Learning While Caring for Indigenous Populations

Last August, Cindy Zhao, a student in the joint MD/MBA track at Penn’s Perelman School of Medicine and Wharton School, hopped on a plane to the Alaska Native Medical Center in Anchorage, Alaska. As someone interested in ophthalmology, she signed up and completed a four-week rotation with the ophthalmology practice at the center — a clinic that handles everything from regular care to complex eye surgeries.

“Indigenous people around Alaska were flying in sometimes hundreds of miles for special surgery,” said Zhao. “That occurs back in Philly, but patients traveling to the Penn campus generally aren’t carefully checking weather reports and scheduling trips via bush planes. There are many more considerations both clinicians and patients are making before the appointments themselves even start.”

Living in remote locations is not the only thing impacting the health of native peoples. Many people with indigenous backgrounds and living on reservations face higher rates of poverty, addiction, and poor mental health. Zhao noted that systematic barriers which propagate such health disparities deserve far more attention.

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Zhao’s travel was supported by a scholarship from the McCracken/MacCracken Student Travel Award for Indian Health. She was able to observe and assist in the clinic as much as her expertise allowed. She was part of a growing cohort of both medical students and residents at Penn Medicine who opt for rotations with the Indian Health Service (IHS), which serves Native Americans and Alaska Natives throughout the country.

Penn’s IHS programs, run in conjunction with Penn’s Center for Global Health, were expanded by Professor of Internal Medicine Robin Canada, MD. Her post-residency experiences as an internal medicine physician at Whiteriver Indian Hospital on the Fort Apache Indian Reservation in Arizona taught her how to care for patients across cultures, about health conditions that disproportionately affect patients from indigenous backgrounds, and the agility and flexibility which IHS clinicians employ to treat these populations, who are also underrepresented in clinical trials and have a lower life expectancy than the American population overall. She then developed clinical rotations for residents.

The program is paying off: One-fifth of the program alums since 2015 have returned to the IHS for their first official jobs as MDs. Which is a true win-win: Indigenous patients receive more high-quality care, and students and new doctors gain valuable experiences they couldn’t have gotten anywhere else, which inform their approach to medicine and commitment to underserved communities.