From Recognition to Action: Improving Healthcare Access for Domestic Violence Survivors
Domestic violence (DV) is a significant public health issue in Canada, with over 100,000 cases reported annually, 79% involving women. This figure underestimates the true prevalence, as many cases go unreported due to fear, stigma, and barriers to accessing support. Alberta reports one of the highest DV rates in Canada, with 13% of women aged 15 and older experiencing spousal violence, highlighting an urgent need for support systems to address physical, emotional, and mental health impacts on survivors.
Despite my limited clinical experience as a pre-clerkship medical student, I partnered with a Calgary community organization that provides a safe haven for women and children facing DV. This organization supports individuals with housing and outreach programs as they rebuild their lives. Through this experience, I spoke with many residents about their healthcare experiences while living with their abusers. Many described feeling helpless, silenced by fear, and doubtful of being believed. I was struck by the number of encounters they’d had with healthcare providers where they felt signs were missed, and opportunities to intervene were passed by. These stories underscored the importance of advocacy in recognizing and addressing DV in patients to improve their care.
While early in our careers, medical students can still play a meaningful role in identifying and supporting DV survivors. In Alberta hospitals—especially in emergency rooms, obstetrics, and family medicine settings—patients often present with symptoms linked to violence, though they may not openly disclose abuse unless asked in a supportive environment. During clinical rotations, students can advocate for DV survivors by recognizing signs that go beyond the physical. Emotional signs, like anxiety or PTSD, are as prevalent as physical injuries. Creating a safe space for disclosure involves approaching conversations compassionately and using open-ended questions to foster a non-judgmental atmosphere—small yet impactful steps in helping those facing DV.
Trauma-informed care is equally essential, as it recognizes the deep psychological impacts of abuse and prioritizes patient safety and autonomy. Engaging empathetically and avoiding re-traumatizing language can make any healthcare provider a valuable support. Something as simple as writing down a shelter’s contact information can empower a patient, as was the case for one resident I spoke with. Alberta organizations, such as the Alberta Council of Women’s Shelters (ACWS), offer critical services to survivor well-being. By collaborating with social workers, medical students can assist in linking survivors to shelters, legal aid, and mental health services.
Yet many barriers remain in Alberta for DV survivors seeking care. Cultural and systemic barriers—such as cultural norms, language differences, and healthcare access disparities—often deter survivors from reaching out for help. Alberta’s demographic diversity, which includes rural and Indigenous communities, demands strong advocacy for policies that promote healthcare equity. Addressing gaps in DV-related training is also crucial, as many students feel unprepared to handle DV cases in clinical settings. Integrating more DV education into Alberta’s medical curriculum would better prepare future doctors to conduct screenings, offer safety planning, and connect patients with local resources.
As medical students, we are well-positioned to advocate for systemic improvements in DV care across Alberta. Enhanced medical education on DV, focusing on trauma-informed and culturally competent care, would equip students with the skills to support survivors effectively. Further, advocating for trauma-informed policies would help make this the standard practice across Alberta’s healthcare facilities, and securing funding for DV services, such as counseling, housing, and legal aid, is essential. Partnering with community organizations, like the one where I volunteered, offers valuable insights into survivor-centered care. Centering the perspectives of those with lived experiences must be at the forefront of advocacy, and volunteering with Alberta-based DV organizations can help deepen medical students' understanding of comprehensive DV support.
One impactful example from my experience involved meeting a woman and her child who were accessing housing at the organization; I had previously seen her in a clinical setting while shadowing. We recognized each other, both surprised by the familiarity in this new context. She confided that when I saw them in clinic, she was enduring abuse at home. Her abuser was present at the appointment, and neither I nor the attending were aware of the reality she was facing behind closed doors. This experience has stayed with me as a stark reminder that one cannot assume someone’s safety at a glance. Though no physical signs were present, I now wonder if I missed subtle cues. I wish I could go back and find a way to speak to her privately about her safety. I won’t soon forget the importance of DV screenings and the need for vigilance in recognizing potential signs.
Medical students may sometimes feel like they are the last in line to assume responsibility, but everyone in the healthcare chain has a role in supporting DV survivors and pushing for improvements in their care. By learning to recognize signs of abuse, providing trauma-informed support, and advocating for policies that enhance DV care, students can help build a more accessible and compassionate healthcare system. These efforts benefit individual patients and contribute to a broader cultural shift toward safety, equity, and respect for all Albertans impacted by domestic violence.
