For Dr. Privia Randhawa, today is a homecoming of sorts.

It’s her first day back at the community wellness centre in Stellat’en First Nation, in northern B.C., where she works as a family doctor and UBC clinical instructor. Everyone is excited to see Dr. Randhawa — but the day carries special significance because, after being away on maternity leave, she has brought her daughter, Soha, with her.

In the centre reception, they’re embraced by staff, patients and members of the community who are eager to meet the new arrival. “It means so much to me to be here with my baby and my husband and always be welcomed with such kindness,” Dr. Randhawa says.

“When doctors and medical students come to work and train in our community, they become part of our family,” says centre health director Cynthia Munger. “Privia and her baby have a home away from home here with us. Soha will eat our traditional food and she’ll learn our culture and our ways. We’ll help raise her.”

“The medicine we get to practice here goes deeper, and I want the students to see that.”

– Dr. Privia Randhawa, UBC clinical faculty

Dr. Randhawa is one of two UBC clinical faculty members based part-time at the centre. She works alongside Dr. John Pawlovich, the Rural Doctors’ UBC Chair in Rural Health. Working closely with Stellat’en First Nation and Carrier Sekani Family Services (CSFS), they provide essential care to the community — and formative training to UBC medical students and resident doctors.

“Much of the learning the students do here, comes from the community and the patients themselves. They are the educators as much as we are, and that’s intentional,” says Dr. Pawlovich, or ‘Dr. John,’ as everyone calls him.

Together, they are giving future doctors the skills to provide meaningful, culturally safe care that puts the whole patient at the center of their practice.

Bringing together Indigenous ways of knowing and Western medicine

For Dr. Randhawa, who is originally from Surrey, the Stellat’en Community Wellness Centre isn’t just a home away from home. It’s where, as an MD student in the UBC Faculty of Medicine’s Northern Medical Program (NMP), she first realized she wanted to dedicate her career to rural and Indigenous family medicine.

“I visited Stellat’en for the first time with Dr. John, who has been working in the community for over 25 years. What I saw were these incredible doctor-patient relationships built on longstanding trust. I saw the difference that makes, and it was a lifechanging,” she says.

“With our Elders and our people, they need to know that they can talk and they’ll be listened to and understood in a non-judgmental way. And that doesn’t happen overnight.”

– Cynthia Munger, Health Manger, Stellat’en Community Wellness Centre

Now a seasoned physician with her own deep ties to the community, Dr. Randhawa brings UBC students and residents to the centre with that experience always in mind.

“The medicine we get to practice here goes deeper, and I want the students to see that. I know my patients, I know their kids, their parents, what’s going on in their lives. I probably know their family trees better than I know my own,” Dr. Randhawa says.

The Stellat’en is one of a number of First Nations communities across the North where UBC learners come to experience and better understand the challenges and opportunities of providing healthcare services in these unique settings. The community experience is delivered in partnership with CSFS, First Nations Health Authority and Northern Health.

But the Stellat’en Wellness Centre is more than a clinic. It’s a space where Western medicine and Indigenous ways of knowing complement and strengthen each other.

In addition to primary care, patients have access to traditional foods from the centre’s busy kitchen — vegetables and herbs grown on-site, as well as meat and fish caught locally in Stellat’en territory. Local healers provide traditional medicines made from the boiled bark of arbutus, balsam, birch and other native tree species.

“If you look at the rates of diabetes and chronic diseases in First Nations communities, it’s quite high. In the old days, there was no ultraprocessed food. We lived off the land and we were healthier,” says Cynthia Munger. “We’re moving back to that — everything we serve comes from the land. It’s traditional food as medicine.”

For first-time visitors, the experience can be eye-opening.

“Whether our students practice rural medicine or go on to become specialists in bigger cities, I think the experience makes them more compassionate caregivers for Indigenous and non-Indigenous patients alike.”

– Dr. John Pawlovich, Rural Doctors’ UBC Chair in Rural Health

“We learn about rural medicine and Indigenous health in our coursework,” says Polina Petlitsyna, a first-year NMP MD student who recently shadowed Dr. Pawlovich on patient visits in Stellat’en and Carrier Sekani communities futher north. “But coming here, I feel like the learning is so much more profound.”

Dr. Pawlovich agrees. “In medicine, cultural knowledge and the so-called ‘soft skills’ are as essential to good care as the technical ones. One of the most important things we can do is give trainee doctors the opportunity to deepen that knowledge and form longer-term relationships with patients and the community, here and in the other member nations of Carrier Sekani,” he says.

“With our Elders and our people, they need to know that they can talk and they’ll be listened to and understood in a non-judgmental way. And that doesn’t happen overnight. It’s all about cultural humility and trust,” Munger explains.

“Over time, the students get to see the incredible benefit of this, for the patients and for themselves as healthcare practitioners,” Dr. Pawlovich adds.

Relationships at the heart of innovation

This approach doesn’t just improve care. It has also sparked innovative projects like the Drone Transport Initiative, which uses drone technology to deliver medical supplies to remote and Indigenous communities faster than ever before, and Real-Time Virtual Support (RTVS). RTVS is an online service that connects physicians and other healthcare providers, and learners working and training in rural, remote and Indigenous communities with virtual emergency and specialist support — when and where they need it.

Both projects emerged from longstanding relationships with Indigenous partners.

“Without relationships and trust, none of this would be possible.”

– Dr. John Pawlovich

“In the case of RTVS, Carrier Sekani Family Services (CSFS) was doing telehealth and virtual care long before the RTVS program commenced. The Rural Coordination Centre of British Columbia — with support from partners including the First Nations Health Authority, Northern Health, the Ministry of Health, and UBC — scaled up that incredible work with the launch of RTVS in 2020. The learnings from the CSFS hybrid-care model significantly contributed to the development of the RTVS program.”

RTVS now brings specialist medical support to communities province-wide, while the Drone Transport Initiative, which recently completed its successful pilot phase, has similar ambitions.

“Without relationships and trust, none of this would be possible,” Dr. Pawlovich explains.

More compassionate caregivers

Leaving her baby in the care of a very happy colleague, Dr. Randhawa slips away down the hall to meet her first patient of the day.

The photographs that cover the walls — images of Stellat’en and its people over more than a century — are a daily reminder of the way that relationships and knowledge bind past and present, making the future possible.

For UBC clinical faculty, and especially those who work in remote communities, the connection is always front of mind.

“Whether our students stay and practice rural medicine, like Privia, or go on to become specialists in bigger cities, I think the experience makes them better, more compassionate caregivers — for Indigenous and non-Indigenous patients alike,” Dr. Pawlovich says.

“As Cynthia often says, talking is medicine. Listening is medicine. More than anything else, that’s the lesson I hope our learners take to heart,” says Dr. Randhawa.