Faces of U of T Medicine: Anna Jarvis
Wherever she trained, says Professor Emerita Anna Jarvis, it was a given that you reach out to those behind you and pull them along. And she has never stopped reaching out. Retired for seven years, Jarvis still teaches emergency life-support skills, participates in evaluative examinations and mentors current and future students at the University of Toronto’s Department of Paediatrics and The Hospital for Sick Children. Her 40-year career began with medical school in Jamaica, and later included a role establishing the specialties of emergency medicine and paediatric emergency medicine in Canada, followed by a decade as Director and Associate Dean Health Professions, Student Affairs at U of T. Jarvis, who received the Order of Ontario late last year, spoke with Faculty of Medicine writer Jim Oldfield about mentorship, her experience as a foreign-trained doctor in Canada and the challenges medical students of all stripes face in Canada today.
Why are you such an active mentor today?
This is my “pay back” for the many mentors who helped me along the way. Through my connections to local and international groups of learners who study in Toronto, I get approached with many questions. I’ll give you an example from the last lady who asked to meet with me. People who are the first in their family to go to university are often at a disadvantage. This woman was born in Canada, but her parents were immigrants. She speaks French and English, obtained an honours degree from U of T in a field appropriate for medicine and did volunteer and research work. She failed to get into a Canadian medical school. Thinking her marks weren’t high enough she applied for and completed a second B.Sc., not realizing it would have been better to complete a master’s. Nobody in her family or social circle could tell her, or refer her for appropriate advice, so she did not know.
What challenges do international medical graduates face in Canada?
When you learn medicine in one country and come to practise it in another, you’re also at a disadvantage. In some parts of the world, medical training is radically different — Japan and Germany, to take two examples. These are first-world, cutting edge medical systems.
In Japan, for cultural reasons, it’s not acceptable to have scars. Therefore, even small cuts on the face are usually referred to a surgical specialist. The result is medical trainees from Japan rarely do sutures, and when they arrive at U of T they need extra time getting up to speed in basic wound repair techniques in order to succeed in many specialties.
In Germany, there is a robust midwife system for delivery of care to healthy women in uncomplicated pregnancies. Many German trainees have little preparation to deal with pregnant teenagers — although they have great training in scientific methodology, developing a thesis, and so on. There are many examples like these. International learners are often highly motivated, brilliant people, but they’re trained differently.
Foreign-trained doctors who pass the required the tests here often find employment in medicine is elusive. Are we doing enough for them?
I worry that Canada is losing out on a great deal of intellectual potential. We hear about professionals from many fields who have come from another country and can’t find work here in their area of expertise, and this a problem in medicine. I’m also concerned that many slots for international grads are in family practice. If you are trained as a surgeon in Russia you’re likely not well-suited to being a family physician, and you probably won’t be satisfied or happy in that role. So the pathway to a medical position for that kind of specialist should not be through family medicine.
As well, many trainees arrive without a good sense of their job prospects, or without knowing they may have to spend years in a remote community on a “return of service” commitment. There is some onus on immigrants to learn their job prospects in advance, however Canada should do more to inform professionals before they are accepted to migrate to here.
How was your experience, coming to Canada as a foreign-trained doctor?
I trained at the University of West Indies, where the model was “straight out of high school to medical school” for a seven-year program. We completed an intense first year in biochemistry, zoology and physics, and if successful progressed to two years of preclinical studies, three clinical years then internship. I’d participated in some community research, but had no background in bench science. There were gaps in my knowledge, questions that didn’t occur to me and many cultural differences in medical practice were not fully appreciated. In the 1970’s no one in North America allowed a trial of labour after a caesarian section, a routine practice in Jamaica. The way patient consent was obtained was different. I was taught to speak to the whole family. Here patient privacy is sacrosanct and you don’t disclose to family without patient consent.
My first position at SickKids was on probation as my marks were seen as not strong enough. I didn't mind — many people who arrived in Canada at the same time failed to obtain positions and were unable to practice medicine. I feel very fortunate and grateful for the opportunities I’ve had here.
Faces of U of T Medicine introduces you to some of the interesting people studying in and working with the Faculty of Medicine. From advising political leaders to providing care to Toronto’s most vulnerable populations, our students and partners are impacting communities at home and around the world. Do you have an interesting story to share? Send us an email at firstname.lastname@example.org.
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Burnout, suicide, depression, and the emotional effects of mistakes. We address physician wellness in the next issue of UofTMed magazine, out May 23.Sign up for your free digital copy.