Overview

Why the AIMES Alliance is Important

Despite the billions of dollars put towards training physicians, hardly any goes to Tribal medical facilities even though they could benefit the most from improved staffing. 

The Alliance brings together voices from all sectors to collaboratively drive solutions forward that will bring graduate medical education (GME) to Tribal communities.

Tribal Health Generally

American Indians and Alaska Natives (AI/ANs) suffer from some of the highest rates of avoidable deaths from preventable and treatable causes. For example, in 2020-2021, the U.S. rate of deaths before age 75 from preventable causes per 100,000 population was 231.9. For AI/AN individuals, however, that rate was more than double the national rate at 478.9. In one state, the rate of preventable deaths was more than 4.5 times the national rate at 1,394 deaths from preventable causes per 100,000 population.

U.S. rate of preventable deaths PER 100,000 population

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*The rate was more than double the national rate for AI/AN individuals.

What is Graduate Medical Education (GME)?

GME is the period of training performed after medical school where physicians gain specific skills and experiences in a particular medical specialty (residency) or subspecialty (fellowship). GME is primarily funded by four federal programs and agencies (Medicare, Health Resources and Services Administration (HRSA), Department of Veterans Affairs (VA), Department of Defense (DoD)) and one joint federal-state program (Medicaid).

Importance of Expanding GME in Tribal Medical Facilities

GME residents and fellows in Tribal medical facilities creates an ecosystem of sustainable high-quality care locally, reducing the need for travel, long waits, and paying for high-cost locum tenens positions. 

Physicians invested in the community are more likely to provide consistent, accessible, and culturally appropriate care to Tribal members.

What’s the I/T/U?

While Indian Health Service (IHS)-operated medical facilities are frequently viewed by non-Tribal individuals as the most visible medical care provider in Indian Country, IHS is only part of the greater system that provides medical care to AI/ANs. This system is referred to as the I/T/U, in reference to the three categories of participating facilities: