title: Balancing Two Cultures: American Indian/Alaska Native Medical Students' Perceptions of Academic Medicine Careers.
abstract: American Indians and Alaska Natives (AI/AN) remain underrepresented in the academic medicine workforce and little is known about cultivating AI/AN medical students' interest in academic medicine careers. Five structured focus groups were conducted including 20 medical students and 18 physicians. The discussion guide explored factors influencing AI/AN trainees' academic medicine career interest and recommended approaches to increase their pursuit of academia. Consensual qualitative research was employed to analyze transcripts. Our research revealed six facilitating factors, nine dissuading factors, and five recommendations towards cultivating AI/AN pursuit of academia. Facilitators included the opportunity to teach, serving as a role model/mentor, enhancing the AI/AN medical education pipeline, opportunities to influence institution, collegiality, and financial stability. Dissuading factors included limited information on academic career paths, politics, lack of credit for teaching and community service, isolation, self-doubt, lower salary, lack of positions in rural areas, lack of focus on clinical care for AI/AN communities, and research obligations. Recommendations included heighten career awareness, recognize the challenges in balancing AI/AN and academic cultures, collaborate with IHS on faculty recruitment strategies, identify concordant role models/mentors, and identify loan forgiveness programs. Similar to other diverse medical students', raising awareness of academic career opportunities especially regarding teaching and community scholarship, access to concordant role models/mentors, and supportive institutional climates can also foster AI/AN medical students' pursuit of academia. Unique strategies for AI/AN trainees include learning how to balance AI/AN and academic cultures, collaborating with IHS on faculty recruitment strategies, and increasing faculty opportunities in rural areas.
authors.affiliation: Rutgers New Jersey Medical School, Newark, NJ, USA. josanche@montefiore.org.|, 9 Legendary Circle, Rye Brook, NY, 10573, USA. josanche@montefiore.org.
authors.forename: John Paul
authors.identifier: 0000-0003-3281-5522
authors.initials: JP
authors.lastname: Sánchez
authors.affiliation: Human Capital Initiatives, Diversity and Policy Programs, Association of American Medical Colleges, Washington, DC, USA.
authors.forename: Norma
authors.initials: N
authors.lastname: Poll-Hunter
authors.affiliation: Association of American Indian Physicians, Oklahoma City, OK, USA.|Sansum Clinic, Santa Barbara, CA, USA.
authors.forename: Nicole
authors.initials: N
authors.lastname: Stern
authors.affiliation: California Department of Public Health, Sacramento, CA, USA.
authors.forename: Andrea N
authors.initials: AN
authors.lastname: Garcia
authors.affiliation: Florida International University Herbert Wertheim College of Medicine, Miami, FL, USA.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Brewster
mesh_terms: D000072957:Alaska Natives / Q000523:psychology / Q000706:statistics & numerical data; D002321:Career Choice; D005260:Female; D017144:Focus Groups; D006801:Humans; D007198:Indians, North American / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D012576:Schools, Health Occupations / Q000191:economics / Q000706:statistics & numerical data; D013337:Students, Medical / Q000523:psychology / Q000706:statistics & numerical data
keywords: Academic medicine workforce; American Indians and Alaska Natives; Medical students