Three decades ago, Dr. Dan Calac, a young Native medical student sat in rooms where people discussed how to bring more Indigenous students into medicine. In 2025, now a senior physician, he sat down with the Johns Hopkins Center for Indigenous Health (CIH) to plan a national series of listening sessions supported by the Robert Wood Johnson Foundation (RWJF), and he named the problem plainly: “We are still having the same conversations about getting more Native students into medicine that we were having 30 years ago. It’s inspiring to finally see so many voices coming together. This effort is long overdue.”
According to the Association of American Medical Colleges, for the 2025-26 academic year, American Indian and Alaska Native students represented just 0.1 percent of both applicants and matriculants to MD-granting programs. AIAN students remain among the most underrepresented in medicine at a time when the need for Indigenous physicians, who provide culturally grounded care and carry Indigenous knowledge into clinical practice, has never been more urgent.
Conventional diversity strategies have not closed this gap. They overlook the realities that make Indigenous experiences distinct, from Tribal sovereignty and accountability to community to the harm done when institutions privilege only Western ways of knowing.
Starting with listening, not a funding announcement
RWJF’s Leadership for Better Health portfolio chose a different starting point. Before designing a funding opportunity, RWJF sought to ground the work in deep listening to the people living it. The portfolio partnered with CIH, which designed and led the formative work: six listening sessions in July 2025 that brought together over 50 voices, most of them Indigenous, including students and alumni, faculty and academic leaders, healthcare professionals, community and cultural representatives, policy and advocacy organizations, and mentorship programs, paired with pre-session surveys and a targeted literature review.
The sessions surfaced the barriers in unmistakable terms. One student recalled discovering that paid MCAT preparation resources, costing from $600 to more than $3,000, were simply out of reach. A longtime recruiter described how newly capped federal medical loans are discouraging Native students from applying at all. Others described the quieter work of building belonging where institutions had not. At one school, Native students established the practice of blessing the anatomy lab before their work with the deceased began, an act of respect that created a cultural safety their institution had not thought to provide.
From this work, CIH identified eight recommendations for institutions and funders, spanning admissions reform led by Indigenous leadership, layered financial supports, culturally safe learning environments, mentorship ecosystems, rotations and partnerships in Indigenous settings, formalized roles for Elders and knowledge carriers, sustainable institutional investment, and transparent data accountability.
From findings to funding
Guided by the research findings and with continued consultation from CIH, RWJF developed the funding opportunity Advancing Institutional Change for Indigenous Equity in Medical Education earlier this year and invited select medical schools to submit letters of intent. Five schools were awarded two-year grants ranging from $300,000 to $500,000 based on alignment with eligibility and selection criteria. Projects with more potential for transformative institutional change were prioritized for higher levels of funding, as outlined in the Request for Proposals.
The awardees span the Southwest, Upper Midwest, and Pacific Northwest, regions that serve substantial Indigenous student populations. Each funded project centers Indigenous leadership, strengthens accountability to Tribal Nations, and aligns institutional policies, practices, and resources with Indigenous priorities.
Indigenous guidance from beginning to end
The commitment to Indigenous leadership did not end when the grants were made. CIH and RWJF have co-launched a five-member Advisory Committee of Indigenous physicians, educators, and health leaders, all of whom contributed to the original listening sessions. Co-facilitated by Dr. Donald Warne, CIH co-director, and Dr. Dan Calac, CIH consultant, both senior Indigenous physicians, the Committee provides culturally grounded guidance and accountability through the initiative’s launch and early implementation.
Indigenous voices have shaped this effort at every stage. They identified the barriers, informed the funding criteria, and now guide implementation and future directions. That continuity is the point. As one administrator told the listening sessions, lasting change cannot depend on a single charismatic leader or a well-timed grant. “We need whole systems of built-in progress that can have the full-on ramp to success that matches the long, long barrier for Native folks into these spaces.”
Why this approach matters
When institutions adopt these practices, Indigenous students feel that they belong. Students who belong are more likely to stay, to graduate, and to return home to serve their communities. By grounding every stage of this work in Indigenous leadership, from listening through funding through implementation, RWJF and CIH aim to help catalyze institutional change that outlasts any single grant, leader, or program.
Hear more from Dr. Donald Warne, Co-Director of CIH, on what these listening sessions revealed and where the work goes next.
To learn more, join Dr. Donald Warne for a national webinar, Advancing Institutional Change for Indigenous Equity in Medical Education, on Thursday, October 13, 2026 from 12:00 to 1:00 PM ET. Register at https://bit.ly/IndEquity.
Read the full report.
