May 4, 2022

Mind the Gap: Breaking barriers for Calgary immigrants

Student team creates patient resource to improve communication with physicians
Ashna Maredia, Zach Hong, Julia Robertson, Katherine Yu
From left: Ashna Maredia, Zach Hong, Julia Robertson, and Katherine Yu

Annually, Canada welcomes over 200,000 immigrants. For most immigrants, English is not their first language. Often, a visit to the doctor’s office can become frustrating and confusing due to language and cultural barriers, complicated insurance policies, and complexities within our health-care system.

To help remove some of these barriers, a team of medical students from the Cumming School of Medicine (CSM) has co-designed a checklist to help patients better prepare for their appointment and bridge the gap between physician and patient expectations.

“We set out to understand the barriers that immigrant patients face within our health-care system. We found a few consistent responses: communication, wait times, and system complexity were the top concerns,” says Julia Robertson, third-year student in undergraduate medical education at the CSM. “We decided to focus on communication and what could be done to improve the conversation between patients and their doctors.”

A community collaboration

The team used a co-design process relying on collaboration and consultation with immigrant partners, community organizations, immigrant communities, and physicians to develop a Doctor’s Appointment Prep Tool (ADAPT). This tool addresses the steps for health-care meetings, provides navigation tips, and empowers physician/patient relationships.

To hear from immigrants directly, the project team conducted focus groups. The team learned this group of patients can experience emotional stress and fear when communicating with physicians who do not speak in their own language. They also felt there was not enough space to have a conversation with their doctor about their concerns or lack of clarity around managing their health.

ADAPT assists immigrants before and during their interactions with health-care professionals in primary care settings. The checklist addresses the steps for meeting with doctors such as identifying medications, addressing any changes in health, questions, and what actions can be taken following an appointment.

“This tool helped me to share my health concerns, and I believe my doctor has a strong understanding of my health needs,” says Mrs. Singh, a focus group participant. “The point is to make our lives easier in accessing the healthcare system.”

Next steps – making the tool accessible

With the project’s planning stages now complete, the Doctor’s Appointment Prep Checklist is now available to anyone and can be accessed through the ADAPT website. Although immigrants are the targeted checklist users, the team is exploring if this tool can benefit patients experiencing dementia or other communication challenges. They are working with Calgary Immigrant Woman’s Association (CIWA) to include the ADAPT tool in their Language Instruction for Newcomers to Canada (LINC) classes.

“To apply our education with a patient-first empathetic approach has raised the bar for my educational learning and enables me to be a mindful, accessible, and patient-centered medical practitioner,” says Katherine Yu, third-year student, CSM.

To learn more visit.

Listen to the ADAPT team describe their work on the podcast Impact Now: UCalgary Medical Students Break Barriers in Providing Care for Immigrant Patients.


This project was made possible through the support of the Imagine Citizens Network, the Alberta SPOR Support Unit, Alberta Medical Association, Dr. Aleem Bharwani, MD Financial Management, and the participation and engagement from the focus group participants.