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Increasing Indigenous Representation in Medicine through Academics Engagement and Innovation (IIMAGIN)

Awarded in 2022
Strategic Education
Updated Aug 22, 2023

American Indians remain significantly underrepresented in medicine and health professions, and IIMAGIN will help us pursue innovative recruitment and retention strategies to address critical health care workforce needs as well as support future students, faculty and providers.

– Bret Benally Thompson, MD

At a Glance

A new initiative called Increasing Indigenous Representation in Medicine through Academics, Engagement and Innovation (IIMAGIN) led by the UW School of Medicine and Public Health’s Native American Center for Health Professions (NACHP) will expand the recruitment of indigenous students into health professions. American Indian/Alaska Native (AI) professionals are underrepresented in medicine and the health professions, and there are gaps along the medical training pathway at two key stages including application to medical school and retention/promotion to faculty. IIMAGIN aims to address the healthcare workforce needs at critical intervention points along the medical training pathway by creating dedicated pre-college and college pathway programs, establishing a pre-faculty development pathway, and developing new AI health and medical curriculum offerings.

The Challenge

American Indian/Alaska Native (AI) professionals are underrepresented in medicine and the health professions, and there is a great need in Wisconsin tribal communities to have medical and health professionals that represent their own communities, cultures and identities. Examination of medical degree application, retention and graduation rates have demonstrated that there has been little change despite the growing efforts to address these disparities. Moreover, there are significant gaps of lower representation of AIs along the medical training pathway at two key stages: application to medical school and retention/promotion to faculty.

The UW School of Medicine and Public Health Native American Center for Health Professions (NACHP) was founded in 2012 with the mission to improve the recruitment, retention and graduation rates of Native American health professional students and promote health education, research and community-academic partnerships with Native communities. Since its inception, the program has grown significantly from serving five Native American students and faculty to more than 50 Native American health professions students enrolled across the UW campus and hosting an advisory council of more than 25 Native American health professionals.

Project Goals

IIMAGIN builds on work NACHP is already engaged in and aims to address the healthcare workforce needs at critical intervention points along the pathway through four specific goals:

  • Create  dedicated pre-college and college pathway programs through collaborations with the College of Menominee Nation and the Lac Courte Oreilles Ojibwe University to increase AI student recruitment, participation and engagement, as well as retention along a continuous pathway of program support and engagement.
  • Establish an AI pre-faculty development pathway, increase coordination and support of faculty retention, as well as community engagement and research.
  • Develop new AI health and medical curriculum offerings.
  • Evaluate IIMAGIN’s contributions through a culturally responsive framework regarding AI health professional pathways and medical education with the Wisconsin Evaluation Collaborative at the University of Wisconsin–Madison Wisconsin Center for Education Research.

Read the IIMAGIN award announcement

More Funded Projects

research icon: microscope and stethoscope
PERC Opportunity Grant

Stroke Prevention in the Wisconsin Native American Population

Year Awarded: 2019
This project, Stroke Prevention in the Wisconsin Native American Population, aimed to establish a stroke prevention program for Wisconsin’s Native American population as this community faces higher rates of stroke, coronary artery disease, and associated risk factors compared to other racial groups. Despite challenges due to the COVID-19 pandemic, the researchers successfully engaged the Native American community with web-based education and a wellness coach who was based on the reservation. Preliminary data showed a greater need for stroke prevention than initially expected, with approximately 80 percent of tribe elders at increased risk for stroke and 50 percent having diabetes. The project has received bridge funding to support their work while seeking additional funding for the long-term continuation of the stroke prevention program.
research icon: microscope and stethoscope
COVID-19 Response Grant

Interferon Responses in “COVID Toes,” Footprints from SARS-CoV2 Infection

Year Awarded: 2020
After the initial peak of the COVID-19 pandemic in April 2020, physicians noted a surge of red to purple bruise-like bumps on the toes of otherwise healthy patients. This symptom, popularly referred to as “COVID toes,” is clinically identical to a skin condition known as chilblains. Rarely, chilblains can be a cutaneous manifestation of the type 1 interferonopathies, genetic disorders associated with elevated levels of type 1 interferons. Type 1 interferons are proteins produced in response to viral infections and are critical in the host response to the SARS-CoV-2 infection. However, the precise link between COVID toes and the SARS-CoV-2 virus remained unknown. Because patients with COVID toes often reported close contacts with COVID-19 infection but consistently tested negative for infection in their blood and nasopharynx, researchers hypothesized that COVID toes could be a manifestation of resiliency to the SARS-CoV-2 virus via a robust and early type 1 interferon response, which remained visible in the toes. Researchers found evidence of local activation of the type I interferon in COVID toe biopsies that was significantly higher than in normal skin from patients without COVID. Researchers also identified the presence of viral RNA in patients’ toes, suggesting that SARS-CoV-2 infection could be a possible trigger for COVID toes. Finally, a golden hamster animal model was employed to evaluate whether SARS-CoV-2 viral RNA could reach the toes. In this model, after low-dose exposure of SARS-CoV-2 through the nasopharynx, viral RNA was found both in the lungs and indeed in the toes of infected hamsters. The hamsters mounted a robust type I interferon response in their lungs and their toes, and this response closely correlated with the presence of SARS-CoV-2 viral RNA. Previous studies in humans with COVID toes found a very early type 1 interferon response in the peripheral blood, which waned within days. This study found a durable type 1 interferon response in skin but not in the peripheral blood, which could explain why most patients with COVID toes felt systemically well aside despite their skin findings.