wo federal programs, the Native American Centers of Excellence and the Health Careers Opportunity Program, which have proven vital to the production of American Indian and Alaska Native health professionals, are threatened with elimination. The centers have attracted hundreds of students to study medicine at major universities. The Association of American Indian Physicians and other focused career programs around the country have served thousands of American Indian and Alaska Native students.
The COE and HCOP programs may be eliminated by Congress. Language contained in the House and Senate versions of the Labor Health and Human Services spending bills for fiscal year 2007 would inadvertently eliminate the future availability of medical training for thousands of AI/AN students, cutting off the supply of Native health providers. Drastic funding cuts in 2006, combined with language in the bill that prioritizes historically black colleges and universities, will, in essence, remove the universities serving Native students as contenders for the COE programs and severely curtail or eliminate the HCOP programs.
The AAIP is a national nonprofit organization that was founded in 1971 by American Indian physicians. There is a diverse membership of more than 300 AI/AN physicians from all regions of the country. AAIP’s mission is to pursue excellence in American Indian health care by promoting education in the medical disciplines, honoring traditional healing practices and restoring the balance of mind, body and spirit.
It is predicted that by the year 2050, racial and ethnic minorities will represent half of the population in the United States. This calls for a dramatic increase in minority physicians, known to be more likely to practice in medically underserved areas. Increasing the diversity in the health care work force has been cited as a solution to narrowing the gap in health care disparities experienced by racial and ethnic minorities.
The centers that focus on Indian populations are located at the University of Minnesota, University of Washington and University of Oklahoma. These health career organizations, along with the Indians into Medicine program at the University of North Dakota, produced nearly a quarter of the nation’s AI/AN medical school graduates from 2002 – ’05. In its first 10 years of funding, the COE programs helped double the number of Native medical school graduates.
Due to programs like these, the number of students entering and graduating from health professions schools is increasing dramatically. The HCOP identifies more than 200 Indian high school and college students interested in the health professions each year and maintains an active database for tracking their academic progress. We establish new relationships each year with higher educational institutions and obtained Educational Assistance Agreements to support students in their entrance into health professions schools.
I would not be where I am today without the recruitment and retention support of the University of Minnesota COE. I was deterred by a high school guidance counselor who informed me that I didn’t come from the “right kind of family” and that I was too poor to go to medical school. I was told that my entire family would suffer if I tried to pursue my “foolish dream.” Five children and many years later, I went back to school to complete my pre-med courses. Fortunately, the University of Minnesota’s COE told me that my dream was not foolish and that I could succeed. They provided me with the cultural, moral, physical and financial support. I was able to graduate from medical school and become a role model for others.
There is a tremendous need for minority health professionals who are willing and able to practice in underserved areas. The Association of American Medical Colleges’ recent 2004 survey of medical school graduates found that minority graduates’ intent to practice in underserved areas was more than twice that of white graduates. Without the existence of HCOP and COE programs, future generations of minority and AI/AN students may not have the opportunity to offer their service as health care providers to their communities.
I cannot believe that Congress would intentionally eliminate the programs that have produced so many physicians and other health professionals serving American Indians and Alaska Natives. We urge Congress to clarify that the Centers of Excellence and the Health Career Opportunity Programs will continue to prioritize support for institutions serving our population. Without this clarifying language and appropriate funding levels, Congress will eliminate a vital resource for health improvement for American Indians and Alaska Natives.
Dr. Susan Sloan, Eastern Cherokee, is president of the Association of American Indian Physicians.