With International Women’s Day here in a couple of days, I thought I’d focus this week’s blog post on Lauren McKeon’s terrific book on what’s ailing feminism.
Although I started calling myself a feminist when I was 13, I confess that my commitment to doing so has wavered over the years. Not because my belief in principles like equal pay and reproductive rights has faltered, but because my willingness to embrace the movement that champions these values has sometimes been shaken by feelings of exclusion.
Maybe that’s why I enjoyed reading The F Bomb: Dispatches from the War on Feminism (Goose Lane, 2017). Author Lauren McKeon (class of 2017) writes passionately and compassionately about some of the concerns women like me have had over the years with feminism as a movement. I’ve always believed that changing the world begins with understanding our opponents, yet I often feel dismissed for saying we need to understand people who I think are clearly on the wrong side. I suspect those who dismiss me (and sometimes “unfriend” me on social media) think I’m saying we need to have compassion for them when what I’m really saying is we need to comprehend where they’re coming from (compassion optional). History’s best generals know you can’t fight a war without having respect for and insight into the way your enemy thinks. In political circles, it’s called “oppo research.”
The F Bomb is incredibly well researched and intelligently written. Its arguments are organized to build from a simple question — where is feminism failing? — to a beautifully argued conclusion. It’s also a perfect vehicle for McKeon’s award-winning journalistic chops. Here’s a sample from the epilogue:
As we wade further into the opposing but jointly skyrocketing feminist and anti-feminist movements, I hope we can learn to listen more to the other side. I don’t exactly mean we should have a tea party with Hitler, Mussolini, and, oh heck, even Trump. Crumpets, tea, and fascism! But I do believe we have to let go of our liberal superiority, the belief that clearly reprehensible views aren’t powerful enough to gain mass traction. We’ve seen they obviously are. It means acknowledging that people who we don’t think have any right to be unhappy—the white middle class mainly—are miserable, hurting. What’s worse, they believe the cause of their pain is the policies of the left. Unless we understand why, it will be impossible to counteract and confront the ripple effect of damage that pain has caused. We can’t fight what we so arrogantly ignore. …
I believe it is possible, still, to fight with compassion and humility. Not just possible, actually, but essential. At its heart, feminism is not about making your life better and more equitable; it’s about making everyone’s lives better. … We must embrace criticism and change. We must live our politic. We must make some fucking room.
To my mind, McKeon hits squarely on a remedy not just for what can make feminism more welcoming for people who often feel they just don’t belong but for what’s ailing so much in the world today. And this is even truer as I write now, as Donald Trump is a couple of astonishing months into his second term as US president, than it was when The F Bomb was published a few months into his first term. If we can’t understand the people who elected him, how can we ever hope to reach them?
I wanted to respond to this column by The Globe and Mail health columnist André Picard last week—a bit off topic for my blog but not for me personally, as will become clear.
My son is a pediatrician. He graduated from St. George’s University School of Medicine in Grenada. There are many stereotypes about doctors coming out of Caribbean schools being less qualified than those trained in Canada. They are false. All doctors working in Canada must demonstrate the same capacity by passing stiff exams at each of four stages: entrance into medical school, entrance into residency, entrance into the profession, and board certification.
A candidate who fails at any one of these stages may not go onto the next and may therefore not qualify to practice medicine in Canada. Candidates who were educated, trained, and have worked in countries where the medical system is significantly different than our own must undergo rigorous education and training to practice up to the standards that make Canada’s medical system globally enviable. But in terms of qualifications, these candidates are not the same as candidates who were educated and trained in systems that may operate on a slightly different model but produce physicians that are equally as qualified as those who attend Canadian medical schools.
I can’t speak to medical schools in England, Ireland, and Australia, where the quality of medical care is similar to ours in Canada. I can only speak to what I know about as a result of the fact that my son attended a Caribbean school, a school that has overcome significant prejudice to become a prestigious medical school in its own right.
So, what’s the educational difference for physicians who graduate from a medical school in Canada or one in the Caribbean?*
First, it’s important to note that medical schools operating in the Caribbean are, for all intents and purposes, USian schools. Students do their first two years at campuses in the West Indies, where the cost of building, operating, and maintaining a medical school is lower than in the US or Canada. They then go onto internships, their first shot at hands-on practice under the strict guidance of experienced physicians, at USian hospitals, where the standards of care are very similar to our standards in Canada.
So, what’s the difference that gets students from basic sciences through internships to graduation and residencies (the second stage of hands-on practice)? It’s basically that Canadian and Caribbean schools use a different operating model, as do medical schools that operate within the geographical US.
In Canada and the geographical US, a student’s credentials for admission to medical school must be the crème de la crème of each year’s pool of applicants. But as Canadian and US-based medical schools operate on a pass-fail basis, once a candidate has been accepted, it’s unusual for them to flunk out.
And the overall credentials for any pool of applicants are influenced by more than quality. For example, the makeup of a particular graduating class might be heavily influenced by economic conditions at the time they applied. This was the case, for example, during the 2008 recession, when jobs were so scarce that people in many fields were accepting positions well below their qualifications and at lesser pay than they might have been offered months earlier (I knew some of them).
At that time, many young people went back to school to improve their qualifications. (I was working in international education at the time and had direct knowledge of this.) Suddenly, for reasons having nothing to do with their qualifications, the pools of candidates increased, and many applicants didn’t make it into schools that might have accepted them just months earlier.
I don’t know if Caribbean schools experienced a bumper crop of applicants at that time, but it would make sense that they did because of their operating model. To gain entrance, one must pass the same rigorous exam as is the basic requirement for all students, but other entrance qualifications may not be as stringent. For example, a student might have just barely passed their exam, might have less volunteer experience in their application, or might not have done as well in the interview.
Does that mean students graduating from these schools are less qualified than those graduating from Canadian schools? Not at all. Caribbean schools operate on a model that accepts students from around the world whose entrance qualifications may be lower than required by Canadian schools. But then, unlike in Canadian schools where it’s near-impossible to flunk out, their progress is graded at every turn.
This gives the students an opportunity to improve on any deficiencies in their entrance requirements and repeatedly show that they deserve their spot in the school. It also contributes to a very high attrition rate, which can top out at around 60%.
This is not cheap for students. At the time my son completed his education, the cost was $400,000 USD, easily four times higher than a Canadian school. And students who flunk out don’t get a refund on what they’ve paid for their year.
The most-qualified applicants are offered significant scholarships to encourage them to attend. However, given the schools’ global focus, the largest scholarships typically go to students from majority world** countries who couldn’t otherwise afford to attend but who will take their education back to their home countries to improve life there—a fair system if I’ve ever heard of one.
After finishing their two years of basic sciences, students complete their internships at hospitals in the US. In contrast to students who attend Canadian or US-based schools, this gives them an opportunity to do part of their internships at different hospitals, working under different doctors and different systems and exposing them to a wide range of perspectives, which I see as a bonus to this system.
In other words, students who make it through the rigorous program of studies at Caribbean-based schools are at least as qualified as students who attend school at a Canadian or US-based medical school, if not in some ways more so.
Yet the column I linked to at the beginning of this post was titled “International med school graduates are an untapped resource, as well as a complex challenge.” In it, Picard writes:
“It’s important to note that there are two types of IMGs. The first are Canadians who study medicine abroad in places like Grenada, Ireland and Australia, usually because they weren’t accepted to Canadian schools. They argue they have a “constitutional right” to compete for residency spots on an equal footing with Canadian grads if they pass Canadian exams.
“The second type of IMGs are those educated in other countries who emigrate to Canada. If they do so before residency, they have little chance of getting a spot. (The exception is grads from countries like Saudi Arabia, who “buy” residency spots but must return home after training – a topic for another day.)
“We limit the number of doctors we train because money isn’t unlimited. We already have 97,384 physicians in Canada, and spend $32.5-billion annually paying them. Rationing is a reality.
“If we want more doctors, then one avenue is to open more residency spots for IMGs. A report last year from a group of independent senators recommended adding 750 spots, essentially doubling the current number.
“Of the group of IMGs who have trained and worked in other countries before emigrating to Canada, some of them could start work tomorrow while others do not have the appropriate qualifications. The challenge for regulators is to figure out who’s who.
“The path to practice has many hurdles: demonstrating you graduated from a legitimate medical school, having your credentials verified, passing Canadian exams, showing competency in English, having your competency tested and finding a job.”
I agree that ensuring the IMGs who lived, trained, and worked in other countries before coming to Canada must be carefully vetted before working as physicians in Canada, and doing so can be complicated. But when it comes to Canadian students who simply went overseas to train in systems that operate on a slightly different model but graduate physicians who are equally as qualified as those who study at Canadian schools, as demonstrated by the rigorous screening they must go through before practising in Canada, I fail to see the challenge. As the first link in the above quote (to SOCASMA, the Society of Canadians Studying Medicine Abroad) notes:
“Currently, provincial Ministries of Health allow Canadian medical schools to control selection for entry level training jobs called medical residencies. Canadian medical schools have used this power to exclude qualified Canadians from competing against their graduates for these positions.
“Canadians who have studied medicine anywhere but Canada and the U.S.A. are prohibited from competing against their peers who graduated from Canadian and American medical schools. They can only compete in the IMG (international medical graduate) stream, and only if they agree to enter into return of service contracts. The IMG stream is a very limited opportunity stream.
“In British Columbia, only 4 out of 65 medical disciplines are available to Canadians who have international medical degrees despite passing the national medical knowledge and clinical skills exams.
“Canadians, who choose to study overseas, and other international medical graduates, are treated as second class citizens when it comes to competing for positions in one of the most prestigious callings in Canada. The two-class system of medical residency selection currently in place is an affront to the fabric of Canadian society. This type of class system feeds the growth of a culture of entitlement and it feeds prejudice, both of which are destructive to a free and democratic society. It also prevents Canada from hiring the most qualified Canadian physicians. This impacts access to health care and the quality of health care for all Canadians.”
The blocks to this stream of IMGs practising in Canada are, to avoid mincing words, stupid. At a time when 6.5 million Canadians lack access to a physician, the rules and regulations that categorize Canadian graduates of fully accredited medical schools abroad along with physicians who graduated from medical schools that cannot hold their own in the Canadian system are, not to put too fine a point on it, stupid.
I fully understand and agree with the need to ensure physicians practising in Canada are qualified to practice at a level commensurate with our own graduates. But the existing system miscategorizes graduates of a system where the only differences are that a) Canadian students study outside our borders, b) students who under perform can flunk out at any stage of the game, and c) students pay for the full cost of their education themselves rather than having it subsidized by Canadian taxpayers.
This creates disadvantages that affect all of us. It needs to change. 6.5 million Canadians who don’t have a physician of their own can’t afford for it not to change.
(*There may be other differences between schools in Canada and other countries, such as Ireland or the UK. For example, some countries do not require doctors to complete an undergraduate degree before applying to medical school, as we do in Canada, but admit students directly from secondary school into a pre-med program and from there into medical school.)
(**I prefer the terms majority world and minority world countries to value-laden terms like firstworld and third world or developed/industrial world and developing world.Majority and minority world reflect the reality that the world’s wealth is concentrated in the pockets of the minority populations of a few countries, while the majority of the world lives in poverty that most of us in countries like Canada and US can’t even imagine. I like the way these terms, which I first encountered in a magazine called The New Internationalist and which I highly recommend, force people to stop and think about what’s really going on in the world.)
I wrote this piece years ago about the impact the December 6 massacre had on my life. It was published in The Ottawa Citizen on December 4, 1993, just four years after the massacre. Although there are a few things I’d change or add, for the most part it still resonates, so I thought I’d share it today on the anniversary of the 1989 massacre of 14 women at École Polytechnique.
One night a few years ago I lay frightened in bed. Someone in the parking lot was throwing something repeatedly at my window. While my rational side felt it was just a friendly prank, my mother-bear instinct told me to restrain my curious three-year-old from going to look. What if more than a mischievous smile came through the window, but a brick—or worse?
I’d seen a news feature on violence against women that night. Two weeks earlier, I’d wept over the death of my dog, a Doberman that had provided me with comfort and security for nine years.
During that time, I had almost forgotten the menacing possibilities of unexplained creaks and groans in the floor boards of an aging home. For the first time in years, I remembered what it was like to feel unsafe in my own bed. My little girl curled up to me and said, “Mommy, I wish Blue didn’t die. I wish Daddy was home.”
My children’s father is by no means perfect, but like an increasing number of his peers, he has decided that respect for others and ongoing self-examination should be a cornerstone of his life. Here is a man who is light years beyond “helping out.” He does his share. When I wanted a home birth, he trusted my instinct. When he heard a disc jockey make light of “Take Back the Night” activities, he registered his complaint with the station management.
That night, I agreed with my daughter. I wished her Daddy was home.
The wish, and the fear, lasted only moments. The lock rattled. The front door opened. Footsteps mounted the darkened stairs. A mans’ form paused outside my half-open bedroom door before pushing it open.
“Hi honey, I’m home,” my husband whispered. “Didn’t you hear me throwing things at the window?”
It was the night of Dec. 6, the second anniversary of Marc Lepine’s massacre of 14 women, and the first national day of memorial to female victims of male violence.
“I got lots of comments on my white ribbon today,” he said. “The women were pleased to see it. A couple of the guys wished they’d thought of it. I was surprised how many of the kids knew what it meant. Did anyone comment on yours?”
Heart still racing, I replied no, no one had taken notice.
We live in a word in which property ownership is wealth and wealth is power; in which 80 per cent of the work, paid or unpaid, is done by women, while 99 per cent of the property is owned by men; in which men have the ability to exert both fiscal and physical power over women; in which Marc Lepine is far from alone in instilling fear in women because of his choice to abuse that power.
In this work, it is incumbent upon me to understand life through the eyes of men like my father, who, though never abusive, believed and acted as if he was superior to my mother; men like the ones who abused me as a child, an adolescent, and a woman; even men, like my husband, who strive to behave differently, but don’t always know how.
There is no parallel requisite for them to see the world through my eyes.
My husband’s actions that night are illustrative. He requires neither physical, emotional, nor fiscal superiority over me in order to feel masculine. While he wishes that the economic value of children-rearing was recognized, he respects its intrinsic value as much as if I received remuneration. He does not silently tolerate sexist remarks.
On that December evening, this man committed an act of awareness: He wore a white ribbon. Then he came home and committed an act of unawareness.
Acting aware is a good first step. But for my husband to be aware of what it is to be a woman in 20th-century North America, he must find a way to experience the fear that I live with every day. The panic to which I’ve grown accustomed through years of practice. The heart-quickening anxiety I feel when a guy in a muscle car slows down to take a better look, when heavy footsteps quicken behind me on an empty street, when a stranger—or even a neighbour—knocks on my door in the middle of an evening when I’m home alone, not even a dog to keep me company.
As I lay frightened in bed that night a few years ago, I reviewed my choices: Stay put or go look. If I looked, I knew I’d probably see a friendly smile; or I might be confronted by a man reminded by that evening’s newscasts of his anger at women. If I stayed put, I could be teaching fear to my daughter; or I could be assured that I was protecting the two of us from anger that strikes enough ordinary Canadian women to fill a room in the time it takes to watch a Schwarzenegger video.
If I looked, I might later hear a police officer, doctor or judge berating me for taking unnecessary chances, for assuming that my own home could protect me and my young children from harm. If I stayed put, I could hear the voice in my own head chastising me for consenting to live my life in fear.
Being aware of every move, every minute is the reality of the world through women’s eyes. It is a reality I try daily to share with my husband, one he must find a way to learn and share with other men if it is to change in his little girl’s lifetime. It’s the reason that men like him, who start by wearing white ribbons on Dec. 6, must not stop there.
It’s why Dec. 6 will never again be just another day.
I remember when Pauline Dakin gave her pitch to the class of 2015. We were the inaugural class of the MFA in Creative Nonfiction program at University of King’s College. That meant that everything that first year was a bit of an experiment, with about 20 of us as very willing, very excited lab rats. We’d arrived on a Sunday in August, spent a day getting oriented, and thereafter went into our mentor groups for three hours every morning and whole-group sessions in the afternoons. We started our pitches on the second or third afternoon.
I was intimidated by my classmates. I was a nobody who’d done a dozen years of freelance journalism, much of it for magazines no one had heard of, followed by a dozen years of communications for small not-for-profits, overlapping with a dozen years of copy editing. The rest of the class included a reporter from CBC’s The National, a former assistant editor of Chatelaine, a published novelist on staff at The Walrus, and a graduate of UBC’s esteemed BFA in Creative Writing—writers who were way out of my league.
Pauline was one of them. A long-time health reporter with CBC Radio, she pitched a timely and well-researched idea about the health impacts of screen time on the growing brains of children and youth. It would have made a timely and interesting book. But then she said she had another idea. She’d been toying with it for quite a while, but she wasn’t sure.
Finally, she shared the story of her unusual childhood. As she spoke, the room fell still and silent. After she finished, someone said something like, “I-I really like your first idea but, but your second idea¾wow! Yeah, uh, do that one.”
Pauline might have been the first of us to get a book deal, the result being the bestselling Run, Hide, Repeat: A Memoir of a Fugitive Childhood (Viking, 2017, 2022). The book flap says: “Pauline Dakin spent her childhood on the run. Without warning, her mother twice uprooted her and her brother, moving thousands of miles away from family and friends. Disturbing events interrupt their outwardly normal life: break-ins, car thefts, even physical attacks on a family friend. Many years later, her mother finally revealed they’d been running from the Mafia and were receiving protection from a covert anti-organized crime task force.
“But the truth was even more bizarre. Gradually, Dakin’s fears give way to suspicion. She puts her journalistic training to work and discovers that the Mafia threat was actually an elaborate web of lies. As she revisits her past, Dakin discovers the human capacity for betrayal and deception, and the power of love to forgive.”
Run, Hide, Repeat is the kind of page-turner you stay awake half the night to finish, all the more compelling because every word is true. Winner of the 2018 Edna Staebler Award for Creative Non-Fiction and shortlisted for several other awards, Run, Hide, Repeat was re-released in 2022 to coincide with its launch as a five-part CBC podcast.
Recalling that afternoon pitch session for an article on cbc.ca about the podcast, Pauline says “I did my big pitch [on the impact of screen time on children and adolescents] and everyone nodded. And then, I just stood there. I didn’t know this was coming; I said, ‘Can I pitch you another story?’ … I just told this group of strangers and I was just trembling as I told it. Of course, I finished and they were all looking at me with eyes as big as pie plates going, ‘yeah you should write that one!’
“Even then … I didn’t dive right in. I waffled back and forth over two years about which book I was writing. Ultimately, this was the one. I am so glad I did because I think the act of telling the secret, of being loud about the secret, undid some of the damage of the secret. … Eventually I came to feel that not holding secrets lets you let go. It’s the secrets that are so toxic.”
Books can have such amazing ability to challenge the way you think, make you feel things you didn’t know you could feel, teach you things you never dreamed of learning. Run, Hide, Repeat is the epitome of all that. A powerful book, and I’m proud to number the author among my friends.
