American Indian Health in South Dakota

Director(s): Alberto Puig, Matthew Tobey
Prerequisites: All students are expected to complete pre-rotation paperwork with 4 weeks' notice, read a business school-style case study and watch a 1-hour video. All students will meet over the phone with the rotation director 1-2 times prior to the trip.
Location: MGH - Mass. General Hospital (3)
Open to Exclerks: No (HMS only)
Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Prior approval required, please email Dr. Matthew Tobey,, forward approval to Rural American Indian and Alaska Native (AI/AN) communities face substantial health challenges. In South Dakota, Lakota tribes have built remarkable communities with growing, energetic efforts to renew traditional values in a modern context. Nevertheless, four such counties experience the lowest life expectancy at birth in the United States, with high mortality rates across major causes. This 4-week rotation offers clinical and community-based experiences for medical students who seek to learn from and with members of the Rosebud Sioux Tribe in Rosebud, South Dakota. Clinical experiences are based at the Indian Health Service (IHS) facility. Students are expected to display a high degree of professionalism, integrity and cultural humility throughout the experience. Clinical opportunities include (at least 4 half-days per week): -Primarily: outpatient and inpatient care at the IHS facility in Rosebud, SD, supervised by MGH primary care faculty -Community-based clinical care including home visits, health outreach activities, and care at the tribal jail -Depending on interest, supplemental clinical experiences in women's health, pediatrics, and emergency medicine Community-based opportunities, each subject to availability: -Health education with 1) individuals incarcerated at the tribal jail, 2) residents at the methamphetamine treatment program, and 3) the Rosebud community health worker team -Meetings or collaboration with tribal health programs and non-profit organizations operating in Rosebud -Miscellaneous community outreach, e.g. educating high school students about health careers -In discussion with the elective director, students may pursue community-based activities matching career interest All students are encouraged to participate in the full 4-week elective. Alternate visit plans may be possible in discussion with the elective director, but will not count toward completion of this elective.
Incorporation of Basic Science Content and Evidence-Based Medicine:
Basic science and evidence-based medicine (EBM) are integrated into MGH faculty-precepted outpatient and inpatient care occurring at least 4 half-days each week. Students will join the MGH program's weekly calls, which include a rural health curriculum including EBM.
Grade Criteria:
Honors with Distinction: The student excels at A), B) and C) above, with no concerns raised by staff or community members. Honors with Distinction will be reserved for students who enthusiastically achieve these goals while upholding community perspectives and insights.
Honors: The student performs well in at least A) and B) above, and/or performs well but does not meet the criteria for Honors with Distinction.
Satisfactory: This will be reserved for students who perform satisfactorily, but not well, in categories A) and/or B), or who struggle with A) and C) but perform well with B), above.
Unsatisfactory: Unsatisfactory will be assigned to any student who does not interact well with the community as stated in criteria B), or students who do not meet most clinically-relevant EPAs.