Representation of American Indian and Alaska Native Individuals in Academic Medical Training

Abstract

Key Points Question How does representation of American Indian and Alaska Native individuals at specific stages of academic medical training compare with representation of their White counterparts? Findings This cross-sectional study including 1.35 million American Indian and Alaska Native and White individuals in each stage of the 2018-2019 academic medical training continuum found that, compared with their White peers, American Indian and Alaska Native individuals had 63% lower odds of applying to medical school compared with the general US population and 48% lower odds of holding a full-time faculty position postresidency. Meaning These findings suggest there are distinct stages in academic medical training for targeted policy and program changes to increase the representation of American Indian and Alaska Native individuals.

Characterization of National Medical Societies’ Accessible Resources to Support Underrepresented Minority and Female Trainees

“…In light of this growing awareness, we have seen moderate improvement in undergraduate medical education, but structural racism continues to contribute to differences in achievement of and opportunities for minority students . Progress in representation of Black and American Indian and Alaska Native matriculants have halted if not declined, with the current quota insufficient to serve the representative populations within society . With a growing, racially diverse population and a lagging relative proportion of minority physicians, there is a dire need to develop sustainable initiatives to increase representation.…”

US Medical School Admissions Leaders’ Experiences With Barriers to and Advancements in Diversity, Equity, and Inclusion

“…We conducted purposive sampling to obtain a range of perspectives across school racial and ethnic composition. Using 2018 to 2019 data, 28 we ordered schools by percentage of students who have been historically and structurally excluded from the medical profession (defined as students who identified as American Indian or Alaska Native, 29 Black or African American, Hispanic or Latinx, and/or Native Hawaiian or Pacific Islander), determined quartiles of student diversity (with quartile 1 comprising medical schools with the greatest diversity and quartile 4 comprising medical schools with the least diversity), and targeted recruitment for representation from each quartile.…”

“…American Indian or Alaska Native, 29 Black or African American, Hispanic or Latinx, and/or Native Hawaiian or Pacific Islander), determined quartiles of student diversity (with quartile 1 comprising medical schools with the greatest diversity and quartile 4 comprising medical schools with the least diversity), and targeted recruitment for representation from each quartile. We used the term structurally excluded to signify that certain racial and ethnic minority groups have been (and continue to be) excluded from the profession as a reflection of active rather than passive processes.…”

Repaving the Pathway to Prevent the Loss of Students With Marginalized Identities—Medical Student Attrition

“…4 Particular exploration is needed to understand the experiences of American Indian and Alaska Native students for their attrition after matriculation into medical school, which is a considerable loss to the entire patient and professional population given their near absence in medicine owing to structural racism and indigenous genocide. 5 Improving the learning environment to optimize the success of marginalized students requires a comprehensive approach, with both structural and individual/interpersonal changes. These changes can be developed and implemented promptly after reflection, skill building, policy and procedural adaptations, removals, or enhancements, especially with strong support from institutional leadership.…”

“…Again, although admissions teams have increased access to medical school for many underrepresented groups by adopting holistic reviews, requiring implicit bias training, and expanding their committees to reflect greater diversity representation, it would seem that a similar effort is needed to ensure that the learning environment does not hinder marginalized students’ success . Particular exploration is needed to understand the experiences of American Indian and Alaska Native students for their attrition after matriculation into medical school, which is a considerable loss to the entire patient and professional population given their near absence in medicine owing to structural racism and indigenous genocide …”