Medical Education 2010:
44
: 263–271
Context Distributed medical education sites help train, recruit and retain doctors, notably in rural and isolated areas, by providing education and training in these areas and adapting their curriculum to meet the host community’s health needs.
Objectives The Centre de Formation Médicale du Nouveau Brunswick (CFMNB; New Brunswick Medical Education Centre) was established by a partnership between two academic institutions, the Université de Sherbrooke (University of Sherbrooke), situated in the province of Quebec, and the Université de Moncton (University of Moncton), situated in the province of New Brunswick, in Canada. The CFMNB is specifically targeting a minority community (Acadians). Working to establish a high‐quality medical education programme, the CFMNB has also set community objectives to meet not only the health needs of this population, but also its social and economic needs.
Methods This paper describes the overall objectives of this project, which are: to reduce the gap between community needs and academic institutional needs; to address ethno‐cultural and language differences in a defined minority population, and to develop collaboration between the partners involved, including government and community entities which are often perceived as operating in isolation from one another. We also describe why and how the CFMNB developed community‐focused objectives and the challenges that came with these innovations, and present lessons from the experience that may be relevant to other sites interested in the social responsibility of medical schools.
Conclusions The CFMNB has produced interesting work and innovations in the field of social responsibility and has encountered many challenges. Continuing interaction between medical education, health research and health services to better address the needs of the population has been established. The information obtained by this process has been used to build a strategic plan for the CFMNB in order to ensure that it is socially responsive and has significant generalisable features.
Minority Francophones in a metropolitan area of eastern Canada recently grappled with political questions related to health, education and municipal services involving their language, identity and community. The pursuit of these identity projects called upon strategies of territorial integration and segregation where space shaped the issues, defined the Other and influenced the strategies chosen. Boundaries crystallised spaces of power and played a critical role in the definition of nationalist projects and the formation of minority identity. However, the paper's conclusion requires important nuances. The interplay of territory, institutions and identity is reciprocal. Also, one of the three elements can play a stronger role than the others depending on the territorial scale, the sub-state institution and the status of the minority. Research on nationalism should provide greater focus on the sub-state level and the concept of administrative nationalism is proposed as a means to do so.
Substate administrative institutions such as municipalities, hospital boards, and school districts may help resolve conflicts between minority and majority groups, particularly where a minority forms a majority in a substate territory. Minorities can use substate institutions to counter majority rule exercised through statewide political institutions. Minorities seek control over substate institutions to legitimize nationalist claims over crucial public functions and space and to support identity projects. The present case study, in a Canadian urban area, explains the rise of administrative nationalism and raises theoretical, practical, and empirical questions that summon scholars of nationalism and public administration.
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