First tribal-affiliated medical school bridges the gap in Indian country, rural America


After working for several years as a public health nurse with the Indian Health Services in Oklahoma City, Ashton Gatewood, a Choctaw Nation citizen, knew she wanted to continue her medical education.

She had heard of the country’s first tribal affiliated medical school with the Cherokee Nation and knew she wanted to make it the next step in her career path.

Gatewood, a native of Mustang, Oklahoma, therefore enrolled with other students – native and non-native – in 2020 and was part of the school’s first class, a partnership with the College of Osteopathic Medicine of the Oklahoma State University.

“I have truly embraced the mission of IHS, which is to improve the health and well-being of patients, and they view well-being as physical, mental and spiritual,” she said. “When I saw a newspaper article on the Cherokee Nation campus, I looked at what their goals were and found that their mission was to train doctors to work in tribal communities. I found that the osteopathic philosophy really aligned with the mission that I had already really embraced.

As the first cohort of students began in 2020, the $ 40 million establishment in Tahlequah – the heart of the Cherokee Nation – opened in early 2021.

The Cherokee Nation OSU College of Osteopathic Medicine is the first tribal affiliated medical school on the nation’s tribal lands.

“If we are thinking about training doctors, we want to train them in an environment in which we want them to practice,” said Dr Natasha Bray, acting dean of the school. OSU has invested in recruiting rural and indigenous students for some time, she said.

Conversations about opening a medical school began and accreditation took some time, Bray said.

“We worked on all the documentation and accreditation requirements,” she said, which included showing that there was a need for more doctors in the state. “It’s pretty well known that we need more primary care physicians and even specialty physicians in Oklahoma. “

The Oklahoma State University College of Osteopathic Medicine of the Cherokee Nation in Tahlequah, Oklahoma. (Photo courtesy of Oklahoma State University College of Osteopathic Medicine)

August 2020 saw the inaugural class of over 50 students. And the second class has recently started.

The curriculum is the same as that at the Tulsa campus, which includes anatomy, genetics, and biochemistry, among other courses. Then the students learn more in depth and examine why the patients come, Bray said.

“So patients will come in and say my blood vessels are dilating, so we start talking about this dual role of a doctor – being able to talk to them and gaining their trust but also being a scientist,” Bray added.

Patient populations and the role of historical trauma are also discussed and taught, Bray said. “We’re really talking about some of the barriers of being a person living in a rural community and your access to care is 45 minutes or an hour away and how that will affect the way a patient interacts with the health system. She added.

The most pressing health issues in tribal communities can all be linked to access, said school faculty member Dr Janel H. Johnson.

“Whether it’s diabetes, high blood pressure, murdered or missing Indigenous women, girls and two spirits, the systemic lack of access to coherent and culturally competent medical care, food deserts, environments safe to exist, like lighted pathways and decent sidewalks, all contribute greatly to our health problems… We know health problems; we need to invest in equitable and accessible solutions with the contribution and consent of tribes.

One thing Covid-19 brought about was a shift to telemedicine, noted Bray, which has worked well in areas with broadband access. “If you live in a rural community without broadband access and inconsistent cell service, your ability to access services and do telehealth will be very different,” she said.

Cultural competence is high on the school’s priority list. This year, the school is adding an additional language course – Cherokee – to Spanish and sign language, Bray said.

“We want them to learn the role of language and culture and even basic sentences,” she said.

Gatewood – the second-year medical student – said the first year was difficult, especially due to Covid-19.

“It’s also because we were the inaugural class,” she said. “It really allowed us to become leaders because there was no one in front of us.”

Less than one percent of doctors are Native American, according to a 2018 American Medical Association study.

“It’s hard when you don’t have anyone in your family or your social network who’s done this before,” Gatewood said. “The more students in our community that come to school and become doctors, the more it will inspire others to do the same.”

The school, Gatewood noted, tries to recruit indigenous and rural students so that they can train in an indigenous and rural community and continue their careers there.

“We need the doctors here,” she added.

Of the inaugural class, 20% identify as American Indian, according to the school.

Gatewood said another advantage for a tribal-affiliated medical institution is the cultural background. “If someone doing traditional medicine or tribal ritual healing practices comes along and the doctor is not native and doesn’t recognize him, he may not consider that for the rest of the plan. care and that it can also be judgmental or negative. something that makes the patient uncomfortable.

Gatewood noted that some of the students have families and come from rural areas, potentially making restarting in a new community a bit more difficult. The school worked with the students to overcome all obstacles, she said.

“They’re really adjusting to try to make sure that students can live their lives while pursuing their dream of becoming a doctor,” she said.


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