Oral Papers

Doing it Better in Teaching and Scholarship

May 16, 2024
10:45 AM - 12:00 PM

  • Presenters: Milessa Nutik, Kulamakan Kulasegaram, Risa Bordman, Rachel Ellis, Milena Forte, Joyce Nyhof-Young, Betty Onyura, Nick Petten, Nicole Woods, Sarah Wright, Risa Freeman

    Supporting scholarship through expert consultation is an often used but informal strategy. The education scholarship consultation (ESC) service of the Office of Education Scholarship of the Department of Family and Community Medicine is a rarity in offering a formalized consultation service for education scholarship projects. The ‘Better Together’ ESC service is intended to help faculty develop and clarify the scope of proposed scholarly projects, provide methodological support, and advise about dissemination. It offers paired consultations from clinician educators and education scientists. We report on a program evaluation of this service and lessons learned for formalizing consultations.

    Methods:

    We analyzed administrative data, consultee and consultant satisfaction surveys and conducted consultant interviews over a period of seven years. Participants reported on their experience of consultation and perceived impact which was analyzed to create a logic model and using a stages of change development framework.

    Results:

    Over 300 ES consultations were conducted with the majority being one-time consultations and resulting in over 800 peer-reviewed disseminations. Self-assessment of readiness for scholarship change was reported as having progressed further along the scholarship trajectory by consultees than consultants. Consultees reported high satisfaction and benefiting from diverse perspectives, access to expertise, and clarification of their goals. Consultants reported benefits of capacity building. Both sides reported challenges such as scheduling, resource intensity, and giving/receiving constructive feedback.

    Discussion:

    Collection of multisource program data has provided rich information upon which to further develop our ESC service. Others wishing to develop a similar program can benefit from the lessons learned.

  • Presenters: Aisha Husain, Renee Logan

    As we navigate through chronic healthcare system challenges and try to best serve our patients, many of us are experiencing moral injury(1). How can family physicians cope when we can see that it is the systemic issues, not us, that need to be fixed?

  • Presenters: Deanna Telner, Heather MacNeill

    COVID-19 pandemic caused technology use in healthcare education to go from ‘niche’ to ‘necessity’. Studies demonstrate that medical teachers feel ill-prepared to teach using technology and there are few pedagogically driven Faculty Development opportunities for them. The purpose of this study was to evaluate if participation of healthcare educators in a master’s level course, Educational Technology for Health Practitioner Education had an impact on technology perceptions and use in teaching. A mixed method approach was used. Validated survey questions (based on a modified Technology Assessment Model and Technological, Pedagogical, Content and Knowledge Model) were completed before and 6 months after the course. In addition, focus groups immediately after completion of the course were conducted. Statistical analysis of survey results was conducted using R version 4.3 and qualitative analysis of focus groups using NVIVO software. Results indicated that participation in this course provided some changes in technology knowledge but much larger changes in pedagogically informed teaching and self-efficacy. At 6 months, participants were using technology differently and could identify why they chose certain technological tools to teach. Focus groups revealed a decrease in ‘imposter syndrome’ which participants felt prior to taking the course, increased confidence in using technology and increased awareness of the pedagogy behind the tools being used in education. They described an ability to speak a ‘common language’ with other online educators. This study will help identify Faculty Development needs in this evolving area.

  • Presenters: Stephanie Zhou, Thrmiga Sathiyamoorthy, George Kachkovski,

    Background:

    The Physicians Financial Wellness Conference (PFI Conference) is Canada’s largest conference for physician financial education and practice management. Taking place annually on a virtual platform, PFI Conference was created in response to the increase in physician debt, and its subsequent detrimental impacts on mental well-being, and declining interest in lower-earning primary care paths which are intensified within equity-deserving groups.

    In general, residents report poor financial literacy and thus, feel unprepared for practice management. In a study of 521 physicians, only 18% received financial planning education in medical school, despite financial counseling being an accreditation standard.

    The PFI Conference is a unique intervention to address this gap in education by catering to Canadian medical trainees and physicians at all career levels on a national scale.

    Methods:

    Our study examines the influence of the conference on participants' financial literacy and readiness for practice by analyzing pre- and post-conference questionnaires from 728 attendees in 2021-2022. Using mixed methods, we used descriptive statistics to summarize demographic information and thematic analysis to highlight commonalities and unique observations provided in participant feedback.

    Results:

    Overwhelmingly, our attendees shared that this conference addressed an unmet need by cultivating a community that facilitated networking and mentorship between physicians and trainees. Responses highlighted how this conference provided an unbiased learning platform to discuss topics not otherwise covered in training, such as family planning, retirement and debt management. Of note, the accessibility of the conference encouraged attendance from a majority female audience (63.6%) with representation across rural, suburban and urban geographies.

  • Presenters: Cindy Sinclair, Amirreza Salamat,Ibukun Abejirinde,

    Ontario is experiencing a severe shortage of doctors. 2.4 million Ontarians currently do not have access to a regular family physician. Projections suggest this situation will worsen. By 2026, as an estimated 4.4 million, or 1 in every 4 Ontarians, will face similar or worse access to healthcare. With practising physicians already grappling with burnout, retirement, or alternative career choices for better lifestyle, coupled with the government’s plan to accept 450,000 new immigrants and refugees annually in the coming years and insufficient capacity by Canadian medical schools to produce family doctors at the rate needed, the shortage of doctors will lead to worsening health of both patients and physicians.

    Family physicians are grounded in the CanMEDS-Family Medicine roles in their delivery of care to patients and families across the lifespan. They play a pivotal role in continuity of care, illiness prevention, and in coordinating with specialists and professionals to maintain the health of their patients. Research shows that the current doctor-shortage crisis disproportionately impacts visible minority and marginalized ethnic patients. It further exacerbates healthcare inequities and social injustices.

    The Department of Family and Community Medicine at the University of Toronto, situated in a vastly diverse urban and multicultural city, is uniquely positioned to address this challenge by tapping into the skills of immigrant IMGs. This presentation explores how alternative funding models and partnerships with community organizations and the government can support re-education of immigrant IMGs for alternative healthcare-related careers in healthcare centres, team-based settings, research, education and the wider community.

May 16, 2024
10:45 AM - 12:00 PM

Doing it Better through Data and Innovation

  • Presenters: Eva Grunfeld, Bojana Petrovic

    CanIMPACT was a multi-disciplinary group of researchers, primary care providers (PCPs), cancer specialists, patients and family caregivers working together to improve cancer care coordination. Funded by a CIHR team grant from 2013-2023, this research program was divided into two phases. In Phase 1, we conducted research regarding care coordination between PCPs and cancer specialists, including: 1) analysis of administrative health data in 5 provinces; 2) qualitative interviews with cancer survivors, PCPs and cancer specialists; 3) focus groups with primary care teams focusing on personalized genomic cancer medicine; and 4) an environmental scan and systematic review of initiatives designed to improve care integration. Results suggested that patients, PCPs and cancer specialists encountered challenges with care coordination and communication (e.g., confusion regarding healthcare provider roles, concerns about access to timely information, etc.). The CanIMPACT team presented key findings at a consultative workshop to gather feedback on developing an intervention to address the gaps identified in the Phase 1 studies. Workshop participants recommended an online system for PCPs and specialists (eConsult), with the aim of facilitating communication and care coordination. Phase 2 involved a hybrid effectiveness implementation trial of a cancer-specific modification of eConsult (eOncoNote), and testing eConsult for genetics service delivery in primary care. Additional research assessed virtual follow-up, adapting stratified follow-up care pathways, and exploring ways to improve healthcare experiences among Black breast cancer survivors. This oral presentation will highlight key findings from the CanIMPACT research program with lessons learned and implications for future research and clinical practice.

  • Presenters: MeganJLandes, Jennifer Hulme, Isaac Bogoch, Davor Brinc, Kyle Vose, Alexandra McKnight, Tony Mazzuli

    While Emergency Departments are often the only point-of-contact for many high-risk populations, they continue to be a missed opportunity for HIV testing. Our national environmental scan found most EDs do not offer rapid HIV testing, instead testing is sent offsite to public health laboratories causing delays for results and challenges in linkage to care.

    We implemented and evaluated a rapid HIV testing protocol designed in collaboration with ED, hospital, public health and patient stakeholders. Our protocol, which has been implemented in two large urban academic EDs, combines patient and provider-initiated testing, provider education materials, standardized pre- and post-test counseling scripts, central laboratory testing and reporting, and rapid pathway for linkage to care. Data is being collected retrospectively for turnaround time (TAT), testing indications, linkage to care and clinical outcomes.

    Previously, the median TAT for HIV test results was 109 hours. In the 11 months after implementation, 285 HIV tests were completed with a median TAT of 2.5 hours. Overall, 10 patients (3.5%) tested HIV positive; 3 subsequently disclosed they had known their status/were lost to follow-up and 7 were new HIV diagnoses. Of the new diagnoses five (71%) patients were successfully linked to follow-up care.

    Responsive design of a rapid HIV testing protocol is demonstrating the feasibility of HIV testing in the ED and successful linkage to HIV care. Future directions include scaling to Thunder Bay (underway) and a combined process evaluation to develop best practices for rapid HIV testing in Canadian EDs.

  • Presenters: Ashley Mah, Jennifer Gillis, Anita Benoit, Claire Kendall, Abigail Kroch, Ramandip Grewal, Mona Loutfy, Gina Ogilvie, Janet Raboud, Anita Rachlis, Anna Yeung, Mark Yudin, Ann Burchell

    Introduction

    We aimed to characterize knowledge of anal cancer risk and willingness to undergo anal screening among women living with HIV in Ontario.

    Methods

    A cross-sectional questionnaire was administered from 2017 to 2020 among women in the Ontario HIV Treatment Network Cohort Study. Items assessed knowledge of anal cancer risk and willingness to undergo screening with anal Pap tests or digital rectal exams (DARE). We restricted our analysis to those aged ≥45 years in keeping with forthcoming international guidelines. We assessed associations with demographic and HPV screening and prevention measures using chi-square tests.

    Results

    Among the 325 women, the median age was 55 years (IQR: 10 years). 56% of women believed that they had “no chance” of developing anal cancer and 17% did not know their risk. Most women responded that they were “likely’’ or “very likely” to undergo anal screening if it was offered (anal Pap: 72%; DARE: 69%). There were no statistically significant differences in willingness to screen by age, sexual orientation, race, immigrant status, or HPV vaccination history. However, women who underwent recent cervical screening were more willing to also undergo anal screening than those who had not (DARE: 73% vs 51%, p=0.01; anal Pap: 76% vs 55%, p=0.02).

    Conclusions

    Education on elevated anal cancer risk among women living with HIV is important for the implementation of anal cancer screening in Ontario. Our findings suggest that future uptake of anal screening may reproduce inequities observed for cervical screening without careful attention to barriers and facilitators to both.

  • Presenters: Ritika Goel, Tracey Edelist, Hadeel Al Hadi, Ashley Li, Neha Shah, Christian Singh

    Before undertaking a review of the MD Program Foundations Curriculum at University of Toronto from a social justice, anti-oppression and advocacy lens, our working group reviewed the published and grey literature to learn what other medical schools have done. We will be presenting our findings outlining the various approaches medical schools have taken to review their curricula, develop new curricula and lessons learned about how we can work to infuse and integrate these critical concepts into training, whether undergraduate or postgraduate, for a new generation of physicians.

  • Presenters: Azza Eissa, Victoria Young, Stephanie Garies, Lisa Miller, Andrew Pinto

    South Asian and Black people have higher incidence of Type-2-Diabetes (T2D) with an earlier risk of developing it at 25 or 30 years of age, compared to a 40-year-old White man. Timely screening is warranted. We examined the association between self-reported race and other factors with T2D screening prevalence, and whether income or Canadian-born status may mitigate racial disparities in T2D screening. This cross-sectional study utilized self-reported health equity data linked to EMRs at the SMHAFHT. Adults 35-65 years old without prior T2D diagnosis, as of July 1st, 2019, were included. The primary outcome was completion of a diabetes blood test within 6 months. The secondary outcome was mean HbA1c level. Covariates included age, race, gender, Canadian-born status, income, housing, disability, clinical site, number of clinical visits, provider-type, SBP, BMI, LDL, active neuroleptic and anti-hypertensive medication use. Our study identified 10014 individuals eligible for screening, with a mean age of 47 +/- 8, Male to Female ratio of 0.8 to 1, and mean of 15 visits in prior 3 years. All patients responded to the health equity survey, with 93% response rate to the race-question and data missing at random. Only 19.9% of eligible patients were adequately screened within six months. Black individuals were less likely to get screened, compared to White (OR=0.57, CI=0.48-0.69, and p=0.0004), but not South Asian individuals in multivariable logistic regression models, controlling for Age, Sex, Canadian-born status, Neuroleptic or anti-hypertensive use, Clinical site, and Number of clinical visits. Suboptimal screening reveals missed opportunities for prevention and early detection of T2D.

Doing it Better by Enhancing Clinical Care

May 16, 2024
3:15 PM - 4:30 PM

  • Presenters: Jesse McLaren, Mazen El-Baba

    ECG interpretation is a core clinical competency that should be acquired, nurtured, in an Emergency Medicine (EM) training program, and mastered in practice. This skill is critical in EM to guide time-sensitive management of critically ill patients. Although ECG interpretation is recognized as an essential clinical skill, there continues to be a lack of standardisation and prioritization of ECG teaching. As a consequence, most clinicians do not feel confident in interpreting ECGs, and most medical learners have low accuracy in ECG interpretation. Traditional forms of ECG teaching lack innovation, and rely on pattern recognition without understanding underlying pathophysiology or clinical relevance. At the level of practicing physicians there are advances in ECG interpretation but no formal methods to integrate these into local teaching.

    In this oral paper, we’ll discuss strategies for ECG education and training throughout emergency medicine. This includes 1) standardization: the HEARTS approach provides a simple but systematic approach to ECG interpretation that can be adapted to all levels of learners; 2) education innovation: HEARTS workshops have been adapted at the student and resident level, including EM residents learning ECG interpretation through the process of teaching students (published in IJEM 2023); 3) continuing professional development: audit/feedback as a method to learn new evidence-based advances in ECG interpretation for acute coronary occlusion (published in AJEM 2021).

  • Presenters: Kevin Lai

    The onset of restrictions in March 2020 during the COVID-19 pandemic required family medicine clinics to shift operations rapidly to virtual care. There were major logistical challenges for providing primary care with high quality secure virtual care tools, such as video conferencing, real-time chat, private messaging, and file transfer. Physicians preferred to use tools that were readily available, with video being the lowest usage. It was important for medical clinics to continue to care for our patient population in order to reduce the harms from unintended consequences of isolation, quarantine, and limited doctor-patient interactions.

    Surveys of provider and patient experiences report telephone and video visits together as virtual care. At Get Well Clinic, we pioneered an innovative hybrid virtual-care / in-person care approach to primary care services by restructuring administrative processes and designing a custom e-Platform website using open source and low-cost digital software. Installing and hosting our own e-Platform allowed us to rapidly pivot to virtual care within a week which kept us open to our patients during a critical time period. This workshop will present the innovative system and results of a QI study that tracked the progress of implementing a hybrid in-person / virtual care approach to primary care using open source tools.

  • Presenters: Camille Williams, Elaine Goulbourne, Elijah Gyansa, Ayan Hashi, Ielaf Khalil, Rumaisa Khan, Patricia Rabel-Jeudy, Ruth Heisey, Aisha Lofters

    Background. In Canada, racialized and immigrant women are typically underscreened for breast and cervical cancer. Underscreening is linked to numerous barriers including lack of awareness of screening, fear of pain, the stigma of cancer, as well as socio-cultural and socio-economic factors. In partnership with community organizations, we co-created two culturally tailored events - an educational event and an on-site cancer screening event - to address barriers to screening for Black women.

    Description. Both events were delivered annually in 2022 and 2023. The virtual, free educational events empowered Black women with information about risk factors, prevention, and screening. The screening events created inclusive, accessible, and culturally affirming opportunities for screening. Evaluation included post-event surveys to gauge success and solicit feedback.

    Results. Each educational event attracted 450+ attendees. In both years, more than 87% of post-event survey respondents agreed that an event specifically for Black women helped them feel supported. At the screening events, 46 and 48 women were screened in 2022 and 2023, respectively. 81% of respondents noted that they were (extremely) likely to go for mammogram when next due; 87% said they were (extremely) likely to go for a Pap test when next due.

    Conclusions. Co-created, culturally tailored educational and on-site screening events provided opportunities for Black women to learn about prevention, risk factors, resources, and screening for women’s cancers. It is possible that, over time, such events may reduce or remove the stigmas associated with cancer and decrease differences in cancer-related knowledge and behaviours between racialized and non-racialized groups.

  • Authors: Cassandra Kwok Neil Shah

    Description:

    Community Health and Information Fairs (CHIFs) were designed by the North York Toronto Health Partners (NYTHP) OHT to increase community access to health and care resources, particularly to those without a dedicated primary care provider. CHIFs have been organized and executed through collaboration with partners including local community health centers (CHCs), the North York Family Health Team (NYFHT), community support services, community ambassadors, and physicians. The program addresses pre-existing care gaps that have been exacerbated during the pandemic such as cancer screening, vaccines, access to health and community support services in neighborhoods that have health inequalities impacted by social determinants of health. Offerings are designed with input from the community partners, and by analysis of local health reporting data such as cancer screening rates and number of unattached patients. Following training in cancer screening guidelines, community ambassadors have been a critical success factor in educating clients and encouraging them to come to the CHIFs to access cancer screening tests. This is an innovative approach to offering elements of health care with efforts to connect them with local community health centers and/or link them to Health Care Connect Ontario to help link to a primary care provider. The multi-disciplinary CHIFs offer unattached and equity-deserving patients access to primary care providers offering cancer preventive education and screening (cervical, breast and colorectal), health promotion and prevention education as well as referral to community support services and agencies (including mental health services). The CHIFs aim to improve community health by providing low-barrier access to care in equity deserving neighbourhoods. The cancer screening initiative can reach individuals through engagement by community ambassadors who are trusted and known members of the local community. CHIFs are held directly in locations as guided by information from the community and ambassadors to provide culturally sensitive and informed care to the local community.

  • Authors: Patricia Marr, Noah Crampton, Sarah Reid

    Background:

    - The Toronto Western Family Health Team [TW FHT] conducted a major Medication Safety and Quality Improvement Initiative. The project was selected by our safety committee after reflecting on local safety incident reports. Our team included: Pharmacists, Physicians, Nursing, Reception, IT support, and Leadership. The project had a high degree of team involvement and was conducted at both sites [Bathurst + Garrison Creek]. Our pilot project was recognized by the CPSO as a QI Group Project Initiative for MDs, and at TAHSN QIPS Community of Practice – a city wide partnership of academic hospitals that comprised over 400 members.

    Aim Statement:

    - Improve the accuracy of the medication list in the TW FHT EMR for specific high risk patient groups.

    Overall Results

    - 25 physicians received training on medication reconciliation. 26 clinicians [Physicians + Pharmacists] conducted a total of 131 medication reconciliation appointments over a 2 month time frame. Approximately 95% of cases had at least 1 medication discrepancy and 40% had the potential to cause harm. This is pretty compelling data – given it is estimated that 1 in 9 Emergency Department Admissions may be related to an adverse drug event. [Reference: AHRQ]

    Next Steps:

    - Our team plans to build on the success of this pilot project by embedding this work within normal work flow processes. We plan to involve medical residents and target patients receiving high risk medications in future PDSA cycles. Finally, we plan to offer Patient Education Classes RE: Medication Safety in an effort to better partner with our patients.

May 16, 2024
3:15 PM - 4:30 PM

Doing it Better in Advancing Health Equity

  • Presenters: Azza Eissa, Sheena Madzima, Notisha Massaquoi, Onye Nnorum, Dominick Shelton, Roberta Timothy, Andrew D. Pinto

    Objectives: To examine how Black communities in Canada have historically organized to address systemic racism, advance health equity and/or respond to a public health crisis. To use multiple case study design to identify factors that contributed to success and long-term sustainability of community organizing for Black health.

    Methods: We searched the academic and grey literature from 1900 to present and included cases of community organizing and partnerships that were based in Canada, led by the Black community, and were an organized effort to improve health. We used purposive sampling and engaged community members to discuss three Black community organizing efforts for health: Women’s Health in Women’s Hands (local), the Health Association of African Canadians (provincial), and the Black Health Alliance (national). This study draws from conceptual frameworks of Afrocentricity, Community-based Participatory Research and Coalition Action Theory.

    Results: Cases varied in terms of chronology, contextual and process factors, experience delivering primary care and sustainability. The multiple case study analysis sheds light on several key similarities in how Black community organizing operationalised and used the frameworks to advance Black health equity.

    Conclusions: Community-oriented primary care can promote Black health equity by engaging Black community organizers and health care providers, advancing academic-community partnerships, and advocating for policy changes to address structural racism. Black community members draw on Afrocentric values of collective input, resistance, and strength to address health disparities, using partnership principles that honor Black community knowledge and leadership, intersectionality, capacity-building, and community transformation while seeking shared power to advance health equity.

  • Presenters: Meb Rashid, Michelle Westin, Angela Robertson, Cheryl Prescod

    In the summer of 2023, images of East African refugee claimants sleeping outside homeless shelters in Toronto became national news. Many had fled persecution in their home countries and had arrived in Canada with pressing health needs. In the absence of an effective response from any level of government, a group of citizens rented buses and arranged to move the refugees to a number of churches in the north-west of the city. How to address the health care needs of this population of homeless new immigrants now living on the floors of churches became a challenge. This presentation will describe the rapid response of a community of health care providers, led by Black Creek Community Health Centre, to create the Bridging Clinic, a robust primary care clinic to serve the needs of this population. This workshop will consider the increasing number of forced migrants coming to Toronto and, using the example of the Bridging Clinic, will look at models to address the needs of this growing population.

  • Presenters: Aisha Lofters, Aranee Senthilmurugan, Anjana Rao

    Introduction: The BETTER program enhances prevention screening actions by training health professionals to create personalized prevention plans with patients. Recognizing that sustaining healthy behavioural changes requires consistent support, strategies were developed to bolster the program's longevity by creating the BETTER Women program. This innovative initiative involves training lay individuals as peer health coaches (PHCs) to offer motivational support for patients to adopt healthy behaviours following the prevention visit. An embedded process evaluation seeks to comprehensively understand the impact and effectiveness of the underlying mechanisms of the peer health coaching program.

    Methods: Thematic analyses of qualitative interviews with patients, PHCs, and practitioners, alongside quantitative analyses using descriptive statistics and longitudinal methods, assesses sustainability, effects, and relationships. A type 1 hybrid implementation-effectiveness patient-randomized trial for women aged 40-68 measures effectiveness through targeted behaviors at 6 months. Implementation outcomes, economic evaluation, and identification of core components are assessed through surveys, interviews, and clinical reviews.

    Preliminary Results: Preliminary findings from qualitative interviews indicate a universally positive reception of the Better Women program model. An overall improvement in patients' health is further attributed to a holistic approach in goal setting during their prevention visits and accountability held to PHCs. Additionally, the findings highlight a symbiotic relationship where patients are motivated by their PHCs who, in turn, feel motivated to adopt healthy behaviors. PHCs also express confidence in promoting healthy practices within their families and communities.

    Discussion: Outcomes will determine whether peer health coaching enhances BETTER program benefits for women aged 40-68 by offering insights into impacts on specific health behaviors. Assessment of implementation outcomes will inform dissemination, scalability, and long-term sustainability strategies.

  • Presenters: Aaron Orkin

    The underrepresentation of marginalized populations in epidemiology can jeopardize the validity of research, leading to selection biases, missing data, and undermining generalizability. When marginalized populations are absent from health research, their health needs remain obscured. This can imperil their health and social standing, alienating them from health research and othering them in the scientific narrative. This can further exclude marginalized groups from medicine and research. Still, the inequitable underrepresentation of marginalized groups goes unnamed in the epidemiological lexicon and is insufficiently characterized by existing methodological concepts. Methods, concepts, and the notion of epidemiological rigour must therefore evolve so that the everyday practice of epidemiology can advance science that is both rigorous and equitably advances the health of all. We propose a new methodological concept called ‘disinclusion’ to capture the inequitable absence or invisibility of a group in epidemiological data and health research. We define disinclusion and distinguish it from related methodological concepts. We describe pervasive processes of disinclusion and provide examples of groups who are frequently affected by disinclusion. We propose to consider disinclusion in study design, reporting, and critical appraisal to illuminate the routine epidemiological practices that compound health inequities.

  • Presenters: Stephen Marisette, Joanne Permaul, Zhiheng Zeng, Junyi Mei, Donatus Mutasingwa, Melanie Henry, Andrea Groff, Kathleen Homiak

    Context: Research shows that newcomers to Canada face several challenges including language barriers, cultural differences, socioeconomic issues, and difficulties navigating the health care system. Additionally, lack of familiarity with the Canadian health care system can be a significant barrier to health care for newcomers to Canada. Few studies have addressed how Chinese newcomers to Canada perceive the role of primary health care, and this study aims to address this gap. Methods: Virtual one-on-one semi-structured interviews were conducted in English or Mandarin, with Chinese newcomers in 2023. Residents of Markham, Ontario, ≥ 25 years of age, who immigrated to Canada from mainland China in the last 5 years, were eligible to participate. Interviews were audio-recorded, transcribed, and translated. A questionnaire collected demographic data. Interview transcripts were analyzed using thematic analysis; demographic data were analyzed descriptively. Ethics approval was received from the Oak Valley Health Research Ethics Board. Results: Ten interviews were conducted. The main themes included: barriers to accessing care, differences between the Chinese and Canadian health care systems, the importance of continuity of care, understanding the role of the family doctor, the significance of preventive health care, and the need for more health care system information. Conclusion: Given the significant differences in how health care is provided in China compared to Canada, there is a need to improve newcomer orientation regarding the role of primary care in Canada. A better understanding of the Canadian health care system would help newcomers address barriers and assist them with system navigation.