Supporting the Native health leaders of tomorrow
By Darby Kendall
Creating pathways for American Indian and Alaska Native students in medicine is a powerful effort at the OHSU Northwest Native American Center of Excellence (NNACoE). Innovative programs designed to support the talent of Native youth encourage greater diversity within the health care field.
Erik Brodt, M.D., associate dean for Native American Health and director of NNACoE, is passionate about fostering equity and reshaping the narrative around Native representation in the health workforce. From the Wy’east Medicine Pathway to community-based externships, these efforts are breaking down barriers and inspiring future generations of American Indian and Alaska Native health professionals.
This is an audio story featuring highlights from a conference Brodt spoke at in the spring of 2024.
Transcript
It’s normal to be an American Indian walking through the halls of OHSU now, whereas seven years ago, it wasn’t; you stood out. But now it’s so normal because there’s over 100 of us walking around. That is stunning compared to every other academic health center in the country.
Dr. Erik Brodt is the associate dean for Native American Health and the director of the Northwest Native American Center of Excellence at the OHSU School of Medicine. In addition to caring for patients as a family physician, he works to improve American Indian and Alaska Native health outcomes and develop professional training programs. Here are some highlights from a conference he spoke at in March 2024. This recording was taken outdoors, so you may hear occasional buzzing feedback from the mic.
OHSU has this program called On Track. When I first arrived at OHSU at the end of 2015, that was one program that I had the good fortune of participating in as a speaker. So I went out to a few communities and talked to youth who were interested in science, technology and engineering math careers. It’s usually in the middle schools. And I came to one tribal school, and the teacher came up to me ahead of time, and she said, “There’s a boy sitting over here in the corner.” Let’s just call him Jimmy. “Jimmy’s gonna sit and look out the window because he’s just not that interested in school. It’s nothing against you. He won’t be disruptive. I just don’t want you to be offended.” I said, “Oh, I got this. No problem.”
In Portland, I put up this picture. Every kid knows it’s a fish, that’s as far as we get — as far as the experts, it’s a salmon. So I did this out in this tribal community, and that’s when Jimmy, sitting over there by the radiator, looking out the window, turned and looked. And he said, “That is a spring Chinook salmon, and it’s a male. And I can tell you why, because if you look at that fish, and you look at its mouth, it’s got this black stripe on the bottom of its mouth. Some people call them black mouth. Some people call them spring king. We call them Chinook. And I can tell you where it’s caught too, because if you look where it’s sitting in the river and those rocks around there, that’s typically what the Columbia River looks like after the spring runoff has receded, and it’s left those patterns in the mud around the rocks.”
And I was like, “Oh my God!” Right? Someone’s just like, “Oh wow, they’re a fisherman. That’s so great.” I was like, “No, they’re not a fisherman! They’re an expert. They’re a scientist.” And what they were able to do was, literally, in a minute, teach their entire class some really profound things about this fish: Where it’s from; what kind of fish is it; show you how to identify it; show you how to tell the sex of the fish. This was an expert that was hidden right in the class, yet the system thought that Jimmy wasn’t interested. “He’s not curious. He’s not going to be a scientist. Why would he be a leader one day?”
The world is missing out on American Indian and Alaska Native wisdom and excellence. And it doesn’t have to be that way. We know people who have the skill and the aptitude and the desire and the passion, the discipline, the determination to make this happen, to become a health professional, but for whatever reason, there’s bumps along the way or barriers where they don’t pass those spots. Our mission at the Northwest Native American Center of Excellence is to sustainably address the health care needs of all people by increasing American Indian and Alaska Natives in the U.S. health workforce. What makes us special is the position that we come from and the perspective that we have. We begin with meaningful tribal partnerships, and we’re also driven by our indigenous values of excellence, tenacity, kinship and healing.
I want to talk about two programs. The first one is called Tribal Health Scholars. It is a paid externship program that happens in tribal communities during the academic school year, where the community and the tribe has identified youth that have the skill and the temperament to be what they think would become a health professional one day. We did a pilot program with this. They work in the clinic, they do a day of shadowing, and they have a number of sessions that are done around different health careers to expose them to these crews, to help them imagine who they can become one day. We took it from one pilot program to now we’re operating in over 10 communities all across the region, and there’s more to come.
The next one is Wy’east Medicine. This is the cornerstone of what we do, where we identified a terminal fracture in the pathway to medical school, and we also helped the WAMC, which is the national accrediting body for all medical schools in U.S. and Canada, identify that American Indian and Alaska Natives who apply to medical school once and don’t get in never apply again. That is so different from every other race and ethnicity that applies to medical school; most people give up after three or four attempts. American Indian and Alaska Natives would apply once, don’t get in, and drift away forever. We said that’s got to stop. So we built the Wy’east Medicine Pathway, which is a 10-month, rigorous post-baccalaureate pathway where it’s tuition free; we provide a living stipend. And here’s the kicker, at the end, they earn conditional acceptance into a U.S. medical school — OHSU first, and then recently, we expanded to work with Washington State University and UC Davis College of Medicine.
So now that we helped expand and pilot medicine beyond our institutional walls, what we’ve done is now we’re vertically integrating within OHSU. So we’re expanding with dentistry; we’re expanding with nursing; we’re expanding with public health, College of Pharmacy. We’ve literally become the shining beacon in the country that is cracking the nut in how to do this work, and we’re bringing other people along with us.
