Diversifying the Physician Workforce: American Indian Outreach Programs at Oklahoma State University College of Osteopathic Medicine
Keywords:
American Indian, Medical Education, Physician DiversityAbstract
Despite significant health disparities experienced by American Indian (AI) populations, considerable gaps persist between the AI physician workforce and patient need. This is of particular concern given the demonstrated benefits to health care of provider-patient racial concordance. Since 2010, the Oklahoma State University College of Osteopathic Medicine (OSU-COM) has worked in partnership with Oklahoma tribal nations to increase the number of AI students pursuing careers in science and medicine through several high school and undergraduate outreach programs that incorporate AI cultural traditions into student training. In 2014, OSU-COM established the Office for the Advancement of American Indians in Medicine and Science with the goal of increasing the number of AI physicians and scientists. To date, 175 AI high school and undergraduate students have participated in OSU-COM’s outreach programs and enrollment of AI students has steadily increased to 14% of all COM students. Of all AI students pursuing osteopathic degrees across the country, approximately one-fifth are enrolled at OSU. The COM continues to expand AI student outreach programs and diversify experiences through new and continued collaborations with Oklahoma tribes. Next steps include a formal evaluation of efforts to assess both quantitative metrics, such as increases in AI medical student enrollment and AI providers in tribal communities, and qualitative outcomes, such as student experiences and community impact.References
Association of American Medical Colleges. Diversity in the Physician Workforce: Facts & Figures 2014. http://aamcdiversityfactsandfigures.org/. Accessed October 4, 2017.
U.S. Department of Health and Human Services. State-Level Projections of Supply and Demand for Primary Care Practitioners: 2013-2025. https://bhw.hrsa.gov/sites/default/files/bhw/health-workforce-analysis/research/projections/primary-care-state-projections2013-2025.pdf. Published November 2016. Accessed October 12, 2017.
Association of American Medical Colleges. FACTS: Applicants, Matriculants, Enrollment, Graduates, MD/PhD, and Residency Applicants Data, 2017-2018. https://www.aamc.org/data/facts/. Accessed October 4, 2017.
American Osteopathic Association. 2015 Osteopathic Medical Profession Report. http://www.osteopathic.org/inside-aoa/about/aoa-annual-statistics/Pages/default.aspx. Accessed September 26, 2017.
Chen F, Fordyce M, Andes S, Hart LG. Which medical schools produce rural physicians? A 15-year update. Acad Med. 2010;85(4):594-598.
Xierali IM, Nivet MA, Fair MA. Analyzing physician workforce racial and ethnic composition associations: Physician specialities (Part I). Anal Brief. 2014;14(8). http://www.ohsu.edu/xd/education/schools/school-of-medicine/departments/clinical-departments/radiation-medicine/about/upload/AAMC_analyzing-MD-workforce-racial-ethnic-comoposion_pt-1.pdf. Accessed September 26, 2017.
Rural Policy Research Institute. State Demographic and Economic Profiles: Oklahoma. http://www.rupri.org/Forms/Oklahoma2.pdf. Published 2007. Accessed October 4, 2017.
Chen X, Soldner M. STEM Attrition: College Students’ Paths into and out of STEM Fields. Statistical Analysis Report. National Center for Education Statistics [NCES] 2014-001. https://eric.ed.gov/?id=ED544470. Published 2013. Accessed October 4, 2017.
Lopatto D. Survey of Undergraduate Research Experiences (SURE): First findings. Cell Biol Educ. 2004;3(4):270-277. doi:10.1187/cbe.04-07-0045.
Wilson NF. Introducing high school students to careers in osteopathic medicine. J Am Osteopath Assoc. 2017;117(5):325-330. doi:10.7556/jaoa.2017.058.
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