title: Northern perspectives on medical elective tourism: a qualitative study.
abstract: BACKGROUND
  The Royal College of Physicians and Surgeons of Canada recognizes education to be necessary for doctors to provide culturally safe care. Communities in northern Canada have large populations of Aboriginal people and other marginalized groups. Our goal was to identify the elements of appropriate predeparture curricula for these medical trainees.
  
  
  METHODS
  We conducted our study in Kenora, Ontario. With the help of a core collaborative group and the support of the local Aboriginal Health Access Centre, we interviewed a purposive sample of community members about their interactions with trainees from southern Canada. Aboriginal and non-Aboriginal researchers with roots in northern and southern Canada brought perspectives to the inductive analysis.
  
  
  RESULTS
  We conducted 17 semistructured interviews between February and March 2014. Participants felt that southern trainees were inadequately educated in northern politics, society and history. They identified 2 more themes: determinants of health affecting the local Aboriginal population, and provider and patient factors affecting delivery of culturally competent care. Participants also shared ideas on how best to implement this content into curricula.
  
  
  CONCLUSIONS
  Providing culturally competent care to northern communities is a complex process requiring education. Using a collaborative method, we were able to delineate the experiences of members of a northern community and identify knowledge gaps of southern trainees travelling there. Our results provide a foundation for the content and structure of formal predeparture curricula to enable such trainees to provide culturally safe care.
authors.affiliation: Department of Medicine (Coke, Richardson), Faculty of Medicine (Kuper), University of Toronto, Toronto, Ont.; Waasegiizhig Nanaandawe'iyewigamig Health Access Centre (Cameron), Kenora, Ont.
authors.forename: Sarah
authors.initials: S
authors.lastname: Coke
authors.affiliation: Department of Medicine (Coke, Richardson), Faculty of Medicine (Kuper), University of Toronto, Toronto, Ont.; Waasegiizhig Nanaandawe'iyewigamig Health Access Centre (Cameron), Kenora, Ont.
authors.forename: Ayelet
authors.initials: A
authors.lastname: Kuper
authors.affiliation: Department of Medicine (Coke, Richardson), Faculty of Medicine (Kuper), University of Toronto, Toronto, Ont.; Waasegiizhig Nanaandawe'iyewigamig Health Access Centre (Cameron), Kenora, Ont.
authors.forename: Lisa
authors.initials: L
authors.lastname: Richardson
authors.affiliation: Department of Medicine (Coke, Richardson), Faculty of Medicine (Kuper), University of Toronto, Toronto, Ont.; Waasegiizhig Nanaandawe'iyewigamig Health Access Centre (Cameron), Kenora, Ont.
authors.forename: Anita
authors.initials: A
authors.lastname: Cameron