Growing up in the Choctaw Nation of Oklahoma, having Native doctors and nurses was very common. Though they were located about an hour-long drive from my home, I had access to Indian Health Service-funded clinics like those portrayed on the popular TV show “Reservation Dogs,” staffed largely by Native doctors.
As I got older, I learned that my experience was the exception, not the norm. Only 0.4 percent of active physicians in the U.S. identify as Native, despite the fact that we make up 2.9 percent of the population. This ratio used to be even worse — just 55 years ago, there were only 30 Native medical school-trained doctors across the entire country.
Though strides have been made since then — today there are about 2,500 Native physicians — we have a long way to go. Historical and systemic barriers, such as the accumulated loss of Native land and the forcible assimilation of Native children via federal boarding school policies contribute to present day inequities. These challenges lead many Native college and medical students to drop out of school. We need to address these challenges by easing financial burdens and providing support so Native students can thrive.
This isn’t an isolated issue. People from marginalized communities are underrepresented throughout the medical field — whether as doctors, health care leaders or subjects in clinical trials. This is despite the fact that data shows patients of color report higher satisfaction and better outcomes when treated by a doctor with the same background as theirs.
In addition to a lack of representation, structural inequities also contribute to poorer health outcomes for Native communities. For example, chronic underfunding of the Indian Health Service, a federal agency meant to provide free health care for Native populations, makes it difficult and expensive for Native patients to access timely care.
Native people experience higher rates of diseases like diabetes, respiratory disease, and many cancers. These health disparities are deadly: The life expectancy for Native people is 5.5 years lower than the U.S. average.
As a medical student, I saw this first-hand when I worked at a clinic that provides culturally respectful and community-centric care in the Bronx, New York. By honoring the wide range of factors that contribute to a person’s health — including unique cultural practices and community norms — we were able to build trust and make our patients feel seen.
At this clinic, I often worked with patients who expressed hesitation about the use of medications in their care. One patient explicitly shared that the root of their concern was the historical context of racism in medicine. The legacy of unethical medical practices, such as the Tuskegee Syphilis Study and forced sterilizations in the 1960s and 1970s, has understandably fostered mistrust in marginalized communities. These past injustices left a lasting impact, leading some patients to question the safety and intentions of medical treatments.
By approaching patient concerns with curiosity, I strive to build trust and provide care that is respectful and patient-centered. As medical professionals, it’s imperative we provide this level of compassionate care, especially to those who have been undervalued or unheard by medical institutions.
To make sure all patients have access to this type of care, we need to invest in higher education for marginalized groups — which is central to producing the next generation of doctors. Native college students, for example, have an average unmet financial need of $26,000, and 16 percent of Native students experience homelessness while pursuing higher education. This results in a low graduation rate — with around 40 percent of Native students graduating college in recent years, compared to the national average of 62 percent.
Increased access to scholarships and other funding is crucial to improving Native representation in medicine and beyond. As we continue to see fallout from the ban on affirmative action, we need to expand outreach to Native students and ensure that students feel welcome on campuses, including by supporting spaces where Native students can gather to share their experiences and build community.
As part of a scholarship I received from Native Forward Scholars Fund, a Native-led organization that supports students in pursuing higher education, I received mentorship and culturally relevant resources — such as Rising Native Graduates, an academic coaching program focused on developing career goals and academic success — in addition to financial support. Both of these programs were instrumental in helping me to finish my degree.
Growing representation can sometimes feel like a slow process, but it’s an investment that has positive ripple effects for generations to come. And the change is already happening: In 2023, medical schools saw Native enrollment rise by 14.7 percent.
As a student that once benefited from mentorship and guidance, I am proud to now also be a mentor myself. For a year and a half, I have served as an academic coach to a young pre-physician associate student and supported them through their professional journey. I recently was able to advise my mentee as they were struggling with impostor syndrome that caused them to hesitate to pursue opportunities to shadow physicians. I was able to encourage them to do it with my own experience of having done the same. It’s opportunities like these that make me hopeful and motivate me to keep going and work for a better — and healthier — future for my people.