Author: yipeng

(Letter was delivered electronically via email to the AFMC on December 29, 2023, with minor grammatical and formatting errors corrected below)

Dear AFMC senior leadership and board of directors,

I am writing to you today to express my deep concern for possible bias, discrimination, and racism manifesting itself as interference in the fairness of the Canadian residency program selection and matching process.

Over a week ago, CBC News reported on the censorship acts and attempts occurring in Canadian workplaces and schools for people expressing concern for the health and human rights of Palestinians during the conflict in Israel and Palestine. There were many instances and cases of concern reported in this article, but I will focus on the screenshot of a post from a closed physician group that had “compiled a list of 271 medical students who signed an open letter calling for a ceasefire and an end to targeting health-care facilities and workers in Gaza”, with the “stated intention to share this list with program directors ahead of residency interviews”.

As you know, the practice of medicine of caring for patients and communities, is inherently political through acknowledging and addressing the root causes of disease and suffering.

It was in the first few days and weeks of medical school that I learned about Dr. Rudolf Virchow, a German physician who is known as ‘the father of modern pathology’ and as the founder of social medicine. He is often quoted, that “medicine is a social science, and politics is nothing else but medicine on a large scale”. He goes on to say “medicine, as a social science, as the science of human beings, has the obligation to point out problems and to attempt their theoretical solution: the politician, the practical anthropologist, must find the means for their actual solution. The physicians are the natural attorneys of the poor, and social problems fall to a large extent within their jurisdiction”.

It is for these exact sentiments outlined by Dr. Virchow in the 19^th century, that I chose to study and practice public health and preventive medicine – a field of practice that considers the root causes of the social determinants of health, including that of colonization. We know this all too well in the Canadian context with reports from the Truth and Reconciliation Commission of Canada and its Calls to Action. Health advocacy for Palestinians fits within this scope of drawing attention to the root causes of poor health outcomes as a consequence of war, conflict, and occupation. Medical students are now being systematically targeted for their solidarity. This is so incredibly wrong, and must not stand. These deliberate attempts to punish and discriminate against medical students who have chosen to take a position on advocating for health and human rights for Palestinians must not be punished – they must be supported and protected. Political health advocacy and solidarity do not affect clinical competency. To assume and question such a thing says more about the person making such an accusation out of a place of bias and racism.

Your organization’s statement against discrimination states that as an institution you collectively “stand against racial discrimination as well as all other forms of discrimination” and that you are “committed to working with health partners to ensure that our environments are diverse, inclusive, culturally safe and foster equity”, and that you will “implement institutional change and lead in addressing systemic racism through education and curricular innovation, research and advocacy for equity, diversity and inclusiveness”. However, these are the exact times that matter for action, commitment, and change. So please act and exercise your leadership with the urgency that is required to reassure, protect, and support medical learners from discrimination.

I am aware that your organization has shared a statement, that the “AFMC takes the integrity of the national resident match very seriously” and has provided information to “reinforce this commitment to our students, residents, and faculty”. As someone that has participated in the residency match process as an interviewee, file reviewer, and interviewer, this information with multiple reminders for postgraduate deans and program directors is in large part not new. The reminder that “no external lists, data, or letters may be shared, disseminated, or utilized at any stage in the resident selection process”, appears to be in response to the concerns brought forward by the CBC News report. However, I am troubled and worried that this statement and information alone are insufficient.

The organization, Canadians for Justice and Peace in the Middle East (CJPME), has provided a list of demands, that I think are reasonable. Please see the following:

1. Conducting an investigation into allegations of physicians and CaRMS selection committee members attempting to introduce bias into the CaRMS process,
2. Ensuring that faculty involved with the Facebook group posts are identified and excluded from the CaRMS interview process and selection decisions,
3. Statements from CaRMS, Faculties of Medicine, and program directors across the country to reassure applicants and the public that the residency matching process is fair and free from organized political targeting.

Furthermore, the group Health Workers Alliance for Palestine (HAP), has also provided a list of demands, that I too agree with. Please see the following:

1. An independent investigation into the allegations of physicians and physician groups attempting to introduce bias into the CaRMS process.
2. Ensure all faculty involved with the Facebook group posts reported by the CBC are identified and any actions against residency program applicants are mitigated.
3. Faculty involved with the Facebook group should be recused from the residency match process.
4. Public statements from CaRMS, Faculties of Medicine, and program directors across the country asserting that the residency matching process is fair and free from organized political targeting.
5. Ensure applications for learners targeted by these efforts are reassessed by impartial faculty and residents.
6. Outlining a clear appeals process for trainees who feel their match results may have been affected by these actions.

I strongly believe that anything short of these commitments is a failure of your leadership and organization to protect and support prospective candidates by ensuring that undue political influence may not compromise the integrity of the residency match process. I have already heard from medical learners who have expressed concern that their residency program interview invitations have been affected and compromised because of their solidarity for Palestine, and with the CBC News report feel even more strongly that this is the case.

I look forward to hearing from you at your earliest convenience, on this time sensitive matter.

Sincerely,

Yipeng Ge, MPH MD CCFP (he/him)
PGY4 Public Health and Preventive Medicine Resident Physician

(Letter was delivered electronically via email to the CMA Board of Directors on December 21, 2023)

Dear CMA Board of Directors,

It is with much disappointment that I am writing to you today to share that I have made the difficult decision to resign as a director of the board. I am writing to you from the traditional, unceded, and unsurrendered territory of the Anishinaabe Algonquin people.

In October 2023, I shared social media posts pertaining to the most recent outbreak of violence in Israel and Palestine, using Instagram to draw attention to the humanitarian crisis unfolding in Gaza. I did this in solidarity with the Palestinian people and in the context of my support for their rights to self-determination and struggle for human rights and dignities. My social media statements were founded in anti-racism and respect for international human rights to health equity.

In early November 2023, a physician colleague shared my social media posts publicly on multiple platforms, misrepresenting them in ways I consider highly inflammatory. This physician also shared my posts with CMA leadership.

Unfortunately, my posts have been given an interpretation that is not supported either by their context or plain meaning. I have done my best to share my perspective. Context and intent are important to consider when the phrase “From the River to the Sea: Palestine will be Free” is referenced. The inability to hold multiple truths and interpretations of this phrase at the same time is deeply concerning for me. As is the lack of critical insight and reflection on the harm done upon Palestinian, Arab, Muslim, and allied colleagues in the medical profession by listening, upholding, and valuing one interpretation of the 10-word phrase over another. This pattern of bias, discrimination, and racism must stop.

I acknowledge that there were reasonable opportunities to find a path forward together, but ultimately the attempts to repair the harm that I experienced from the CMA leadership were unsuccessful. My relationship with the organization has become untenable and irreparable, leaving me with no choice but to resign.

Criticism of the actions of Israeli governments is not antisemitic. Criticizing Zionism as a nationalist ideology is not antisemitic. Nor is expressing support for a future in which Palestinians and Israelis can live in equality. We all benefit when we are all freer. 

The persistently negative way in which my social media posts have been painted causes further division and represents an attempt to silence appropriate and much needed dialogue on the ongoing genocide in Gaza. This experience, I have come to learn, is a manifestation of anti-Palestinian racism – repression that silences, excludes, erases, stereotypes, defames or dehumanizes Palestinians or their narratives.

As a clinician and public health professional that has dedicated my career to health equity and tackling the social determinants of health, I take criticisms of my integrity and character very seriously. Reflecting on my identity as a Chinese-Canadian who benefits from the settler colonial state of Canada, I continue to reckon with how my understandings, work, and actions reflect the values and principles that guide me on my own journey of anti-racism. We will all make missteps and mistakes along the way, and acknowledging harm when it has been experienced by others is important to heal and repair relationships. There is an important difference between engaging in dialogue that is hard or uncomfortable and that of abusive or harmful speech. However, we should not shy away from difficult conversations or silence certain voices as we risk avoiding the necessary work of anti-racism at both an individual and institutional level. With that said, I do not condone or support hate speech, prejudice or intolerance against any religion or groups of peoples and communities; and I unequivocally condemn antisemitism, Islamophobia, and anti-Palestinian racism.

I have substantial concerns related to the actions of the CMA leadership that has created an unsafe environment for me on the board as the sole resident board director – only one of two medical learners on the board. I experienced bullying, harassment, and intimidation from multiple people within CMA leadership related to these posts. Instead of being first and foremost being seen as a “human being”, I was being managed as a “risk” to the organization. I believe what I have experienced is a failure of the CMA leadership to meaningfully reflect on the role that anti-Palestinian racism has played in its response to my social media posts. Similar reprisals are happening to so many others in academic institutions and workplaces, including healthcare organizations, across Canada.

The CMA has taken a stance they consider “neutral” in the face of ongoing Israeli apartheid and genocide. This is unacceptable to me. I cannot in good conscience remain a board director that upholds the primary purpose of being a “key enabler and champion of CMA mission and vision”. This is an impossible situation for me to be in. Being neutral in the face of structural oppression and settler colonialism, is taking the side of the oppressor. I refuse to be a bystander and cannot in good conscience support the CMA as it continues to be a bystander on this human rights issue.

Now more than ever, we need opportunities to bridge divides, find common ground, and lead with compassion and humility for learning and growth. As health professionals, we require environments that at a bare minimum are brave spaces where respectful but sometimes challenging dialogue can take place for this kind of mutual learning and growth to happen so that we can create the conditions for collective and organizational change. It is an extremely difficult and emotional time, and what I have experienced and seen is a lot of emotional reacting rather than mindfully responding to one another.

I am struggling to find medical leadership that reflects the moral courage and moral clarity that we need in times like these. The work of equity, diversity, and inclusion means very little if organizations like the CMA fail to protect and support their medical learners when situations like this occur. It also means very little if we remain silent on the humanitarian and public health crisis unfolding in Gaza, including stopping short of demanding for a ceasefire and a stop to the unacceptable attacks on healthcare workers, patients, and infrastructure.

We need to lead with humility, patience, and kindness for others and ourselves. This is what I have practiced in responding to CMA leadership. I will continue to do what I know is right, and work to learn and grow through respectful dialogue with others. I am hopeful in knowing that I am not alone – there are so many that are choosing to stand with moral courage and clarity. We need more of such people in this world despite the challenges they face. I am so proud and grateful to know some of them and to call them my trusted and respected friends and family.

Best wishes,

Yipeng Ge