The annual, rigorous competition to secure one of the 288 spots available for prospective physicians at the University of B.C.'s School of Medicine could fray the nerves of the coolest of customers.
But Peter Eppinga could not have been more relaxed as he faced an admissions committee with the potential to decide his entire professional future.
In a scene that would have been unthinkable not so long ago, Mr. Epping showed up for his interview wearing a cedar hat and a traditional Haida blanket, and those about to question him included a native elder, a Métis, a healer, and several aboriginal physicians.
"It's a whole different dynamic from sitting across from someone in a suit, who is kind of looking down at you," Mr. Eppinga recalled. "You're sitting there in your own skin, and you can express yourself the way that you wish. I felt very comfortable."
Bolstered as well by good marks, the medical school hopeful from Haida Gwaii received a green light from the special admissions committee, and last May, he was among a dozen natives – the most ever in a single year – to graduate from UBC's remarkably successful program to increase the province's supply of aboriginal physicians.
The program is on target to meet its original goal – graduating a total of 50 doctors by 2020 – six years early.
While there are no firm figures on how many graduates intend to remain in B.C. or return to their home base, early indications are promising. Aboriginal program co-ordinator James Andrew said he believes many plan to practice in or near their communities, pointing to Jennifer Parker, a Cree Métis raised in the Peace River region, who is in family practice in Fort St. John, with regular visits to outlying areas.
Buoyed by attending the program's 10th anniversary celebration last week, B.C.'s relatively new Health Minister, Margaret MacDiarmid, said she would like the province to do even more to encourage aboriginal graduates to stay.
"I realize there are still places struggling to find a physician, and we're looking at that," she said. "This is an area where we still have work to do."
Mr. Eppinga said he intends to spend about six months a year on Haida Gwaii after his residency training. Studies show that patients in native communities are more likely to follow the advice of aboriginal physicians, resulting in better health outcomes, he said.
"It is just that much easier if an aboriginal person is looking after their own people," Mr. Eppinga said. "We are going to make health 100 per cent better on reserves."
The Health Minister could not agree more. Her experience as a young medical student spending eight weeks in the native community of Bella Bella is seared in her memory.
"They had so many problems, it was a hard place to live," said Ms. MacDiarmid, a family physician. "I met some of the best people I've ever met in my life, but I felt inadequate. What did I know about where they came from, with the kind of background I had? I tried to talk to them about things like managing alcoholism, but why should they listen to me? I was just passing through, and they knew that."
UBC's medical school sets aside 14 places a year for aboriginal students, a decision that some initially resisted as a misguided affirmative action program that might lower standards.
As aboriginal students have graduated, passing the same examinations with the needed marks as all other medical students, such criticism has died away. The main difference in the road to their degree is extensive counselling and workshops by Mr. Andrew, the program co-ordinator, plus the special admissions committee, which interviews all aboriginal applicants.
"They wanted me to talk about my aboriginal heritage, and how I might mix Western medicine with the traditional knowledge of aboriginal people in B.C.," said Mr. Eppinga. "Their underlying message was: it's good to go back and give back to where I came from, and that's what I intend to do."
The university has yet to fill its annual aboriginal quota in any year, usually falling a few spots short. David Snadden, executive associate dean of education for UBC's medical faculty, said the low number of aboriginal students graduating from high school is a problem. "There's a lot of work for society to do there," he said.