MD ID 6660 - Improving Indigenous Health Care Delivery

Utah is home to 8 Native American (NA) tribes: Confederated Tribes of Goshute Indians, Navajo, Northern Ute Tribe, Northwestern Band of Shoshone, Paiute Indian Tribe of Utah, San Juan Southern Paiute, Skull Valley Band of Goshute, and White Mesa Band of the Ute Mountain Ute. In addition, the surrounding states in the Intermountain and Southwest Regions are home to many others. Utah has a network of tribally and federally administered healthcare systems, as well as an active Urban Indian Center in Salt Lake City, which provide primary care and mental health services to this historically under-resourced population. Many NAs throughout the U.S. receive health care services through a network of federal and/or tribal-administered healthcare systems, which are underfunded and often under-staffed. This system, including its origins, is complex and poorly understood by most medical students. In addition, the historical context – namely European settler colonialism, the genocide inflicted upon Indigenous peoples of North America, the subsequent relationship and power-differential between the federal government and NA tribes, the resultant effects on individual and community health and wellbeing, and continued efforts at maintaining tribal sovereignty and building cultural resilience – is also poorly understood by most medical trainees, as well as the faculty and preceptors charged with educating them. Health inequities in NA communities are well documented, where 20% or more of the population live in poverty. To respond to these injustices – made all too visible during the COVID pandemic – federal, state, and local organizations must work with tribal communities towards solutions that provide consistent, high-quality, culturally competent care. An important piece to this response includes implementation of a robust, locally responsive, and culturally appropriate curriculum taught by local tribal members/elders and experts in NA health, education, culture, history, and tribal law (to name a few). There are several academic centers that have developed impactful, locally appropriate curriculum in NA health. The University of Utah School of Medicine Tribal, Rural, Urban Underserved Medical Education (TRUE) Program has worked closely with experts from one such center, the University of Missouri School of Medicine, utilizing their “Indigenous Heath Toolkit” to create this 1-credit, 7-mdodule course. This course, created through this close collaboration, and in partnership with Utah’s local tribes and NA stakeholder organizations, is a requirement for successful completion of the TRUE Graduate Certificate, starting with the Class of 2026 (beginning medical school in 2022), and is an invitation for lifelong learning to improve knowledge, skills and behaviors around working with NA patients and communities. The class is also open to all medical students and all health professional trainees in the other schools and colleges at the UU interested in learning about NA health and how best to engage with members of these communities and the healthcare systems entrusted to provide them comprehensive medical care. There are no prerequisites for this course.