Physician Workforce Partnerships in Rural American Indian/Alaska Native Communities and the Potential of Post-Graduate Fellowships

How Should Health Professions Schools Partner With AI/AN Communities?

“…Several other institutions have also recently developed programs that place fellows in clinical positions at tribal facilities. 8 Since there is a physician vacancy rate of over 25% in AI/AN communities, these continuity models are intended to reduce local physician staffing gaps. 8 There are nursing student equivalents of these immersion programs as well.…”

“…8 Since there is a physician vacancy rate of over 25% in AI/AN communities, these continuity models are intended to reduce local physician staffing gaps. 8 There are nursing student equivalents of these immersion programs as well. 6 These programs represent several institutions' commitment to building the workforce of clinicians who know how to navigate the range of culturally sensitive issues and to narrow AI/AN health disparities.…”

“…6 These programs represent several institutions' commitment to building the workforce of clinicians who know how to navigate the range of culturally sensitive issues and to narrow AI/AN health disparities. 8 These institutions have allowed their faculty the time it takes to engage tribal entities in the provision of education and clinical care. 6,8 They have also prioritized recruitment of AI/AN students and provided additional support for retention so that they can complete their education and enter practice.…”

Developing Graduate Medical Education Partnerships in American Indian/Alaska Native Communities

“…Distance between AI/AN communities and AHCs may challenge relationship building toward GME rotations, but it is not an insurmountable barrier given modern transportation capabilities, wellmodeled global rotations at many AHCs, and the opportunity to use and develop technologies such as telemedicine or online learning. 13 Rotations require establishment of stable material resources (housing, available food sources, etc); they also require trainees, staff, and community organizations committed to educational exchange. Finally, there appears to be an increased need for recruitment of AI/AN administrators in leadership roles within AHCs, who may be able to better engage across tribal/IHS leadership and AHC administrations to promote GME partnerships in AI/AN communities.…”

“…Few graduate medical education (GME) training programs are based in rural AI/AN communities. 13 Thus, GME learning primarily comes from Native American Health Center (NAHC) agreements with AHCs for elective resident rotations, which includes both tribal health systems and the Indian Health Service (IHS). However, to our knowledge, formal GME curricula for rotations in AI/AN communities in the United States have not been published.…”