Nicole Stern, MD, MPH, FACP

2021-2022

Assistant Professor of Medical Education, California University of Science and Medicine, Colton, CA; Staff Physician, Sansum Clinic, Inc., Santa Barbara, CA

Nicole Stern is an enrolled member of the Mescalero Apache Tribe of New Mexico and is the first member of her tribe to become a physician. She graduated from the University of Arizona College of Medicine in Tucson, where she completed a residency in Internal Medicine. She was a fellow in Primary Care Sports Medicine at the University of Oklahoma Health Sciences Center in Oklahoma City, and completed a Master’s in Public Health degree in Health Management from Harvard T.H. Chan School of Public Health. She was a Commonwealth Fund Fellow in Minority Health Policy at Harvard Medical School and her practicum project focused on American Indian physician workforce development.

Currently, Dr. Stern is an Assistant Professor of Medical Education at the California University of Science and Medicine in the Inland Empire of Los Angeles, a part-time urgent care physician, and a primary care sports medicine team physician for sport clubs at the University of California, Santa Barbara Department of Recreation. She is a fellow of the American College of Physicians and has extensive experience with the Association of American Indian Physicians (AAIP), having served as President-Elect, President, Immediate Past President, and a two-time At-Large-Director of the Board of Directors.

For 7 years, Dr. Stern served as the liaison from AAIP to the Association of American Medical Colleges’ (AAMC) Committee on Student Diversity Affairs, and currently sits on AAMC’s Strategic Action Plan 4 Advisory Council. In addition, Dr. Stern is on the Summer Health Professions Education Program’s American Indian/Alaska Native National Engagement Committee and continues to work closely with the AAMC to collaborate on strategic plans and initiatives that emphasize the need to increase the American Indian and Alaska Native physician workforce with the goal of improving health care, and reducing health care disparities, for AI/AN people. As one example of Dr. Stern’s career investment, she helped create the “American Indians Accessing Health Professions Program” in 2013 which is a two-day program exposing American Indian and Alaska Native community college, tribal college and early university students to health professional and public health career options.

Building Physician Workforce Development Capacity for American Indian Communities on the East Coast

Background: Physician workforce development represents a meaningful and impactful lever of health equity for American Indians and Alaska Natives (AI/AN) in the United States (US). According to data from the Association of American Medical Colleges (AAMC), as of July 2019, there were only 2,570 AI/AN physicians (designating AI/AN alone) practicing in the US. This staggering total corresponds to only 0.3% of the total US population. Since AI/AN people make up 2.9% of the total US population (2020 US Census), this percentage should prompt efforts to build a physician workforce that is inclusive of the entire US population. This lack of AI/AN physicians reflects the decreasing number of AI/AN students applying to, matriculating at, and graduating from US allopathic medical schools. This extremely low number of AI/AN medical school applicants, matriculants, and active physicians poses a health care crisis for our AI/AN communities, and the nation as a whole, as disproportionately high rates of chronic diseases overburden private and public health care systems. Therefore, AAMC, in collaboration with the Association of American Indian Physicians (AAIP), the Indian Health Service (IHS), and the American Indian Higher Education Consortium recently convened a national summit to promote workforce development at a regional level. At this summit, the East Coast was identified as the least developed region for AI/AN physician workforce development.

Objectives:

  1. To understand university, state, or tribal, policies regarding AI/AN physician workforce development across five East Coast states.
  2. To identify the gaps in programming pathways for AI/AN students interested in health professional careers as a starting point for improving support for AI/AN students from the East Coast.
  3. To increase awareness of approaches used to build sustainable networks for change.

Methods:

  1. Complete a needs assessment which includes AAMC data to understand the current physician workforce, feeder institutions, and practice patterns.
  2. Interviews and listening sessions with tribal, university, and organizational representatives.
  3. Review existing policies, practices, and programs for AI/AN college students interested in the health professions, as well as state and tribal government level workforce policies.
  4. Identify, and map out, culturally responsive effective practices used in other US regions.

Results: American Indian physician workforce development capacity is lacking in the East Coast. Both quantitative and qualitative data highlighted the need for policy and funding improvements focused on AI/AN physician workforce. The critical barriers to achieving capacity on the East Coast include smaller tribal communities, lack of existing programming, and little to no engagement with AI/AN youth and students from East Coast states. The institutions (or tribes) making intentional efforts to educate, mentor, or train AI/AN students along the medical education continuum are few and distanced far between on the East Coast.

Future

  1. Develop talent and a strategy to recruit American Indian students from within the East Coast.
  2. Establish effective practices and create an action plan for collaborations with AAIP, AAMC, Indian Health Service and other organizations.

Preceptor: Norma Poll-Hunter, PhD, Senior Director, Workforce Diversity, AAMC