Caring for the Community

The Indian Health Service and The University of New Mexico School of Medicine have partnered to create a family medicine residency program at the Northern Navajo Medical Center in Shiprock, N.M.

“I want to extend my most sincere congratulations to the Indian Health Service for establishing this unique and crucially important training program,” said Paul B. Roth, MD, MS, UNM’s Chancellor for Health Sciences. “It reflects the commitment and creativity of our faculty working side-by-side with IHS and the Navajo government to address their medical workforce needs.”

“The Indian Health Service is excited to work with the University of New Mexico School of Medicine to establish a family residency program to serve our American Indian and Alaska Native community,” said Rear Adm. Michael D. Weahkee, the Indian Health Service director and an officer in the U.S. Public Health Service Commissioned Corps.

“There is a growing need for physicians in rural areas. We hope this partnership will attract more physicians who want to serve in these areas while allowing residents to work in a diverse setting that facilitates learning in a small group environment.”

UNM was awarded the five-year $2.4 million Health Resources and Services Administration Residency Training in Primary Care Program planning grant to create the residency program.

The grant provides for gaining accreditation for the program, creating a site-specific curriculum and recruiting residents, said principal investigator Daniel Waldman, MD, associate professor and residency director in UNM’s Department of Family & Community Medicine.

The program will model a “1+2” rural training track. Residents will spend their first training year on the UNM campus in Albuquerque, with the remaining two years at the medical center in Shiprock. UNM will serve as the sponsoring institution for the program, Waldman said.

The Northern Navajo Medical Center serves approximately 50,000 people in the Four Corners region. Ninety-one physicians practice at the medical center and in two satellite clinics, with additional health care services provided by nurse practitioners, physician assistants, midwives, podiatrists, physical therapists and dentists.

The new residency will enable family medicine practitioners to maintain their own outpatient panels and build relationships over time. The medical center currently hosts visiting residents from around the country who generally serve one-month rotations.

The residency will also offer participants an opportunity to build their cultural competency, said Heather Kovich, MD, medical education coordinator at the Northern Navajo Medical Center.

“The residency program will train residents in understanding health disparities and how they affect health care in Native communities. They will also have the opportunity to learn more about Native cultures,” Kovich said. “We are excited to include the community as teachers, sharing their culture and experiences with the residents in the program.”

Family physicians at the Northern Navajo Medical Center provide a full spectrum of medical care including inpatient, outpatient and obstetric care, medical center CEO Fannessa Comer said. They work in the hospital and outpatient clinics, field clinics, school based clinics and a variety of other settings.

“We are excited about the opportunities this program will provide to residents and our staff at the medical center,” Comer said.

The HRSA grant realizes a decades-old vision for bringing medical training to the Navajo community, said Arthur Kaufman, MD, UNM’s Vice Chancellor for Community Health and former chair of Family & Community Medicine.

When Kaufman joined the newly formed department in 1974, several of his colleagues had, like him, served as commissioned officers in the Indian Health Service, and they were actively developing a plan to create a medical school for the Navajo Nation.

That idea never came to fruition, but the need to train physicians to serve Navajo patients remained, Kaufman said. In recent years, when new federal funding became available to establish 1+2 residencies to serve rural areas, Kaufman and his colleagues decided to revive the idea and apply for a grant.

Kaufman singled out the efforts of two Office for Community Health members, Helen Tso, a Shiprock-based Health Extension Regional Officer who helped solicit community support for the grant, and research lead Janet Page-Reeves, PhD, who coordinated the grant application.

“This new training program could strengthen the IHS workforce and, we feel, could be a model for dissemination,” Kaufman said. “This has revived the whole idea we had 50 years ago.”