American Indian and Alaska Native Medical School Applicants: Physician Workforce to Address Health Disparities or Social Reproduction in the Profession of Medicine?

The paucity of American Indian and Alaska Native (AI/AN) physicians is an ongoing challenge in medicine’s efforts to provide health care for all Americans. A physician workforce reflecting the nation’s diversity is vital. Racial, cultural, and linguistic concordance between care providers and patients leads to better health outcomes. Moreover, greater inclusivity in the physician workforce atones for the profession’s role in the historical discrimination and atrocities inflicted upon America’s marginalized groups. Physicians who are representative of American Indian and Alaska Native communities are integral to better care. They are also essential to the federal obligations owed Tribal Nations. Tribes were promised health care in the still-valid treaties created when Indigenous peoples were forced to relinquish their ancestral homelands to White colonizers and settlers. Despite decades of educational pipeline programs, the proportion of AI/AN applicants continually hovers around one percent of medical school applicants. By contrast, the percentage of AI/AN people in the U.S. population has grown to over two percent. Compounding the problem of few AI/AN applicants is a lack of knowledge about them. The group is severely understudied. In this investigation, secondary data analysis was conducted to describe the sociodemographic and educational attributes of the 2002-2012 AI/AN medical school applicant pool. To explore the heterogeneity within this pool, the group’s data were disaggregated by AI/AN identity subgroups for part of the analysis. The purpose of the study was to learn more about the AI/AN group, including in comparison with other applicant groups, to find ways to increase the number of AI/AN students in medical schools. The AI/AN applicant group shared more characteristics with the other historically underserved/marginalized groups than with the White applicant group. Historically underserved/marginalized groups more often reported socioeconomic and educatio