detector goes off, you need to take them on the side, find out what’s going on.”

Wardere says what’s most important about what she does is making children aware of FGM and then sending them home to discuss it with their parents.

“For the first time,” she says, “that conversation is happening.”

Ali also teaches about FGM and talks about her experience. She recently returned from the Women of the World festival in Karachi, Pakistan. She says she’s received threats for sharing her story, “mostly from men.” She says people will come right up and tell her to her face.

“Just because I was talking about my own experience and something that’s happened to me, they were like, ‘F—  you’ and ‘You’re selling out to the white people’ and I just kept saying: ‘No. Actually, I’m talking about feminism and I’m talking about women’s rights.'”

Wardere also felt resistance. At first.

“Sometimes communities don’t know who is for them and who is against them,” she says. “Even if you come from that community itself. They need time to adjust and you know, figure out who you are, and then respect you and then let you in.”

Source: U.K. girls learn about female genital mutilation before danger of ‘cutting season’ – World – CBC News

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Diversity In Canadian Literature Is Long Overdue #DiverseCanLit | Jael Richardson

2016/05/17 Leave a comment

One of the things that I always found interesting is the number of Canadian authors of diverse backgrounds (e.g., Ondaatje, Vassanji, Hill, Hage) and how that enriched Canada. Richardson argues not enough and has organized this upcoming event aims to address that:

In 2014, I met with Scholastic Book Buyer Leonicka Valcius. She was doing important work on social media via the hashtag #DiverseCanLit. She was passionate about increasing the representation of people of colour in the industry. She was also interested in dismantling literary elitism — pushing against the hierarchy that places literary fiction in the upper echelon of worthy reading and leaves genres like graphic novels, science fiction, speculative fiction, crime novels and romance novels on the literary worthiness periphery.

Together, we made plans to kickoff the first Festival of Literary Diversity in May 2016.

In our first planning meeting, our small team of three talked about where we might host the festival. Toronto is so dense — literary events happen throughout the city year-round, the literary scene is vibrant — supporting numerous long-standing series and events. In the suburbs, reading series are not as common. Many readers have never been to a literary festival or a reading, and many suburban and rural writers I know feel disconnected from the action.

Brampton is one of Canada’s youngest cities. It is amongst the most diverse cities in the country. The downtown core is easily accessible from Union Station and close to the airport. It was the perfect place for the FOLD.

But Brampton was also a risk. It’s considered to be a “bedroom community” by some — a place where residents sleep, but not a place where they go to enjoy life or work. And while the population is large and the downtown core boasts great accessible venues, the FOLD would be the city’s first major event.

So while the Festival of Literary Diversity will serve as a necessary addition to Canada’s literary landscape, it will also play an important role in Brampton’s growth and development. Backed by a committed planning team and a supportive board of directors — as well as significant municipal and provincial funding — the first festival is set to welcome over 40 authors, spoken word artists and literary professionals for a three-day event on May 6 to 8, delivering more than 30 sessions for readers and writers from all walks of life in historic, downtown Brampton.

Our hope is that the FOLD will benefit readers and writers across Canada — showcasing voices they may not otherwise encounter, highlighting topics and discussions that will evoke thought-provoking conversations which will have a positive impact on Canada’s literary arts scene for years to come.

Source: Diversity In Canadian Literature Is Long Overdue | Jael Richardson

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Sadiq Khan and the Future of Europe: Mehdi Hasan

2016/05/16 Leave a comment

Mehdi Hasan on Sadiq Khan’s election, contrasting multiculturalism and integration in Britain and other European countries:

Mr. Khan’s resounding victory was a stinging rebuke to the peddlers of prejudice. Here is a Muslim who prays and fasts and has gone on the hajj to Mecca. But he sees no contradiction in being a card-carrying liberal, too. As a member of Parliament, he voted — despite death threats from Islamist extremists — in favor of same-sex marriage and he campaigned to save a local pub in his constituency from closure. He has pledged to serve as a “feminist mayor” of London and made his first public appearance after the election at a Holocaust memorial service.

The capital, admittedly, is a city apart — diverse, immigrant-friendly and home to around four in 10 of England’s 2.6 million Muslims. But even outside London, the more relaxed and tolerant British model of multiculturalism has done a far superior job of integrating, even embracing, religious and racial diversity than the more muscular, assimilationist models in Continental Europe.

While Angela Merkel and Nicolas Sarkozy have declared multiculturalism a failure, the truth is that their countries, Germany and France, have never tried it. As Tariq Modood, the author of “Still Not Easy Being British,” writes, multiculturalism is the “political accommodation of difference.” For the French, however, difference has never even been tolerated, much less accommodated. In contrast, British-style multiculturalism has treated integration, as even David Cameron conceded almost a decade ago, as “a two-way street” and never required, in the words of Will Kymlicka, the author of “Multicultural Odysseys,” that “prior identities” must “be relinquished” in order to build a national identity.

Is it surprising that polls find that British Muslims are more patriotic and take more pride in their national identity than their non-Muslim counterparts and studies show that ethnic and religious segregation in Britain is either steady or in decline?

That isn’t to deny the problems. Britain’s Muslims tend to have the highest unemployment, worst health and fewest educational qualifications of any faith community. But this likely has more to do with a history of racism than it does with an unwillingness to integrate. A 2013 study found that Muslim men in Britain were up to 76 percent less likely to get a job offer than Christian men of the same age holding similar qualifications, while Muslim women were 65 percent less likely to be employed than Christian women.

The situation, then, is far from perfect, but there is a good reason that British Muslims look across the English Channel and breathe a sigh of collective relief.

Source: Sadiq Khan and the Future of Europe – The New York Times

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How and Why You Diversify Colleges – The New York Times

2016/05/16 Leave a comment

Frank Bruni on the efforts by USA elite colleges to broaden socioeconomic diversity of their student populations:

The socioeconomic diversity at elite colleges is hardly the most vital concern about higher education. These colleges serve a small fraction of the country’s students.

But that diversity is important nonetheless. It’s a mirror of our values — in particular, of how well we own up to stacked decks and how willing we are to make adjustments.

Amherst is an exemplar of such adjustments. It’s tweaking campus operations to recognize that some less affluent students stick around during breaks. It’s marshaling extra resources so students from low-income families can take on the sorts of unpaid internships and research opportunities that other students do.

I mentioned community colleges before: About 10 years ago, Amherst took just seven transfers from those schools. It has taken 34 in each of the last two years.

The college’s president told me that one of her current passions is to admit more military veterans, who bring to the campus abilities, experiences and outlooks that other students don’t possess.

She wasn’t talking about doing them a kindness. She wasn’t outlining a social experiment or anything gimmicky. She was embracing the reality that real learning and a real preparation for citizenship demand the intersection of different life stories and different sensibilities. Colleges should be making that happen.

Source: How and Why You Diversify Colleges – The New York Times

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For Muslim women in Canada, a sense of vulnerability: Sheema Khan

2016/05/16 Leave a comment

Sheema Khan focuses on gender differences in analysis of the recent Environics Institute survey:

The recent Environics Institute survey of Muslims in Canada reveals a community that belies facile stereotypes – no more so than when you analyze the results along gender lines.

For example, the survey (for which I served as an unpaid consultant) found that fewer Muslim women share the optimism about Canada felt by their male counterparts. And while both groups believe that their Muslim and Canadian identities are very important, when asked to choose between the two, women choose their Muslim identity at a far higher rate. As a corollary, fewer women than men believe that immigrants should set aside their cultural backgrounds and try to blend into Canadian culture. Furthermore, more female immigrants have indicated that their attachment to Islam has increased since moving to Canada.

The survey, based on telephone interviews with 600 Muslims across the country, also provides an interesting snapshot of gender-based attitudes toward community institutions. For example, only 33 per cent of Muslim women attend a mosque at least once a week for prayer, compared with 62 per cent of men. The lack of female attendance is not surprising, given that many mosques do little to encourage female participation. Interestingly, a core of about 20 per cent of women (and men) is unhappy with opportunities for women to play leadership roles in Muslim organizations. This could provide the basis for an unmosqued movement, or the creation of women’s mosques.

 When it comes to family life, a whopping 90 per cent of Muslim men and women believe the responsibility for caring for the home and children should be shared equally. However, more men believe that the father must be the master in the home, placing the Muslim level of support for family patriarchy roughly equal to that of Canadians in the 1980s. However, today’s younger Muslim generation rejects patriarchy at roughly the same level as that of other Canadians.

Muslim women are less optimistic about relations with non-Muslims than men are, the survey found. A greater number worry about the reaction of Canadians toward Muslims, believing that the next generation of Muslims will face more discrimination. They are also more concerned about media portrayal of Muslims, and stereotyping by colleagues and neighbours.

It seems the crux of the matter lies in discrimination, as 42 per cent of Muslim women (compared with 27 per cent of men) say they have experienced some form of discrimination or ill-treatment during the past five years. Such incidents occurred mainly in public places – stores, restaurants, banks, public transit. Of women who experienced xenophobia, 60 per cent said they are identifiably Muslim. This ratio is reversed among the 25 per cent of Muslim women who experience difficulties at border crossings. As a result, women worry far more about discrimination, unemployment and Islamophobia than men.

The discrimination concerns are real, as illustrated by employment statistics from the 2011 National Household Survey, in which the unemployment rate of Muslims was 14 per cent, compared with the national average of 7.8 per cent, despite Muslims having high levels of education. The unemployment rate was highest in Quebec (17 per cent), which was double the provincial average. In comparison, the national unemployment rate of visible minorities hovered around 10 per cent.

Even Canadian-born Muslims, who graduated from a Canadian institution, fared worse than the national average, with an unemployment rate of 9.5 per cent. One can only imagine the difficulties in finding employment for the 60,000 Muslim women who head a single-parent household.

Clearly, Muslim women feel more vulnerable about the future, given that they bear a greater brunt of discrimination than their male counterparts.

Source: For Muslim women in Canada, a sense of vulnerability – The Globe and Mail

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Sweden’s rape crisis isn’t what it seems: Saunders

2016/05/16 Leave a comment

Doug Saunders provides the needed nuancing regarding Sweden and refugees:

But aren’t refugees and immigrants responsible for a greater share of Sweden’s sexual assaults?

In a sense. Statistics show that the foreign-born in Sweden, as in most European countries, do have a higher rate of criminal charges than the native-born, in everything from shoplifting to murder (though not enough to affect the crime rate by more than a tiny margin). The opposite is true in North America, where immigrants have lower-than-average crime rates.

Why the difference? Because people who go to Sweden are poorer, and crime rates are mostly a product not of ethnicity but of class. In a 2013 analysis of 63,000 Swedish residents, Prof. Sarnecki and his colleagues found that 75 per cent of the difference in foreign-born crime is accounted for by income and neighbourhood, both indicators of poverty. Among the Swedish-born children of immigrants, the crime rate falls in half (and is almost entirely concentrated in lesser property crimes) and is 100-per-cent attributable to class – they are no more likely to commit crimes, including rape, than ethnic Swedes of the same family income.

What also stands out is that almost all the victims of these crimes – especially sex crimes – are also foreign-born. But for a handful of headline-grabbing atrocities, it isn’t a case of swarthy men preying on white women, but of Sweden’s system turning refugees into victims of crime.

That is the real Swedish crisis. Refugee shelters are terrible, dangerous places, whoever is in them. When such shelters, then known as displaced persons camps, held millions of Europeans in the 1940s and 1950s, histories show they were at risk of sexual predation and organized attacks against Jewish refugees.

Because otherwise generous Sweden doesn’t allow refugees to seek work until they know the language, tens of thousands of people are stuck in these awful places, in similar conditions, or in welfare-dependent netherworlds.

There they become victims of violent crime, victims of economic exclusion and victims of a grotesque, viral story that portrays them as predators, entirely because of their skin colour.

Source: Sweden’s rape crisis isn’t what it seems – The Globe and Mail

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Hollywood Studios Targeted by Feds in Gender Bias Investigation – The Daily Beast

2016/05/14 Leave a comment

Interesting to see how it turns out:

As much as powerful female voices in Hollywood like Patricia Arquette have helped bring national awareness to the industry’s alleged gender bias, Maria Giese, one of the women directors interviewed by the EOCC [Equal Employment Opportunity Commission], deserves credit for helping to spearhead the investigation.

Giese began working on the issue at the end of 2011, when she met with the Directors Guild of America.

“The DGA fought me so ferociously and were so hostile to the activist efforts I was making inside the guild to increase hiring of women directors,” she told The Daily Beast. “I realized there was a huge conflict of interest—here was a union run by a vast majority of male members pretending to have an interest in hiring mandates of women when they own the lion’s share of the pie.”

She first met with the ACLU in February 2013, and again in April and May, and explained why the issue was so significant and how they could possibly mitigate it, either by coming up with solutions to take legal actions themselves or by getting the EEOC involved.

She had previously met with the EEOC and said that they were more interested in a single woman filing a lawsuit with smoking gun evidence against a studio than in getting involved themselves. She now believes that government involvement is the only way to affect real change.

Very few women directors have been as vociferously critical of the industry as Giese, who admits she has essentially sacrificed her career in doing so.

“I knew I would risk getting blacklisted in an industry that is run on personal relationships,” she said. “But I hadn’t been able to get any work for a very long time and I felt I had nothing left to lose.”

 There are only a handful of women directors who have achieved enormous success in Hollywood, most notably Kathryn Bigelow. Giese said that roughly 4 percent of studio features are directed by women, and nearly 100 percent of those women are movie stars, pop stars, or relatives of movie moguls (Angelina Jolie, Drew Barrymore, Sofia Coppola, and Jodie Foster, to name a few).

“There’s no guarantees that this investigation will amount to any change, and that puts women directors and allies of women directors in a precarious position if they choose to speak out right now,” said another female director who asked to remain anonymous.

If the EEOC found evidence of widespread discrimination in Hollywood, they could potentially sue studios or seek to negotiate a solution that would increase their hiring of women in various roles.

Source: Hollywood Studios Targeted by Feds in Gender Bias Investigation – The Daily Beast

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Toronto school [Thorncliffe Park] offers sanitized sex-ed amid parent concern

2016/05/14 1 Comment

Seems like an accommodation that preserves the essence of the curriculum while addressing parental sensitivities:

An alternative to Ontario’s updated health curriculum is being offered by the Toronto elementary school that found itself at the centre of the sex-education controversy — with Grade 1 students having the option to learn about “private parts” instead of proper names for genitalia.

Thorncliffe Park Principal Jeff Crane said because a number of parents had concerns about their children being taught the words penis and vagina, the school decided to offer a class where teachers covered the key issue of inappropriate touching without being specific about body parts, a move meant to keep kids in school this week and at least learn some of the curriculum.

About 60 per cent of the 300 students in that grade were taught the proper curriculum, the remaining 40 per cent the sanitized version.

“We let parents know ahead of time when the health strands for human development were being taught and, for Grade 1, that there would be one lesson where there would be discussion of body parts … They were told if learning the names of genitalia was a concern, they could write me a letter requesting a religious accommodation,” said Crane, whose school is located in the riding represented by Premier Kathleen Wynne, who championed the updated health curriculum.

Parents were told “the lesson would be exactly the same, but instead of using proper terms like penis and vagina, we would use the term ‘private parts.’ The key learning in that expectation is that this is a part of your body always covered with clothes, nobody touches it and you don’t show anybody. We were able to maintain the integrity of the expectation with a very simple accommodation.”

Last September, Thorncliffe Park school was hit by protests — which saw hundreds of children pulled out of school because of the sex-ed curriculum — where parents set up their own classes in the adjacent park. Even weeks later, when that protest ended, enrolment remained lower than expected. But now, it has rebounded and sits at 1,310 students, down from the projected 1,350.

Crane said he held 20 sessions with more than 650 parents to go over the curriculum and to counter misinformation circulating in the community, which has a large Muslim population.

He said he expects to offer modified lessons to students in Grades 4 and 5, when puberty and menstruation are among the topics covered.

Source: Toronto school offers sanitized sex-ed amid parent concern | Toronto Star

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