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Letters to the Editor

One Small Step Illustrating How Medical Schools Can Promote Indigenous Students’ Well-Being

Lopez-Carmen, Victor A. (Waokiya Mani), MPH1

Author Information
doi: 10.1097/ACM.0000000000004459
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To the Editor:

I am a Dakota medical student. In January 2021, my tribal government sent a letter to my medical school that read in part:

I am writing this letter on behalf of our enrolled member who is a student at your school. He will be attending two very important traditional Dakota ceremonies this year and will need to be excused from school.

The response was no struggle. In a methodical process, my school, my tribe, and I cogenerated a simple solution. I was financially supported to take 1 month for my ceremonies, and 1 month was added to my rotations. Most importantly, I did not have to choose between my culture and my education.

At the ceremonies, I learned more of my tribe’s language, which improved my mental well-being. 1,2 I gained traditional knowledge, increasing my confidence. 3 I built relationships with elders, making me feel more supported. 4 Participating in my culture added to a foundation of trust and cultural safety that can strengthen the future clinical care that I plan to provide in the community. 5

My experience also affirmed international standards. The United Nations Declaration on the Rights of Indigenous Peoples, 6 endorsed by the United States, sets the minimum standard of Indigenous rights. Article 14 states that Indigenous youth have the right to education without discrimination, including education in their own cultures. 6

The way my medical school handled my tribe’s letter should be a model of best practice for medical education globally. It is imperative that medical institutions instill frameworks that are inclusive of Indigenous peoples’ rights to education and culture. Making it simpler for Indigenous medical students to participate in cultural milestones has the potential to bolster Indigenous enrollment and retention, as well as the physician workforce, through the promotion of Indigenous students’ well-being and community connectedness while they are attending medical school.


1. Hartmann WE, Wendt DC, Burrage RL, Pomerville A, Gone JP. American Indian historical trauma: Anticolonial prescriptions for healing, resilience, and survivance. Am Psychol. 2019;74:6–19.
2. Hinton L, Huss L, Roche G, eds. The Routledge Handbook of Language Revitalization. 2018.1st ed. London, UK: Routledge;
3. Schiff JW, Moore K. The impact of the sweat lodge ceremony on dimensions of well-being. Am Indian Alsk Native Ment Health Res. 2006;13:48–69.
4. Kahn CB, Reinschmidt K, Teufel-Shone NI, Oré CE, Henson M, Attakai A. American Indian Elders’ resilience: Sources of strength for building a healthy future for youth. Am Indian Alsk Native Ment Health Res. 2016;23:117–133.
5. Laverty M, McDermott DR, Calma T. Embedding cultural safety in Australia’s main health care standards. Med J Aust. 2017;207:15–16.
6. United Nations. United Nations Declaration on the Rights of Indigenous Peoples. Published September 13, 2007. Accessed October 6, 2021.
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