For medical learners, summer is a time of new beginnings – from newly graduated medical students heading out on their residency journey to senior residents making the final transition into full medical practice.

In July, Dr. Cinera States started her fourth year of residency with the Department of Psychiatry at Dalhousie University in Halifax.

Dr. States provides care at several locations, including the QEII Health Sciences Centre and the Nova Scotia Hospital. She also covers call and the emergency departments at the IWK Health Centre and the Halifax Infirmary.

She remembers the shift from medical school to residency was quick, and at times, overwhelming. “In the beginning, you don’t believe you’re actually a physician,” she said. “You graduate in May, write your exams in June and start practising in July.”

“You realize early on what you didn’t learn in medical school. My first call shift was in internal medicine – a speciality I found challenging. There was a senior resident we could call if we were worried about a patient. We relied on them sharing their experiences and resources. It’s about not being afraid to admit that you don’t know everything.”

Reaching out to others took on new meaning for Dr. States during this time. “My mom was diagnosed with cancer in my third year of medical school, and she passed away during my first year of residency,” she recalled.

“It was very difficult, but I found purpose in my work that helped me get through the loss. I realized that no matter what was going on in my life, I’d always be able to find joy in psychiatry.”

Born and raised in Windsor, Ontario, she attended Dalhousie Medical School following a double major in biology and psychology at Dalhousie. Her personal connections to Nova Scotia drew her to study in the province. “My mom was born in North Preston and my dad is from Windsor, N.S.”

Medicine had been on her radar since she was a kid. “My mom took me to a pediatrician when I was six years old,” recalled Dr. States. “Her name was Dr. Sharon Burey, a Black female physician with a practice in my hometown. After meeting her, I could visualize someone who looked like me and could see myself having a career in medicine.”

The visit sparked an idea about what she could do with her life and how she could inspire others.

While pursuing her undergraduate degree at Dalhousie, Dr. States worked with Imhotep Legacy Academy. It’s a mentorship program that introduces African Nova Scotian youth to science, technology, engineering and mathematics (STEM).

Kids learn from university students who are studying STEM, steering them towards academic paths they might not otherwise consider. The academy provides afterschool and tutoring programs, and scholarships for university students to partner with Dalhousie researchers.

She enjoyed sharing her career aspirations with the kids. “I told them I wanted to study medicine and they helped keep me on that goal. I wanted to show them that they could do anything they wanted to.”

Learning about the challenges they faced was eye-opening for Dr. States. “A few kids were on individual program plans, which really limit their opportunities for postsecondary education,” she said. Among them was a student who was doing work above her grade level. Dr. States brought it to her parents’ attention and the student got back in the regular stream.

“In school, Black students don’t often see role models who look like them,” said Dr. States. “When I told one of the kids that I was finishing med school, she said, ‘It makes sense for you, but I’m not like you.’ That really shocked me. There’s nothing special about me – I don’t have the highest IQ. You just need a passion, a goal and determination, and you can achieve whatever you set your mind to.”

Mentoring has been a two-way street for Dr. States. During medical school and residency, she trained with many physicians who became her mentors, including infectious disease physician Dr. David Haase and emergency medicine paediatrician, Dr. Heather Rose.

“I did an elective with Dr. Rose at the IWK and at her clinic in Preston,” Dr. States said. “She was great. Having someone who believes in you is so encouraging.”

Now a senior resident, Dr. States is keen to pursue her own interests in mental health. She’s taking part in a research project exploring the mental health experiences of African Nova Scotians.

“Early on in medical school, I noticed that not many people who look me would come in to the hospital or clinics for psychiatric care,” Dr. States said. “There are systemic reasons that contribute to the decreased amount of African Nova Scotians accessing mental health services and I’d like to be a physician who addresses this gap and does something to change this.”

The study will examine the barriers to care they face and what ideal mental health care could look like in their communities. Her supervisor for her project is staff psychiatrist Dr. Zenovia Ursuliak. Dr. States plans to publish a report on the research for her residency project.

While Dr. States doesn’t know what the future holds when she finishes residency (she has two years left), she hopes to stay in Halifax and help inspire the next generation of physicians.

“I’m leaning towards focusing on adult outpatient psychiatry. My passion is with African Nova Scotian communities like North Preston. I’d love to continue serving the people there.”