When Washington State University Native American Health Sciences (NAHS) Director, Naomi Bender, flew to Portland in fall 2019 to meet with Portland Area Indian Health Service (IHS) leaders, she hoped that, at a minimum, she could open a few more doors for health sciences students to train in Indian country.

Little did she know her meeting would result in something historic for the University—a first-ever master agreement securing six new student training locations in Native communities in Washington, Idaho, and Oregon.

“Their interim Chief Medical Officer, Thomas Weiser, took time away from his vacation that day to dig deeply with me and really invest himself in discussing our initiatives and where we could partner,” Bender said. “I am still in shock and awe over everything we’ve accomplished since.”

Not only did Weiser corroborate on a shared vision for partnership between WSU’s NAHS program and Portland Area IHS, including more upper-level students rotating through IHS health care settings, also referred to as clinical rotations, but he relayed the importance of ongoing collaboration when permanent Chief Medical Officer, Andrew Terranella, MD, was appointed to the full-time position.

“Next thing I know, Dr. Terranella is an advocate alongside me and the master agreement starts taking shape,” Bender said.

The agreement, in effect as of the 2020 – 2021 academic year, generates opportunities for both Native and non-Native students to rotate and work in Indian country. This is important given that many of these lands are rural and attracting health care workers is often difficult.

Students from multiple WSU health sciences programs—medicine, nursing, pharmacy, nutrition and exercise physiology or speech and hearing sciences—will be able to complete clinical rotations in six outlying IHS service areas across the Pacific Northwest. The areas include Colville, Washington, Fort Hall, Idaho, Warm Springs, Oregon, Wellpinit, Washington, Salem, Oregon and Toppenish, Washington.

The agreement not only helps students who will soon enter the workforce, but there are potential major long-term benefits to Indian country—sending students to native communities could inspire them to work in these locations after graduation.

“These rotations can help to grow the local and Native workforce,” Terranella said. “In addition to recruiting these students to ultimately work in these areas, these health sciences students, especially those who are Native, can act as role models for our communities and inspire the next generation.”

WSU Health Sciences Vice President and Chancellor, Daryll DeWald, signs historic agreement
WSU Health Sciences Vice President and Chancellor, Daryll DeWald, signs historic agreement with Portland Area Indian Health Service that not only helps WSU health sciences students who will soon enter the workforce, but will have also have potential major long-term benefits to Indian Country.

“We need more culturally knowledgeable and skilled health care workers in our tribal communities,” Bender said.

Terranella echoed that sentiment.

“IHS rotations are one of the best ways to recruit students to work in native, rural health,” he said. “As more practitioners join this field, we are able to expand health care access for native communities and families.”

Non-native students will get an experience they may not get in a classroom or at health care facilities in non-native communities.

“Health and healing in tribal communities is holistic in nature and not always based on the western medicine model,” Bender said. “It’s important that our students have the opportunity to learn that patient care doesn’t happen in a vacuum or revolve around what they learned in a classroom.”

Portland Area IHS has entered into agreements in the past with universities, but typically the agreement was only for a specific service unit and a specific school, Terranella said. The agreement with WSU Health Sciences encompasses all six service units and all WSU Health Sciences programs.

“It is our hope that through these broader agreements, we can establish a regular pipeline to educate the next generation of health care workers who will serve rural and Native communities into the future,” Terranella said.

Said Bender, “The enthusiasm Dr. Weiser conveyed during the initial meeting in fall of 2019 put this into motion. Dr. Terranella completed it, and I also want to acknowledge Sam Schirer in WSU’s contracts office, who was helpful in co-writing and editing the document in legal terms and vetting it with the Federal government.”

Concluded Bender, “To say I feel blessed this happened the way it did is an understatement.”

What is a clinical rotation?

Clinical rotations are experiences health sciences students gain in the latter years of their education. Students are present in health care facilities and shadow health care workers to gain valuable hands-on experience. They have access to patients, with physicians and students acting as their professors as they solve complex medical dilemmas.