Summer Internships Spark Conversations on Native American Representation in STEM

By Jillian Rose Lim

Nineteen-year-old Chermiqua Tsosie grew up in Phoenix, AZ – a sprawling city of mountain skies, warm weather, and roots in the Native American communities that first peopled its valleys. Tsosie, a member of the Diné (Navajo) nation, was raised in the city’s urban center and recalls summers spent at her grandparents’ house near Monument Valley on the Navajo reservation.

This summer, however, looks a little different. Having completed degrees in Medical Studies and Family and Human Development at Arizona State University, Tsosie is in Philadelphia for the Children’s Hospital of Philadelphia Research Institute Summer Scholars Program (CRISSP). The intensive 10-week internship involves practical training in academic research and exposure to pediatric-focused research career trajectories under the mentorship of CHOP faculty. Complementing her passion for global health, Tsosie works with her mentor Elizabeth Lowenthal, MD, MSCE, a global health investigator at CHOP, to conduct research as part of Dr. Lowenthal’s team.

For Tsosie, the experience has been “transformative” and a “dream come true.” But it’s also been enlightening: As the only student from the West Coast and of Native American descent, Tsosie has become more aware of the need for Native American representation in Science, Technology, Engineering, Math, and Medicine (STEM-M).

“Some of the things we do in medicine are Westernized, and not something you’re raised to believe in traditional Native culture,” Tsosie said. “Looking at cadavers, talking about death, there are some traditional views in that aspect. But it’s also hard being in a space that wasn’t designed specifically for Native Americans or minorities. There’s a lack of STEM mentors for Native American youth, for example, so it can sometimes feel isolating.”

Raised by her mother in a single-parent household, Tsosie says if it wasn’t for one of her three sisters, who is a nurse, she might not have even considered medicine as a career.

The statistics reflect Tsosie’s lived experience: According to a 2023 biennial report, “Diversity and STEM: Women, Minorities, and Persons with Disabilities” from the National Center for Science and Engineering Statistics, American Indian and Alaska Natives made up less than1 percent of the STEM workforce, with 0.4 percent working as physicians and 0.3 percent in a STEM-related PhD. Amid this lack of representation in science and medicine, Native Indians and Alaska Natives have a lower lifespan than all other U.S. races as well as a greater disease burden during their lives.

Internships like CRISSP and the Native American Research Internship (NARI), a summer research opportunity for Native American undergraduate junior and senior students interested in health sciences, seek to address these disparities by exposing students from diverse backgrounds to different career trajectories in STEM.

Increasing Native representation in science and medicine may lead to more culturally inclusive, culturally aware approaches to healthcare. But what do such efforts look like in action?

New Perspectives for the Next Generation: Empowering Native Health

CHOP invited three NARI alumni to answer exactly this, asking them to give talks to this year’s CRISSP students, faculty and other interested members of the community. Tsosie, who also completed the NARI internship in 2021, said the June 12 visit from Nishoni Huber, Jillian Landers, and Shai-Anne Nalder helped to open the door for conversations on Native American health.

“Philadelphia is a very different atmosphere from Arizona, so having [NARI alumni] speak about Indian policy, healthcare, and land was very much a breath of fresh air,” Tsosie said. “It gave me the perspective that though I grew up with this, there are people who haven’t been educated on these things. The NARI talks really helped open those conversations – not only with my roommates, but other people in the CRISSP program.”

In a presentation titled “Resilient Roots,” Huber, a member of the Diné (Navajo) nation, shared how preventative measures, advocacy, and a culturally inclusive perspective can help bridge the “lifespan / health span” gap that exists in Native American populations. Health span refers to the length of time a person is healthy during their life.

Prevention includes health education, early screenings, vaccinations, and environmental interventions for conditions such as obesity and diabetes, which tend to be more prevalent on reservations. But these efforts must also be culturally sensitive: A person may be more likely to receive counseling from a traditional healer versus someone from a science background, so it’s important to offer options within cultural settings.

“Advocacy begins with being an ally to Native Americans,” Huber said. “Stop talking and listen, learn more than what you are taught, celebrate triumphs of Native Americans, and support Native American organizations.”

Landers, a member of the Muscogee (Creek) nation, followed with a closer look at mental and behavioral health concerns in Native American communities. One in three American Indian/Alaskan Native children live in poverty resulting from historical factors and long-term economic instability. Landers explained that poverty can often expose children to adverse childhood experiences, from abuse to neglect to food insecurity, that result in higher rates of chronic physical and behavioral conditions.

Future healthcare providers can make a difference by promoting health awareness, looking for disparities in patients, and staying knowledgeable about resources like therapists with experience working with people of color.

“We need to expand diversity in the fields of medicine and mental health so that more providers will serve their home communities and relate to patients of diverse cultural backgrounds,” Landers said. “As an intern, many patients talked to me about not having the same consistent provider for over a year because physicians would travel out to the communities and then go home. We need long-term providers who stay, hopefully in their own community.”

Nalder, a member of the Muscogee (Creek) nation, rounded out the talks with a presentation on her doctoral work elucidating the biology and cause of malaria. Nalder presented findings that expand the current paradigm for understanding the fundamental antiparasitic mechanisms of doxycline (DOX), a key antimalarial drug. The work supports the suggestion of repurposing DOX as a faster-acting antimalarial at higher dosing, which could potentially limit the resistance of parasites.

Nalder’s presentation was especially meaningful for Tsosie.

“I think Shai-Anne's presentation was really inspiring – it was really great to see that a NARI alumna from a few years ago is now doing her PhD,” Tsosie said.

Continuing the Conversation

Dr. Lowenthal, who is an active mentor in the CRISSP program, hopes to keep CRISSP partnering with more programs like NARI moving forward. Through her experience working in Botswana, especially before the country built a medical school, Dr. Lowenthal found that greater representation often predicts greater – and more sustained – interest in healthcare and healthcare careers.

“What we saw in Botswana was that if you have a critical mass of people who left for medical school then came back, that made it much easier for more young physicians to stay and feel like they had a supportive community,” Dr. Lowenthal said. “So, hopefully we can help a little bit with that activation and engagement that’s needed and specifically knowing some of the pediatric problems that exist in Native communities, nurturing pediatric champions will go a long way.”

By the end of the CRISSP program, Tsosie, in addition to completing research with her mentor, will have shadowed different specialties at CHOP including developmental and behavioral pediatrics, adolescent medicine, global patient services, and emergency medicine to learn more about the breadth of opportunities in pediatrics and pediatric research.

“I want to spend the next two years just doing what I want to do, and loving what I’m doing,” Tsosie said, who would like to pursue a medical degree and is interested in neonatology and global health. “I want to hike and take the time to really study for the MCAT. And when it’s time, I’ll apply to medical school and see where it goes from there.”