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Last week in the Canadian Medical Association Journal (CMAJ), Sherif Emil, a pediatric surgeon at McGill University, penned a letter criticizing a picture of a young girl in a hijab used in an earlier piece.

The result was an Islamophobic tirade denigrating the dignity of Muslim women in Canada and around the world. Emil’s letter has since been formally retracted with an apology issued by CMAJ, which has committed to adding Muslim representation to CMAJ “advisory bodies.”

The actions taken by CMAJ are a welcome first step. However, this incident, which demonstrates how easily Islamophobia slips into even academic spaces, demands more than words from CMAJ.

To inspire real accountability, actions must be taken to educate or shake-up CMAJ leadership. As for Emil, it should be requested he no longer be able to evaluate medical trainees at McGill.

The letter, which can be viewed here, lays out some ludicrous points, including claiming hijab-wearing is a practice of “the most extremist religious homes,” likening the hijab to “child abuse,” and claiming young girls who wear the hijab are “typically also banned from riding a bike, swimming, or participating in other activities that characterize a healthy childhood.” 

Muslim women continue to expose the harmful impact of this article. You can read their stories in various places, including here and in the countless responses to the article.

CMAJ’s Interim Editor-in-Chief, Kirsten Patrick, claims in her retraction and apology that she takes “full responsibility for the inadequacy of editorial process that led to this error”.

In order to maintain some sense of accountability following these events, if she’s truly committed to anti-racism, the Muslim physicians and trainees of the Canadian Medical Association, and the Muslim patients she serves, Patrick must resign from her position as Interim Editor-in-Chief.

At the very least, Patrick should recuse herself from pieces discussing matters of racism and social justice until the process of learning and accountability is firmly established.

The idea that Patrick could be swayed by one phone conversation about personal traumas to publish such a floridly Islamophobic letter without consulting a broader group of Muslim women is flabbergasting.

The fact that she published this piece despite acknowledging the deadly consequences of Islamophobia, as well as outlining plans and making statements embracing anti-racism at CMAJ in a March 2021 editorial, is a clear indication that placating words alone are meaningless in the fight for racial justice.

No one’s perfect. As someone who has been employed by a university equity, diversity, and inclusion (EDI) office, been involved with EDI-related research, and who often finds myself in conversations around EDI, I frequently make mistakes.

We may gloss over a stereotype, phrase, or word that has fallen out of favour. We may not always pick up on things being left unsaid or unacknowledged—it happens.

However, when it comes to Emil’s letter, anyone with a baseline level of social consciousness—especially a physician and editor of a significant academic medical journal who claims to understand the weight of Islamophobia—should have seen red flags.

Instead, not only did the Islamophobic letter make it through an expert editorial filter without raising a whiff of concern, Patrick herself took “full responsibility” for crafting the incredibly stigmatizing headline that accompanied the piece.

To let this incident pass without real accountability or a significant structural shift would be an ugly stain on CMAJ’s reputation and call into question its alleged values of service, evidence and integrity.

Many in the medical community have lost faith in CMAJ’s ability to present unbiased social commentary, especially when it comes to the health and well-being of Canada’s largest religious minority, and this will remain the case until real action is taken.

In this instance, we can’t allow words to be enough.

Until sufficient action is taken, more individuals and groups should follow in the bold steps of the Black Health Education Collaborative—who suspended their special issue with CMAJ on Black Health—and impose similar academic conditions and boycotts to press for accountability.

In addition to CMAJ, the piece’s author should also be held accountable.

Emil’s letter has highlighted significant anti-Muslim sentiment that calls into question his ability to fairly evaluate Muslim trainees—particularly those who wear the hijab.

If the Islamophobic overtones of his letter weren’t already clear, a quick browse of his Twitter makes it hard not to place Emil among the 69 per cent of Quebecers—and 54 per cent of Canadians—who hold unfavourable views of Islam.

Tweets from just the last two months demonstrate Emil conflating “mainstream” Islam practiced by almost two billion Muslims and the violent extremism at its fringes—a centuries-old orientalist trope still used to scapegoat and justify Islamophobia today.

As a Muslim trainee, I’d be uncomfortable wondering if Emil, despite likely being an excellent clinician, would believe I harbour Taliban-esqe views on women’s rights and free speech. Especially if he was leading a discussion around “Spirituality, Religion and Medicine.”

Emil’s attempts to deflect responsibility by citing his work with Muslim patients in Africa and his suggestion we “should be able to find” any episodes where he “disrespected a Muslim patient, family, trainee or colleague” do little to help his case.

At the time of writing, Emil hasn’t apologized or demonstrated remorse for the harm his words have caused the Muslim community within or outside of McGill.

At minimum, rhetoric adopted in Emil’s public statements present the appearance of anti-Islam bias. He should no longer be privileged with evaluating medical trainees, learners, or applicants.

The CMAJ must start actively repairing the damage done by Emil and Patrick.

Unfortunately, as a Muslim resident physician practicing in Kingston, much of this is unsurprising. Data shows 60 per cent of identifiably Muslim medical residents experience discrimination, compared to 33 per cent across all residents. This number is higher among visibly Muslim women.

Generally, Muslims in Canada are seen less favourably by our fellow Canadians than any other social group polled. Quebec, where Emil is based, is also home to Bill 21—notoriously anti-Muslim legislation that bans the wearing of hijab and other religious symbols for public sector employees.  

The publishing of Emil’s letter could have been avoided if the parties involved had known more about Islam and Muslims. This is why, in addition to educating and diversifying the CMAJ team, the CMAJ should commit to educating the public about Muslim health and Islam’s rich medical historical traditions.

Furthermore, if the team behind CMAJ truly “always respect and support the right of women to choose to dress as they wish,” as claimed in the apology statement, then a commentary on Bill 21’s negative impact on Quebec Muslims’ mental, physical, and social health would also be welcome.

In some ways, we should thank the CMAJ, Patrick, and Emil for reminding us of the extent to which Islamophobic narratives are engrained in our society and the culture of medicine. We can also thank them for giving members of the Muslim community a chance to show solidarity with one another and with our allies—a glimmer of hope in a sea of negative statistics.

As we ponder our gratitude and come together for healing once again, let us all renew our commitments to educating ourselves as we work towards justice for all—inside and outside the medical system.

Imaan Javeed is a first-year medical resident.