American Indian and Alaska Natives in the US Physician Workforce

American Indians and Alaska Natives (AI/AN) face higher mortality than all other racial and ethnic groups in the United States and are found to have better outcomes and experiences with racially concordant care. However, AI/ANs have consistently remained under-represented among medical school applicants, matriculants, and graduates, in residency programs, and in the physician workforce. Herein, we review AI/AN history and current social determinants of health. We report AI/AN representation at various points in the medical training pathway in terms of representation quotients and describe opportunities to increase AI/AN representation in medicine. Many barriers to medicine for AI/ANs lie before application to medical school, thus interventions must encourage and support AI/AN youth and premedical students in pursing medicine. This support must be continued into medical school and beyond, particularly by acknowledging AI/ANs’ unique historical and cultural context in medicine. Throughout this chapter, we acknowledge that AI/ANs have been inappropriately under-represented and underserved in medicine, and we advocate for a future where AI/AN trainees and physicians are proportionally represented in medicine and health disparities are reduced and eliminated for AI/AN communities.