Zazay Ismail, Burmeister James R, Jung John K
Medical Student, John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX, USA.
Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
J Med Educ Curric Dev. 2025 Sep 12;12:23821205251378792. doi: 10.1177/23821205251378792. eCollection 2025 Jan-Dec.
Indigenous populations continue to experience health inequities that are exacerbated by systemic barriers in medical education. These challenges both limit the success of Indigenous students and leave the broader physician workforce underprepared to provide culturally safe care.
This narrative literature review explores the educational experiences of Indigenous medical students and examines evidence-informed strategies to enhance cultural competency and inclusion within medical curricula. Studies were identified through database searches using Ovid MEDLINE and relevant MeSH terms, followed by citation chaining. A total of 13 studies were included in the final narrative review.
Key themes from the selected literature include structural marginalization in curricula, lack of Indigenous representation, and the emotional burden faced by Indigenous learners. Promising interventions include Indigenous-led simulations, cultural immersion programs, and experiential learning in community settings. However, implementation challenges-such as time constraints, faculty training gaps, and financial barriers-persist.
A longitudinal, integrated model of cultural humility, embedded throughout medical education, is recommended. Such an approach supports both Indigenous and non-Indigenous learners in delivering more equitable healthcare.
Medical education reform must incorporate Indigenous knowledge systems, address institutional racism, and center Indigenous voices to achieve cultural safety and reduce health disparities.
原住民群体持续面临健康不平等问题,而医学教育中的系统性障碍使这些问题更加恶化。这些挑战既限制了原住民学生的学业成就,也使广大医生群体在提供具有文化安全性的医疗服务方面准备不足。
本叙述性文献综述探讨了原住民医学生的教育经历,并审视了基于证据的策略,以提高医学课程中的文化能力和包容性。通过使用Ovid MEDLINE及相关医学主题词进行数据库检索,随后进行引文链追踪来确定研究。最终的叙述性综述共纳入了13项研究。
所选文献中的关键主题包括课程中的结构性边缘化、缺乏原住民代表性以及原住民学习者面临的情感负担。有前景的干预措施包括由原住民主导的模拟、文化沉浸式项目以及社区环境中的体验式学习。然而,实施方面的挑战,如时间限制、教师培训差距和资金障碍,依然存在。
建议采用一种贯穿医学教育始终的文化谦逊纵向综合模式。这种方法有助于原住民和非原住民学习者提供更公平的医疗服务。
医学教育改革必须纳入原住民知识体系,解决制度性种族主义问题,并以原住民的声音为核心,以实现文化安全并减少健康差距。