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Posted inTribal Affairs


FIRST TRIBALLY-AFFILIATED MEDICAL SCHOOL BRIDGING GAPS IN INDIAN COUNTRY, RURAL
AMERICA

OSU College of Osteopathic Medicine at the Cherokee Nation trains primary care
physicians to work in rural and underserved communities, making sure their
skills meet the needs of environments they'll go on to serve in.
by Kristi Eaton August 16, 2021August 13, 2021


SHARE THIS:


Dr. William Pettit (left), Dr. Kayse Shrum and Chuck Hoskin, Jr., take part in a
ribbon-cutting at the Oklahoma State University College of Osteopathic Medicine
at the Cherokee Nation in Tahlequah, Oklahoma, on Friday, January 15, 2021.
(Photo courtesy of Oklahoma State University College of Osteopathic Medicine)

After spending several years working as a public health nurse at Indian Health
Services in Oklahoma City, Ashton Gatewood, a citizen of the Choctaw Nation,
knew she wanted to further her medical training.

She had heard about the first-in-the-country tribal-affiliated medical school at
the Cherokee Nation and knew she wanted to make that the next step in her career
path. 

So Gatewood, originally from Mustang, Oklahoma, enrolled with other students –
both Native and non-Native – in 2020 and became part of the first class at the
school, a partnership with Oklahoma State University’s College of Osteopathic
Medicine. 



“I really embraced the mission of IHS, which is to improve patient health and
wellbeing, and they look at wellbeing as physical, mental, and spiritual,” she
said. “When I saw a newspaper article about the Cherokee Nation campus, I looked
into what their goals were and found out that their mission was to train
physicians to work in tribal communities. I found that the osteopathic
philosophy really aligned with the mission that I had already really embraced.”

While the first cohort of students started in 2020, the $40-million facility in
Tahlequah – in the heart of the Cherokee Nation – opened in early 2021.

The OSU College of Osteopathic Medicine at the Cherokee Nation is the first
tribally affiliated medical school on tribal land in the country with a focus on
educating primary care physicians who have an interest in serving rural and
underserved populations in Oklahoma.



“If we think about training physicians, we want to train them in an environment
in which we want them to practice,” said Dr. Natasha Bray, interim Dean of the
school. OSU had been invested in recruiting rural and Native students for some
time, she said. 

Conversations around opening a medical school started and accreditation took
some time, Bray said. 

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

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

August 2020 saw the inaugural class of more than 50 students. And the second
class recently started. 

The curriculum is the same as the Tulsa campus, which includes anatomy,
genetics, and biochemistry, among other coursework. Then the students move into
learning more in-depth and examining why patients come in, Bray said. 


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“So patients will come in and say my blood vessels are dilating, so we begin to
talk about that dual role of a physician — being able to talk to them and gain
their trust but also be a scientist,” Bray added. 

Patient populations and the role of historic trauma are also discussed and
taught, Bray said. “We really talk about some of the barriers of being a person
who lives in a rural community and your access to care is 45 minutes or an hour
away and how that will affect how a patient interacts with the healthcare
system,” she added.

Most pressing health issues in tribal communities can all be related back to
access, said Dr. Janel H. Johnson, a faculty member at the school.

“Whether it’s diabetes, high blood pressure, murdered and missing indigenous
women, girls, and two spirits, the systemic lack of access to consistent and
culturally competent medical care, food deserts, safe environments to exist,
like lighted pathways and decent sidewalks, all contribute heavily to our health
issues…We know the health problems; we need investment in equitable and
accessible solutions with tribal input and consent.”

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

Cultural competence is high on the list of priorities for the school. 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 the language and culture and even basic
phrases,” she said.  

Gatewood – the second-year medical student – said the first year was
challenging, not least of which was due to Covid-19. 

“It’s also because we were the inaugural class,” she said. “It really made us
all step up as leaders because there wasn’t anyone ahead of us.”

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

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

The school, Gatewood noted, is trying to recruit Native and rural students so
they will train in a Native and rural community and continue their career
there. 

“We need the physicians here,” she added.

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

Gatewood said another benefit to a tribally affiliated medical institution is
cultural context. “If someone comes in who is doing traditional medicine or
tribal ceremonial healing practices, and the physician is non-Native and doesn’t
recognize that, they may not consider that for the rest of the care plan and
they could also be judgemental or negative about something that makes the
patient feel uncomfortable.” 

Gatewood noted that some of the students have families and come from rural
areas, potentially making starting over in a new community a little more
challenging. The school has worked with students to overcome any obstacles, she
said. 

“They’re really adapting to trying to make sure the students are able to live
their life while pursuing their dream of becoming a physician,” she said. 


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 * 



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