Chances
are, most Oregonians have never met a Native American doctor -- even if they
live on a reservation or an urban center with a high concentration of Native
people.
Less
than half a percent of Oregon’s 11,000 physicians identify as American Indians
or Alaska Natives.
So
when Erik Brodt was rejected from a pre-med research program, despite a letter
of recommendation from a prestigious biomedical professor, it just reaffirmed
what he had internalized without realizing it his whole life -- he didn’t
belong.
The
number of Native Americans in medical schools has steadily declined over the
last three decades, with only 39 in the entire U.S. last year out of more than
21,600. In 1980, that number was 60. It is a crisis that few have tried to
solve. Native people face a complex and intertwined set of obstacles to get
into medical school the traditional way -- high rates of poverty, cultural
clashes and few models of how it can be done.
So
the first time Brodt saw an Ojibwe doctor, it made such an impression he
remembers the exact date and seat he was in.
After
Brodt’s rejection, he was recruited to program to help Native people get into
the health professions. During that, a man walked in with braids like the kind
men from Brodt’s tribe wore.
“I
saw who I could become one day if I stayed on this path,” he said.
Brodt
now leads Oregon Health & Science University’s new Wy’East program, a
10-month post-baccalaureate program that recruits students who have been
rejected from medical schools and gives them free tuition and a stipend to
become successful medical school students.
All
10 members of the first class graduated in early summer, with six headed to
OHSU’s medical school in the fall. One will go into public health. The
remaining three plan to attend medical school after they shift out of careers
in other fields.
While
Brodt wants to see them become doctors and researchers and vaccine inventors,
the program could also be a boon to Oregon’s nine tribes, as well as the Yakama
and Nez Perce who live or work in both Oregon and neighboring states, which are
critically underserved by the existing health systems in the Northwest.
Native
American students are about 55% more likely to serve tribal communities than
non-Native doctors.
That
could make a huge impact on the care nearly 110,000 tribal members in Oregon
receive, because they experience some of the worst health outcomes of any
racial or ethnic group. The life expectancy for an average tribal member is at
least five years less than for a white person.
Native
people have some of the highest rates of diabetes, heart disease, cirrhosis and
other liver disease and life-threatening injuries.
But
there are almost no medical professionals who understand firsthand the cultural
factors and challenges that contribute to American Indian and Alaska Natives’
health outcomes.
“My
wife and I, our families live this. So kind of selfishly, I’m trying to figure
out how to solve this challenge,” Brodt said. “I want my family to have access
to high-quality, culturally responsive, affordable health care.”
Brodt
helped create the program as part of a larger OHSU push to boost indigenous
representation in the medical industry. A $3.4 million grant from the U.S.
government kicked off a series of programs that target Native American youth
and students -- the first American Indian and Alaska Native grant of its kind.
Wy’East joins a 12-week program for high school students that places them in a
medical setting where they are paid to do intern work. The first three came
from the Warm Springs reservation and are all now accepted to colleges where
they plan to prepare for careers in the medical field.
Grand
Ronde and Siletz students have joined with plans to keep expanding to other
reservations.
OHSU
is also helping produce a video series called “We Are Healers” that features
tribal members in medical professions.
All
of it is geared to play on the strengths of tribes’ cultures to help retain
students who might otherwise wash out.
Jacob
Smith declared he wanted to be a doctor at 6 years old. He spent years in and
out of OHSU Doernbecher’s Children’s Hospital when he was young with a host of
severe allergies and abdominal issues, a lacerated spleen and a tumor.
But
his score on the Medical College Admissions Test, the med school equivalent of
the SAT, didn’t win him admittance anywhere after he graduated from Linfield
College in 2017.
Instead,
he received an email that said he would be a good applicant for the Wy’East program.
“At
the time, it was a godsend,” Smith said.
Smith,
who is a member of the Walla Walla band of the Confederated Tribes of the
Umatilla, had never seen a Native doctor during his years as a patient. Growing
up in Hillsboro, he wasn’t aware that any of his classmates or teachers were
Native.
He
grew up going to Umatilla, Grande Ronde and Siletz powwows with his
grandmother. But fell out of the habit when he began to play soccer
competitively, which he did all the way through college.
The
Wy’East program reacquainted him with his heritage, he said, and gave his dream
a direction.
The
program begins with a Yakama Nation elder performing a strengths ceremony held
on sacred space on the Columbia River.
For
Smith’s cohort, the elder sang songs and the students created bundles to
represent what they feared. Then they offered them up to their ancestors.
The
idea is to show these students who were rejected from med school that they do,
in fact, belong.
“We
believe they are going to be amazing physicians because of where they come
from, not despite where they come from, and we say that from the beginning,”
Brodt said.
Smith
and his classmates spent eight Saturdays traveling to Eugene to take an MCAT
course. During the week, they took all the classes that first-year medical
students -- from any background -- struggle with. Many of those classes are
taught by the professors who will teach them when they enter medical school.
They
also discussed hot topics in medicine -- opioids, homelessness, attention
deficit disorder -- with a focus on indigenous culture.
It
helped acclimate the students to the structure and rigor of medical school in a
way that felt culturally relevant.
“I’m
no longer scared crapless of going to medical school,” Smith said.
They
end the 10 months with a blanketing ceremony, in which Brodt and the leaders of
the program place a blanket on their shoulders. It stands alone as a cultural
honor, but also as a nod to the white coat ceremony they will go through in
medical school.
For
Smith, some of the most impactful work was with Oregon tribes, which is
required of the students to gain hands-on experience.
He
has already applied to a scholarship program that would require four years of
service with an underserved population after graduation, which he would most
likely choose to be on a reservation.
“I
want to get out there and get my hands dirty as soon as possible,” Smith said.
--
Molly Harbarger
mharbarger@oregonian.com |
503-294-5923 | @MollyHarbarger
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