Advancing Health Equity Through Indigenous Health Education: Gaps in Implementation and Accountability in Canada
Srishti Sharma, Kaden Hill, Meelad Saber, Sawayra Owais and Patricia Farrugia*
ABSTRACT
Indigenous peoples in Canada experience persistent health inequities driven by colonial legacies and systemic barriers. The Truth and Reconciliation Commission’s Call to Action #24 calls on medical schools to integrate Indigenous health, cultural safety, and anti-racism into curricula. We conducted a scoping review to examine how Canadian undergraduate medical education has responded since 2015. MEDLINE, Scopus, and Informit were searched from inception to March 2026. Data were extracted and analyzed using qualitative thematic synthesis, guided by cultural safety and decolonizing frameworks. Nine peer-reviewed studies met inclusion criteria, with gray literature used for contextualization. Three key themes emerged: (1) structural integration supported by institutional commitment and longitudinal curriculum design; (2) a shift from cultural competence toward cultural safety, emphasizing reflexivity, power awareness, and anti-racism; and (3) community-engaged experiential learning grounded in relational and decolonizing approaches. Canadian undergraduate medical education has made progress in integrating Indigenous health, but efforts remain uneven. The primary challenge is not the absence of Indigenous health content, but gaps between implementation and institutional accountability. These findings have implications beyond medical education, as gaps in training may contribute to persistent inequities in healthcare delivery and outcomes for Indigenous populations, with relevance to other settler-colonial and global health contexts.
