A first-of-its-kind medical school could transform healthcare in Indian Country for the better.
The Indigenous School of Medicine (ISOM), a proposed medical school that weaves ceremony, culture, and Indigenous practices into physician education, could welcome students as early as 2030.
Dr. Donald Warne (Oglala Sioux), physician and co-director for the Center for Indigenous Health at Johns Hopkins and ISOM president, told Native News Online that the school aims to provide an environment where students don’t have to check their Indigenity at the door, but instead center their education and practice around their culture.
The school could not only increase the number of Native American physicians — only 0.3% of practicing physicians are American Indian or Alaska Native — but would also create a space in medical academia for Native people.
“A big challenge in medical education is that we have zero medical school deans who are American Indian,” Warne said. “We’re not underrepresented — we’re unrepresented.”
We talked to Warne about creating a curriculum that leaves medical students healed instead of exhausted, the omnipresence of Indigenous medicine in healthcare, and why culture is critical to care in Indian Country.
This Q&A has been edited for clarity and length.
When we use the word Indigenous with medicine, society tends to automatically categorize it as anecdotal, not evidence-based or simply as a nice add-on. We know that isn’t the case, though. There is a wealth of evidence attesting to the efficacy of Indigenous medicine and culturally centered care. All that being said, what would distinguish an Indigenous medical school from a typical medical school?
A lot of our American Indian and Alaska Native students have this sense that they need to check their culture at the door in order to fit into the culture of modern medicine, and it really is a shame. Another big challenge in medical education is that we have zero medical school deans who are American Indian. We’re not underrepresented — we’re unrepresented. Deans are the chief executive officers of medical schools, and we’re not at those tables. We’re not involved in curriculum development. We’re not involved in student wellness as American Indian people, so we’re relying on the non-Indian world to train our students. Something like one in 1,000 tenured medical professors is American Indian.
What would distinguish an Indigenous school is the incorporation of traditional Indigenous medicine into the curriculum. There’s also a huge misunderstanding of how much Indigenous medical science has already contributed to the field. For example, even aspirin is willow bark tea. When you go to the ER, and they suspect a heart attack, the first thing they give you is willow bark tea — in the form of aspirin. That’s our medicine. It’s been our medicine for thousands of years. There are actually hundreds of examples of Indigenous medicine that have been incorporated into modern medicine.
You mentioned Native students feeling like they need to check their culture at the door. What was your own experience with that in medical school like?
I wear my hair in a traditional way, and there were even comments about that. I started medical school in 1990, so that’s 36 years ago. Things have improved since then, but there’s still a lot of work to do. There’s this whole concept of education by humiliation — the idea that fear is a great motivator. If you get something wrong, you can be belittled and berated in front of your fellow students, and it’s very traumatizing. I went to Stanford for medical school, and one of the attending physicians said I had to suffer, so you will too.
We already face high dropout rates from high school and lower college completion rates among Native students, so we have fewer potential pre-meds to begin with. And unfortunately, even in medical school, American Indian students have the highest dropout rate. It’s a travesty to get that far and not finish. The Association of American Medical Colleges has what’s called a graduate questionnaire, and in some years, as many as a quarter of graduates already regret going into medicine because of the way they were trained. That’s our future workforce. The way we’re doing it is wrong. We shouldn’t be graduating traumatized scientists. We need healed healers. The tagline for ISOM, the Indigenous School of Medicine, is “Healed Healers Heal.”
In our curriculum, we’ll incorporate wellness, culture, and ceremony. We’re focused on producing healed healers who can provide higher-quality care. When you think about it, the provider’s health and balance directly affect how they interact with their patients.
Who can apply to ISOM?
This school is open to anyone. You do not have to be an Indigenous person, but you do have to have demonstrated commitment to Indigenous health. If we have allies who are committed to working with our people, they are welcome. My sense is that the majority of applicants will probably be Indigenous, but we welcome allies as long as they are truly committed to working with Native communities.
Where does the feasibility study currently stand, and where might the school be located?
We received a $1 million grant from the Robert Wood Johnson Foundation to conduct a feasibility study, business plan, and economic impact assessment. We’ve had discussions with several cities — Rapid City, South Dakota; Anchorage, Alaska; Santa Fe, New Mexico; and Flagstaff, Arizona. By far the greatest support has been in Rapid City. We have letters of support from the mayor, from the CEO of Monument Health, from the dean of the University of South Dakota Medical School, from the presidents of South Dakota State University and the South Dakota School of Mines and Technology, and from the large tribal clinic in Rapid City. The political, academic, economic, and health system support is tremendous. Our business plan will be complete by the end of July, and then we move into fundraising. ISOM will be a nonprofit medical school, so we’ll depend on fundraising and large-scale endowments.
We know there are massive health disparities in Indian Country, driven by many factors. How could ISOM close those gaps?
Many of the health disparities we deal with are preventable. One of the big missing pieces is Indigenous-focused medical education in which our providers are healthy and balanced, culturally sensitive and humble, and can work effectively with our people. If we have higher-quality care and access to more services, we will see those disparities improve. The long-term goal — seven generations from now — is to have no disparities, to have equitable health for all populations. That’s the dream our future generations will live out.
