Barriers and Facilitators of Minorities in Research and Medicine

by Nadia Boachie and Laura Best

What do you want to be when you grow up? It’s a common question; one that, you too, were likely asked. Perhaps you dreamt of becoming a physician or architect, an astronaut or an accountant – one day obtaining an education based in science, technology, engineering or mathematics (STEM). Or, perhaps, because of factors unrelated to your intelligence, abilities or work ethic, these career options seemed impossible.

Despite increasing efforts among STEM fields to increase accessibility for Black, Indigenous and People of Colour (BIPOC), systemic barriers exist that prevent BIPOC from entering and succeeding in STEM careers. However, 2020 has illuminated some of the issues that prevent minority groups from entering STEM fields, as well as the detrimental impact that excluding certain groups of people can have on the overall success of these fields.

Diversity in science refers to cultivating talent and promoting the full inclusion of excellence across the social spectrum.

Dr. Kenneth Gibbs, Jr. (Scientific American, 2014)

Consider the journey for a student through the Ontario education system. As early as elementary school there are signs that children from minority groups are not treated equally. Not only does this affect their wellbeing, but also their future. Though institutions try to tackle the lack of diversity in STEM fields at the post-secondary level, deeply rooted biases and systemic barriers exist in early education systems that prevent BIPOC from pursuing STEM fields.

Combatting these barriers is Dr. Chika Oriuwa, a recent graduate and valedictorian of the University of Toronto (U of T) Medical Class of 2020. Recently, IMS Magazine had the pleasure of sitting down with her to discuss her experiences. Dr. Oriuwa is black, a child of immigrant Nigerian parents, and a prominent advocate for diversity and inclusion in medical education and beyond. She feels that “when you have a more culturally and ethnically diverse class, you’re really providing better health care to the community that you’re servicing.” 

Dr. Oriuwa identified issues that likely prevented many of her peers from following the same career path as she. “It was long before medical school [when] I realized that there was racial inequity in regard to who was even pursuing science and who wasn’t,” Dr. Oriuwa explains. “As far back as elementary school, you start to pick up on the fact that black students are often placed into academic streams below their capability” she further explains.  Despite her secondary school being one of the more culturally and racially diverse institutions that she attended, Dr. Oriuwa recalls the impacts of academic streams were still evident. “There were definitely less black students in my sciences, mathematics, my calculus, chemistry, biology courses – things that would prepare you for an undergraduate degree in some kind of science field,” she explained.

It was announced this July that Ontario plans to end streaming. This practice, where high-school students were required to choose the pursuit of an “academic” or “applied” track, has been criticized for pigeonholing a disproportionate number of black and disadvantaged students. Education Minister, Stephen Lecce, says the province’s math curriculum will be the first to be de-streamed as of September 2021. Research has shown that racialized groups or people of low-income households are often forced into non-academic streams which, in turn, affects graduation rates and future employment prospects.1 Implicit biases cause educators to discourage students from pursuing STEM-based paths, which are often based on wrongly perceived capabilities of these students. By eliminating stream-based learning, Ontario’s education may finally align with the rest of the country and remove one facet of inequity that was built into the education system.

As far back as elementary school, you start to pick up on the fact that black students are often placed into academic streams below their capability.

Dr. Chika Oriuwa

Upon attending the Health Sciences Program at McMaster University, Dr. Oriuwa once again noticed the lack of diversity: “I was the only black student in my year of program and that was quite jarring… what I found was that so many students that were in the Health Science Program actually came from private schools or they came from extremely affluent backgrounds.” Too often, university classes, including those in medical schools, are not reflective of the socioeconomic and racial diversity present in society. The number of black and Indigenous medical students and doctors has been historically much lower than what is representative of the general population. The black population is about 4.7 percent of Ontario’s population,2 but the Black Physicians’ Association of Ontario estimates that black physicians make up about 1 to 1.3 per cent of the physician population.3 In 2016, Dr. Oriuwa was the only black medical student in a class of approximately 260.4  “It is profound – there are so many factors that go into why we don’t see a lot of black individuals in these higher academic, ivory tower-type situations,” says Dr. Oriuwa. Socioeconomic status and destabilization of families due to higher rates of caregiver incarceration for example, are disproportionately higher in minority groups, and are known to impact child wellbeing.5

Universities are trying to address this gap at the post-secondary level. U of T has introduced an application stream and support systems for BIPOC students. The Black Student Application Program (BSAP), a program that Dr. Oriuwa is “exceptionally passionate about”, aims to “break down some of the barriers that might impede black students from applying, and nurture an inclusive environment that is welcoming to all”.6 This year, twenty-four black students, the largest group in Canadian history, were admitted to the University of Toronto’s faculty of medicine. This represents the potential for change, despite a myriad of early-life barriers remaining to be addressed. Dr. Oriuwa also highlights mentorship as an important resource to support BIPOC and economically disadvantaged students. The Community of Support is one such initiative offered by the U of T Faculty of Medicine. It longitudinally supports BIPOC and economically disadvantaged students through preparation and applying for medical school.7 Overall, however, when asked about inequities in both education and health outcomes, Dr. Oriuwa feels that “we need to take a proactive approach [about] how we’re going to deal with anti-blackness and anti-indigeneity. Everything else will kind of just be a band-aid solution.”

The insufficient solutions to academic barriers earlier in life, results in a lack diversity among medical professionals downstream.  This lack of diversity amongst doctors and researchers can lead to poorer health outcomes among minority groups. Black people’s health and access to care is affected because of the racist environment in which they live and, similar to the experiences of Indigenous peoples, racism during interactions with medical professionals.8 One suggestion to improve health outcomes in racialized patients is race-matching. This is the idea that patients treated by doctors of the same race have better outcomes. While race matching may help improve patient outcomes, and some studies have found this to be true,10 it still does not address the underlying socio-economic reasons that racialized groups tend to have disproportionately worse health outcomes.

Similarly, there is strong evidence of a gap in medical research pertaining to minority groups.  The omission of health data about racialized groups like black Canadians can be life threatening. One study showed that although black Canadians are the third largest minority group in the country, researchers could find only 23 studies pertaining to breast cancer, cervical cancer and black Canadian women within the last 15 years. In addition, black women could be predisposed to worse outcomes from these diseases.9 Collecting racialized data in healthcare and acknowledging inequities forces investigation of the underlying cause. 

In the last few months, the world has witnessed thousands of people marching in streets across North American in solidarity with the Black Lives Matter movement. There has been a dramatic increase in civil protests of unjust treatment of BIPOC. Though inequities and barriers have existed for centuries, discussion around this topic has most definitely increased. As such, it is our duty, as academics from all walks of life, to come together to try and unlearn centuries of systemic racism that has inhibited the success of racialized groups in STEM.

This is the first article in the new IMS Magazine Diversity in Science Feature. Check out future issues for more discussion on diversity in science.  


  2. Stats Canada (2016)