Award-winning medical student and her family physician mom share their medical school experiences in Q&A
Ashley Monture, who is Mohawk and Cree, is in her final year of medical school at the University of Manitoba. In 2023 Ashley won the Foundation for Advancing Family Medicine (FAFM)’s Indigenous Medical Student Scholarship, which is supported by MD Financial Management and Scotiabank.
Dr. Marlyn Cook, CCFP, is a First Nations family physician from Misipawistik Cree Nation. Dr. Cook is the first First Nations woman to graduate from the University of Manitoba, has worked across Canada in rural and remote northern communities, and is Ashley’s mother.
Dr. Mandy Buss, CCFP, is a Métis family physician, President of the Indigenous Physicians Association of Canada, and a member of the College of Family Physicians of Canada’s Indigenous Health Committee.
In this piece, Dr. Buss interviews the mother and daughter to learn more about their experiences and their passion for family medicine.
Ashley, how did you start on the path to medical school?
Ashley: A lot of it has to do with what I was exposed to when I moved around with my mom. Some of my earliest memories are tagging along with her and wanting to help when she was with patients. There’s one story she tells about a patient who came in with chest pain. I had taken off and when they found me, the patient was leaning over the side of the bed, letting me look in his ears.
Marlyn: I walk in and he’s leaning right over on the stretcher and she’s on the little step stool with the otoscope and looking in his ear.
Ashley: We were living in Moose Factory, Ontario, when I started considering medical school more seriously. So, I left the community and mom when I was 16 to attend a boarding school on the outskirts of Toronto.
How has your experience been in medical school so far, Ashley?
The first few years were difficult. It was a big transition and I struggled with imposter syndrome and questioning if I belonged. At the same time, I met a lot of great people, made a lot of good friends, and we helped each other through all of it.
Marlyn, how did your community help support you as an Indigenous family physician?
I’m a single mom, so I had a lot of help from people in the community—she was basically raised at the nursing station. Ashley knew the joy of practising medicine in the north because you get to do so much, be involved, help people as much as you can.
Historically, the Indian Act prohibited First Nations people from entering university to become doctors unless they gave up their First Nations identity. There are few Indigenous parent and child doctors. What are your thoughts about being a second-generation doctor, Ashley?
When my mom was in medical school, it was just her and two others. Seeing a second generation is pretty amazing. One of my classmates, who is Métis, their mom is also a physician, and in the class behind me, there’s another Indigenous parent-daughter pair. It’s something we will hopefully see more and it shows we can succeed here, and we do belong and deserve to be in this program, too.
Ashley, what did it mean to enter medical school with a parent who is an Indigenous doctor?
It was helpful. When things came up or I had questions, I could ask my mom about it. But I was able to talk to her, not only as my mom, but as a colleague. There was some pressure at the same time, especially when people realized who my mom was. I remember one doctor giving a tour of medical school and said, “this is Dr. Cook’s daughter and she has big shoes to fill.”
Marlyn, how did you feel about your daughter going into medical school?
I was scared for her. If you were not obviously Indigenous, you had an easier time. I remember when I was a medical student, the head of nephrology was talking about a patient who was dying and he said, “and the whole bloody tribe is there.” I didn’t like the way that conversation was going, so I let him know and he screamed at me in front of the other students. There were so many incidents like that, the obvious racism. And I knew it still was there, so I was scared. I also knew it would be a lot of hard work.
Ashley, how did this impact your decision to enter medicine?
It made me consider if this was something I wanted to do or if it was because it was what I was exposed to the most growing up. Mom prepared me for what going through medical school is like, what it’s like working as a doctor in a community. I was able to take all of that and decide for myself that this is something I wanted to do.
Marlyn, do you see any similarities between what you went through in medical school and what Ashley is going through now?
Racism is still there. I think we have come some distance from when I was there because the faculty of medicine, staff, they were used to having things a certain way and now the younger students and general people are speaking up more. Also, Ashley grew up with traditional medicines and ceremony—that’s something we didn’t have growing up because they were taken away from us. Ashley is a sun dancer, a pipe carrier, and that gives her strength.
Ashley, did your mom ever talk about her experiences with racism in medical school? Do you feel it’s different now?
During my mom’s pre-med studies, she experienced more overt racism. I think it’s a lot more subtle now. You leave the interaction thinking, ‘That was kind of weird’ and ‘I don’t feel good about that.’ And you question why that happened or what was going on. I thought I would have seen more incidents of racism. A friend of mine said you do see more if you look white. They’re more careful when you’re not. So, it’s still there but it’s more hidden.
Ashley, what is your interest in medicine?
It’s always been family medicine. I always wanted to work in the north and do what my mom has done. I want to go back to the communities I have lived in and work there. It’s a good way to give back to the communities.
Marlyn, what would your advice be for Ashley, working in family medicine in northern, remote, Indigenous communities?
I suggest she work in a community that has more than one doctor so she has support. She should also phone the emerg docs, cardiologists, whoever, and say ‘I have this patient and I need some advice.’ They are always willing to talk to you and give you advice.
Ashley and Marlyn, what advice do you have for students who are interested in family medicine?
Marlyn: It’s the only way to practice medicine! I think in our communities, you need to be a family physician. And even though kids who come from rural and northern communities and reserves may struggle in med school, they’re also the ones who come back to work in their communities.
Ashley: I’d say it’s a great area to go into. There’s a lot of variety. You’re exposed to a lot of different things. You play a really important role in your patients’ lives.
What is one piece of advice you would give Indigenous medical students?
Ashley: You deserve to be in medical school. You belong here. Don’t ever doubt that. You were picked to be in this program for a reason.
Marlyn: I always tell them just keep going. It’s hard work but you will get through it. I don’t think any Indigenous student should be failing. If Indigenous students are failing, it’s a failure on the part of the system. It is up to us as older doctors to carry, to drag, and to push students over the finish line. When it was all over the CBC about the 20 Indigenous students being accepted into medical school, I said don’t celebrate until you have gotten 20 students across the finish line. We need to ensure that every student gets across the finish line.
I’m inspired by the work that you’ve done, Marlyn, and the path you created for us to walk on. Ashley, I’m excited that you are continuing to walk on that path and hopefully inspire other First Nations, Métis, and Inuit students to come into medicine, to share their stories of getting through the struggles, and the strengths in doing that.
Meegwetch.
Dr. Marlyn Cook, CCFP, is a First Nations family physician from Misipawistik Cree Nation. Dr. Cook is the first First Nations woman to graduate from the University of Manitoba, has worked across Canada in rural and remote northern communities, and is Ashley’s mother.
Dr. Mandy Buss, CCFP, is a Métis family physician, President of the Indigenous Physicians Association of Canada, and a member of the College of Family Physicians of Canada’s Indigenous Health Committee.
In this piece, Dr. Buss interviews the mother and daughter to learn more about their experiences and their passion for family medicine.
This interview has been edited for brevity.
Ashley, how did you start on the path to medical school?
Ashley: A lot of it has to do with what I was exposed to when I moved around with my mom. Some of my earliest memories are tagging along with her and wanting to help when she was with patients. There’s one story she tells about a patient who came in with chest pain. I had taken off and when they found me, the patient was leaning over the side of the bed, letting me look in his ears.
Marlyn: I walk in and he’s leaning right over on the stretcher and she’s on the little step stool with the otoscope and looking in his ear.
Ashley: We were living in Moose Factory, Ontario, when I started considering medical school more seriously. So, I left the community and mom when I was 16 to attend a boarding school on the outskirts of Toronto.
How has your experience been in medical school so far, Ashley?
The first few years were difficult. It was a big transition and I struggled with imposter syndrome and questioning if I belonged. At the same time, I met a lot of great people, made a lot of good friends, and we helped each other through all of it.
Marlyn, how did your community help support you as an Indigenous family physician?
I’m a single mom, so I had a lot of help from people in the community—she was basically raised at the nursing station. Ashley knew the joy of practising medicine in the north because you get to do so much, be involved, help people as much as you can.
Historically, the Indian Act prohibited First Nations people from entering university to become doctors unless they gave up their First Nations identity. There are few Indigenous parent and child doctors. What are your thoughts about being a second-generation doctor, Ashley?
When my mom was in medical school, it was just her and two others. Seeing a second generation is pretty amazing. One of my classmates, who is Métis, their mom is also a physician, and in the class behind me, there’s another Indigenous parent-daughter pair. It’s something we will hopefully see more and it shows we can succeed here, and we do belong and deserve to be in this program, too.
Ashley, what did it mean to enter medical school with a parent who is an Indigenous doctor?
It was helpful. When things came up or I had questions, I could ask my mom about it. But I was able to talk to her, not only as my mom, but as a colleague. There was some pressure at the same time, especially when people realized who my mom was. I remember one doctor giving a tour of medical school and said, “this is Dr. Cook’s daughter and she has big shoes to fill.”
Marlyn, how did you feel about your daughter going into medical school?
I was scared for her. If you were not obviously Indigenous, you had an easier time. I remember when I was a medical student, the head of nephrology was talking about a patient who was dying and he said, “and the whole bloody tribe is there.” I didn’t like the way that conversation was going, so I let him know and he screamed at me in front of the other students. There were so many incidents like that, the obvious racism. And I knew it still was there, so I was scared. I also knew it would be a lot of hard work.
Ashley, how did this impact your decision to enter medicine?
It made me consider if this was something I wanted to do or if it was because it was what I was exposed to the most growing up. Mom prepared me for what going through medical school is like, what it’s like working as a doctor in a community. I was able to take all of that and decide for myself that this is something I wanted to do.
Marlyn, do you see any similarities between what you went through in medical school and what Ashley is going through now?
Racism is still there. I think we have come some distance from when I was there because the faculty of medicine, staff, they were used to having things a certain way and now the younger students and general people are speaking up more. Also, Ashley grew up with traditional medicines and ceremony—that’s something we didn’t have growing up because they were taken away from us. Ashley is a sun dancer, a pipe carrier, and that gives her strength.
Ashley, did your mom ever talk about her experiences with racism in medical school? Do you feel it’s different now?
During my mom’s pre-med studies, she experienced more overt racism. I think it’s a lot more subtle now. You leave the interaction thinking, ‘That was kind of weird’ and ‘I don’t feel good about that.’ And you question why that happened or what was going on. I thought I would have seen more incidents of racism. A friend of mine said you do see more if you look white. They’re more careful when you’re not. So, it’s still there but it’s more hidden.
Ashley, what is your interest in medicine?
It’s always been family medicine. I always wanted to work in the north and do what my mom has done. I want to go back to the communities I have lived in and work there. It’s a good way to give back to the communities.
Marlyn, what would your advice be for Ashley, working in family medicine in northern, remote, Indigenous communities?
I suggest she work in a community that has more than one doctor so she has support. She should also phone the emerg docs, cardiologists, whoever, and say ‘I have this patient and I need some advice.’ They are always willing to talk to you and give you advice.
Ashley and Marlyn, what advice do you have for students who are interested in family medicine?
Marlyn: It’s the only way to practice medicine! I think in our communities, you need to be a family physician. And even though kids who come from rural and northern communities and reserves may struggle in med school, they’re also the ones who come back to work in their communities.
Ashley: I’d say it’s a great area to go into. There’s a lot of variety. You’re exposed to a lot of different things. You play a really important role in your patients’ lives.
What is one piece of advice you would give Indigenous medical students?
Ashley: You deserve to be in medical school. You belong here. Don’t ever doubt that. You were picked to be in this program for a reason.
Marlyn: I always tell them just keep going. It’s hard work but you will get through it. I don’t think any Indigenous student should be failing. If Indigenous students are failing, it’s a failure on the part of the system. It is up to us as older doctors to carry, to drag, and to push students over the finish line. When it was all over the CBC about the 20 Indigenous students being accepted into medical school, I said don’t celebrate until you have gotten 20 students across the finish line. We need to ensure that every student gets across the finish line.
I’m inspired by the work that you’ve done, Marlyn, and the path you created for us to walk on. Ashley, I’m excited that you are continuing to walk on that path and hopefully inspire other First Nations, Métis, and Inuit students to come into medicine, to share their stories of getting through the struggles, and the strengths in doing that.
Meegwetch.
