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 Educ->Funding/Grants: University of Minnesota's medical schools actively recruiting American Indians to become doctors
Posted on Sunday, December 11 @ 16:48:20 PST



The Center of American Indian and Minority Health is recruiting American Indian students to become students at the University of Minnesota's medical schools.

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American Indians die at a rate nearly 50 percent higher than the national average for people their age, according to the U.S. Indian Health Service. There are many reasons for the deaths -- accidents, suicides, chronic diseases, poverty and a lack of adequate and culturally sensitive medical care.

"Having well-trained Indian doctors go back to their communities can make a real difference," said Indian Health Service spokesman Leo Nolan.

The University of Minnesota's Center of American Indian and Minority Health is working to make that difference. The center recruits American Indian students and helps them through the university's medical schools in Duluth and Minneapolis.

"I came here for this medical school. It is known for its commitment to American Indian health, and that's the direction I was going in," said first-year medical student Jean Howell. Howell, a member of the Cherokee Nation, is originally from California and plans to become a family practice doctor in an American Indian community.

While a doctor doesn't have to be an American Indian to relate to Indian patients, it is helpful, center Director Dr. Joy Dorscher said. In July 2003, Ben Muneta -- then president of the Association of American Indian Physicians -- told a U.S. Senate committee that minority patients seeing a white doctor are less confident that they will receive adequate care than are white patients.

Such mistrust may cause some Indians to avoid doctors. "As soon as I started, people wanted to see me just because I am native," said Dr. Arne Vainio, who works at Min-O-Aya-Win Human Services Center on the Fond du Lac Reservation. "We understand each other. I grew up without electricity and indoor plumbing a lot of the time. I understand what poverty is and how it is to have things stacked against you."

A Mille Lacs Band member, Vainio grew up near Cook. He worked in a sawmill and a body shop, as a bartender and a construction worker before becoming a paramedic with the Virginia Fire Department. It was that job that made him interested in medical school.

"UMD is a great place for native medical students to go because of the center," he said. "It certainly offers a lot of support to native students." Vainio received his doctorate in medicine in 1994 and did his residency with the Seattle Indian Health Board. He's been at Min-O-Aya-Win since 1997. "I love it," he said. "It's exactly where I wanted to be."

Vainio believes there is a need for more Indian doctors. "They are very, very underrepresented," he said. "It's pretty rare to have a native physician working with native people."

American Indians make up 2.8 percent of the U.S. population, according to the 2000 census. But only 0.3 percent of students in the nation's medical schools in 2000 were American Indians.

In the early 1970s, the university's medical schools began programs to encourage American Indians to enter medicine. The school established the Center of American Indian and Minority Health in 1987 to coordinate and lead its efforts.

The center is one of three Native American Centers of Excellence in the nation, supported in part by the U.S. Department of Health and Human Services. The Minnesota center begins its recruiting efforts in middle school with programs designed to keep students interested in education and attract them to scientific fields.

"Not long ago, minorities were told not to bother because they couldn't do things like this," said UMD social work instructor and Leech Lake enrollee John Day. "We're telling them early they can do this."

UMD's Department of Social Work and the Center of American Indian and Minority Health work together on some issues, including giving social workers experience in medical settings.

Dr. Kathleen Annette, the Bemidji, Minn., area director for the Indian Health Service, took part in some of the first Indian-directed programs done by the University of Minnesota medical school in the early 1970s -- first as a high school student, later as an undergraduate and medical student at UMD.

"The program was really a magnet for both undergraduate and graduate programs," she said. "Students go through these programs and they bond. A support system develops so there is support to succeed in science and in math and in medicine -- whatever program you're going through."

After piquing the interests of students in middle and high school and in college, the center helps prospective medical students with study programs and workshops to prepare for admission to medical school. To help American Indian students through medical school, the center provides academic counseling, guidance from American Indian doctors and volunteer opportunities.

"We provide academic support, but the issues are very seldom academic," Dorscher said. "They are something else. Sometimes it is the fear of losing who they are."

The center helped Dorscher, a Turtle Mountain enrollee, learn more about her culture when she was a medical student in the early 1990s. Her mother had kept Dorscher away from traditional ways.

"The center gave me the opportunity to explore those things," she said. "I found that extremely helpful. Culture is an asset, not a deficit."

An advisory board of American Indian elders and professionals helps guide the center's activities.

"The center is really good about making it to where a native student can go through medical school and still relate their experiences to traditional values and traditional medicine," Howell said.

Fourth-year medical student Erik Brodt, an Anishinaabe from Cadott, Minn., said that in many ways the center is like a family.

"I think all of us have had moments where we need lots of support and then other moments where we are called upon to support other people," he said. "The support the center provided me really made medical school a much more enjoyable experience than the torment many people associate with medical school." Brodt would like to practice medicine at a tribal clinic in northern Minnesota.

The center's approach seems to work. The school graduated 16 American Indians during the 1970s and again during the 1980s. It graduated 70 during the 1990s. So far this decade, 37 Indians have either graduated or are attending the school. Another six have already enrolled for next year.

The Association of American Medical Colleges reports that the American Indian medical school ranks second in the nation for American Indian graduates, although it ranks 19th for the total number of graduates.

"We're really trying to get more Indian physicians into rural areas," Annette said. "UMD's strength has always been its ability to encourage students to go on into rural practice. And many of us come from reservations, so it is a natural fit."

The number of American Indian graduates is only one measure of the center's success. Increasingly, medical schools are moving away from producing doctors well versed in primary care and treating chronic illnesses to producing doctors trained in high-tech, hospital-based medical care, said Dr. Craig Vanderwagen, the Indian Health Service's chief medical officer.

Vanderwagen, who is white, grew up on the Zuni Reservation in New Mexico and remembers being proud of mastering skills such as inserting an arterial line. But after graduation, he found such skills of little use in Indian Country. He needed to know more about such things as prenatal care, delivering babies and dealing with chronic diseases.

"IHS wants to create public servants with skills to improve Indian health," he said. "The Indian programs in North Dakota and Minnesota have been much more focused on what I think are the right skill for serving Indian communities."

Howell would likely agree.

"The center is amazing for Native students and students interested in Native American health," he said. "It's a great school that has a lot of emphasis on producing doctors that are real people who want to work in normal communities."

ABOUT THE AUTHOR:
STEVE KUCHERA is a staff writer for the Duluth News Tribune. He can be reached at (218) 279-5503, toll free at (800) 456-8282, or by e-mail at skuchera@duluthnews.com




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