The Cherokee Nation Medical School graduates its first class

TThere are so few native physicians in the United States – just 0.3% of physicians – that their numbers barely appear in charts and graphs showing the diversity of the medical workforce. But at least nine more will be added from Thursday.

Thursday is the graduation ceremony for the first class of the nation’s only tribal medical school, the Oklahoma State University College of Osteopathic Medicine in the Cherokee Nation. Started in 2020is an effort to increase the number of indigenous doctors and physicians willing to treat patients in rural areas facing severe physician shortages.

The nine Native American graduates represent 20% of the first class of 46 students. That may sound small, but it’s a start. In future classes, the number of tribally affiliated students ranges from 16% to 30% of the class. Students represent 11 different tribes in all four years and come from 46 Oklahoma counties, said Natasha Bray, dean of the medical school. The graduating class at OSU’s larger main campus in Tulsa includes 15 additional Native physicians.

Of the nearly 850,000 doctors in the country, only approx 2,500 are Indian. According to the Association of American Medical Colleges, some specialties, including endocrinology, neonatal medicine and vascular surgery, do not include Native Americans at all. Nationally, AAMC statistics show that this year’s graduating class is inclusive approximately 250 students who identify as Native American or Alaska Native, alone or in combination with another race.

Recent graduate Caitlin Cosby, 24, will begin a family medicine residency in rural Durant, Oklahoma, on Choctaw lands, where she is an enrolled member of the tribe. When she completes her training, she would like to provide care to Native American patients at the Choctaw Nation Family Clinic, where in addition to caring for patients, she hopes to be a role model for the next generation.

“To show people that as a Native American you can work in medicine. It’s not impossible,” said Cosby, who recalled treating a Choctaw patient who asked what tribe she was from and then told her how proud he was of her for being Native American and a woman who worked to to become a doctor. “He said, ‘Thank you for representing us,’” she said. “I just wanted to cry.”

The school also does community outreach, helping guide potential future physicians on what classes to take in college and when to take the MCAT medical school entrance exam, and helping them with personal statements for medical school applications and interview skills . Many tribal students come from small schools or community colleges that don’t offer such support, Bray said.

Because a high percentage of Native American medical students drop out of medical school or do not complete within four years, Bray said her campus offered resources and support to students who needed more time for medical or family reasons. “We want them to finish,” she said. “We need each of them to go out and serve their communities.”

Cosby and her class began their medical training in the throes of the pandemic, when their families were not allowed to attend the white coat ceremony, a rite of passage for medical students as they begin their clinical training. The students could not meet in person and could not enter the brand new $40 million, 84,000-square-foot building that the Cherokee Nation paid to build in Tahlequah, a small town in northeastern Oklahoma where the tribe has its headquarters. The new campus is a partnership between the Cherokee Nation and OSU.

Things soon got better. In 2021, students moved into the building, which is decorated with 200 pieces of Cherokee artwork and surrounded by a garden with plants traditionally used for healing, including elderberries, which students harvested and used to make jam. The campus took full advantage of the knowledge of native elders, healers, artists and writers, Bray said, through art classes and a library filled with hundreds of books by writers from Oklahoma’s 38 federally recognized tribes.

“I am absolutely overwhelmed with joy, pride and gratitude,” she said of the new doctors. “The success of what we have done is a testament to that first class.”

Students also have access to state-of-the-art technology, including a simulation lab. Cosby said the mix of modern and traditional was a highlight of her training, as was being able to learn from Native American physicians who provide health care in the Cherokee Nation.

While the school hopes its new graduates will serve tribal and rural patients in Oklahoma — 75 of the state’s 77 counties are facing a shortage of healthcare workers – that is not a requirement. Graduates are free to practice wherever they wish and pursue any field or specialty. Sixteen of the new graduates will train in specialties such as urology, pathology, psychiatry and, in the case of Ashton Glover Gatewood, 34, obstetrics.

Gatewood worked as a public health nurse at the Oklahoma City Indian Clinic for six years and jumped at the chance to become a doctor when she read about the new school in a newspaper. Medical school was difficult: she has two young children, so studying around the clock was not always possible. But she’s now headed to a gynecology residency at the University of Oklahoma, inspired by a female Native American general surgeon who encouraged her. “At first I wanted primary care, but I got to a point and realized I wanted to deliver babies every day,” she said. “I loved the OR and the surgical aspect of it.”

When Gatewood completes his residency, he hopes to work at a hospital serving Native American expectant mothers and help curb the disease. maternal mortality crisis among indigenous women.

Gatewood said the best part of medical school for her was having numerous Native American medical students as colleagues. “At most medical schools you might only have one student per class, or three in the entire school,” she said.

Gatewood, who is a member of the Choctaw tribe but also has Cherokee and Chickasaw ancestors, said she knows firsthand that cultural competency is critical. Once, while working as a nurse, a coworker was about to call child protective services to report possible child abuse because a child from the Muskogee Creek Nation had scratches on her arms. Gatewood was able to ask a Muskogee elder about the stains and discovered that they were part of a purification ceremony and that the child had not been harmed. Clinic staff told parents how to keep the scratches clean and free of infection, avoiding an incident that could have increased distrust of doctors and nurses. “We knew the parents’ goal was the same as ours: to keep the child healthy and well,” she said.

The new medical school is part of a long-term plan to improve health care in the Cherokee Nation by investing in health facilities and staff. One of the early signs of success was the nation’s exemplary response to the Covid-19 pandemic, which earned national praise.

Earlier this week, before Thursday’s graduation ceremony on the OSU campus in Tulsa, the new physicians were honored at both a Native ceremony featuring leadership from their respective tribes and a dinner held for them and hosted by Cherokee Nation Principal Chief Chuck Hoskin Jr. Our ancestors would undoubtedly be proud of their achievements,” he said, “knowing that their perseverance continues to inspire progress and healing in our communities.”