AAMC Reporter: November 2005

Indian Health Pathway graduates at 2005 Blanket Ceremony, University of Washington (l to r): Molly Armijo, Michelle Show (Assinibone), Elina Durchman, Allison Kelliher (Koyokan Athabaskan), Shana Sniffen (Pacific Islander)

Diversity in Action

Centers Prepare Medical Students to Serve Native American Patients

By Whitney L.J. Howell

An image of several people huddled together around a pile of heated rocks in a darkened, dome-shaped structure probably is not what most people would associate with medical training. But for some students at the University of Washington School of Medicine, learning about and experiencing a sweat lodge for purification is an important part of their preparation to become doctors.

The students are part of the Native American Center of Excellence, which — in addition to recruiting Native American and Alaskan Native medical students — works to integrate traditional Native American healing methods with modern Western medicine.

"Having a center like this really enhances the communication between Indian country and academic medicine," says Polly Olsen, the center's director and a member of the Yakama Tribe. "Students learn the cultural norms of Indian country, and they stay connected with the community, their heritage, and the ongoing research that will affect Native Americans and Alaskan natives." Financed by the Bureau of Health Professions Service Administration in the Health Resources and Services Administration, the center was started in 1992 by Walt Hollow, M.D., a faculty member who is affiliated with the Assinibone and Sioux Tribes.

Washington's Center of Excellence is one of four similar programs nationwide. The others are at the University of Oklahoma College of Medicine, the University of Minnesota-Duluth Medical School, and the University of Hawaii John A. Burns School of Medicine. Washington's center, which also attracts non-Native American students interested in treating underserved populations, is connected to the medical school through Indian Health Pathway (IHP), a unit of the center with its own curriculum and research requirements. IHP prepares students for health care careers with Native American groups and encourages them to study health issues that such groups face. Students who satisfy IHP requirements participate in a Blanket Ceremony, where they receive a certificate of completion, along with a blanket to protect them from harm during their service to American Indian communities.

The curriculum includes two required courses. One covers long-standing Native American health topics, such as traditional Indian medicine and smudging ceremonies (in which herbs are burned and smoke is moved around to cleanse and purify participants' "space"). Reservation health care also is covered in this course. The other course deals with analysis of common and unique health problems in native populations.

The IHP also offers clerkships or preceptorships. First- and second-year students can take an optional eight-week introductory course in family medicine. Third- and fourth-year students get more hands-on experience through two required clerkships. The first is a four-week traditional Indian-medicine clerkship in an urban or reservation health care facility, where students observe how Western physicians fuse traditional Indian healing techniques into their care of Native Americans. The second is a four-week Indian health clerkship in which students provide care on a reservation or through the Seattle Indian Health Board.

Walt Hollow, M.D., founder of the Native American Center of Excellence at the University of Washington School of Medicine, and center director, Polly Olsen, a member of the Yakama Tribe

Olsen says many of the center's former students have "come back to say 'thank you' for the tips they learned about the Indian culture" before starting their own medical practices. Their educational experiences help them become accepted later on by the people they serve, she explains. Students also learn "the importance of asking patients a full circle of questions — not just about family history and how they're feeling, but also about any herbal medications" and whether the patients have been seen by local healers.

The center currently enrolls 30 students, including 11 American Indians. In the last three years, 48 Native Americans have graduated from the center and returned to care for the underserved populations in tribe-run clinics. Many graduates remain closely connected to the center, where they serve as mentors.

Last month, for the first time, the center began a formal effort to encourage much younger students to prepare for medical careers. The center received an endowment from Nelson Fausto, M.D., chair of the department of pathology, and Ann DeLancy, M.D., a psychiatrist associated with the school, for a two- to three-day mini medical school specifically for middle school students.

Physicians have important roles in disasters, but not only in the response phase. They also have a part to play in the pre-planning and long-term recovery processes that facilitate community resilience. The medical education community must not fail to prepare future physicians more thoroughly for the inevitable disasters to come.

Contact Us    © 1995-2008 AAMC    Terms and Conditions    Privacy Statement