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Indian Health Service Headquarters The Reyes Building 801 Thompson Ave TMP-450 Rockville, MD 20852-1627 robert.pittman@ihs.gov
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PROGRAM PERFORMANCE DATA |
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Educating, Recruiting and Retaining Health Professionals to Serve in Indian Health Care Settings |
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The Indian Health Service (IHS) Division of Health Professions Support (DHPS) plays a vital role in the IHS mission to improve the physical, mental, social and spiritual health of American Indian and Alaska Native (AI/AN) people to the highest level possible. Through the provision and administration of scholarships, externships, loan repayment, recruitment, grants and other career support services, DHPS invests in the future of AI/AN health care professionals and the communities they serve in Indian health programs across the nation. |
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IHP Program Funding Summary
SECTION |
TITLE |
FY 2008 FUNDING |
103 |
Health Professions Preparatory Scholarship |
$ 3,745,096 |
104 |
Health Professions Scholarship |
$ 10,277,745 |
105 |
Extern Program |
$ 1,181,932 |
108 |
Loan Repayment Program |
$ 17,488,854 |
112 |
Quentin N. Burdick American Indians into Nursing Program |
$ 1,713,624 |
114 |
American Indians into Medicine Program |
$ 1,126,253 |
217 |
American Indians into Psychology Program |
$ 757,386 |
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TOTAL APPROPRIATED FOR INDIAN HEALTH PROFESSIONS |
$ 36,290,890 |
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ADDITIONAL DHPS FUNDING |
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108 |
Loan Repayment Program - Hospitals and Clinics |
$ 4,981,727 |
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Recruitment - Hospitals and Clinics |
$ 6,010,747 |
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SUBTOTAL |
$ 10,992,474 |
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TOTAL IHP PROGRAM FUNDING |
$ 47,283,364 |
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IHS Scholarship Program
The IHS Scholarship Program provides financial assistance to AI/AN students in health professional education programs. Scholarships are awarded to qualified students at the preparatory, pre-graduate and professional levels.
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For fiscal year 2008, IHS awarded 337 scholarships, comprising 50 preparatory, 46 pre-graduate and 241 professional scholarship awards with an average award of $47,114.
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Deferment for Residency or Post Graduate Training
Some health professional disciplines including physicians, clinical psychologists, social workers and dietitians require additional post-graduate clinical training before they can become independent licensed practitioners. Individuals in these disciplines request a deferment of their scholarship service obligation until they complete their post graduate clinical training. Physician deferments are limited to primary care specialty residencies: |
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Deferment for Residency or Post Graduate Training Summary
Physician Specialties Approved For Deferment |
Deferment Period |
Other Disciplines Approved For Deferment |
Deferment Period |
Family Medicine |
3 years |
Clinical Psychologists |
2 years |
General Pediatrics |
3 years |
Social Workers |
2 years |
Obstetrics and Gynecology |
4 years |
Dietitians |
1 year |
Emergency Medicine |
3 years |
Pharmacists |
1 year |
General Psychiatry |
4 years |
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Internal Medicine/Pediatrics |
4 years |
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Internal Medicine/Family Practice |
4 years |
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General Surgery |
5 years |
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Anesthesiology |
5 years |
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In FY 2008, there were 83 health professionals on deferment. An additional 17 health professionals on deferment completed their residencies/training.
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Scholar Placement
Most scholars begin looking for a position at an IHS, Tribe or Tribal Organization, urban Indian program (Indian health system), or in private practice serving Indians, many months before graduation or completion of training. The Area Scholarship Coordinators, discipline chiefs, IHS Headquarters Recruitment Branch and Area Recruiters all work with scholars to assist them in finding a position that meets their professional and personal needs and the needs of the Indian health system. The IHS Scholarship Program requires scholars to have a full-time clinical position in their discipline within 90 days of graduation. Scholars not meeting this deadline are subject to involuntary placement by the IHS. In FY 2008, the target was to place 52 percent of scholars within 90 days of graduation or completion of training. The IHS Scholarship Program exceeded the goal with placement of 61 percent of scholars within 90 of graduation or completion of training.
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Recent IHS Scholarship Program accomplishments include:
- Review of over 1,700 scholarship applications annually for 100 new awards.
- Complete redesign of the IHS Scholarship Program Web site.
- Development of new Scholarship Program materials including:
- Promotional materials and advertisements
- Updated online application for new scholars and developed a new online application process for continuing scholars
- Development of eight E-newsletters
- Finalization of print and radio advertisements
- Review of scholar retention figures and development of a baseline retention rate beyond obligated service. A sample survey of 1,500 IHS Scholars revealed an average retention rate of 6.13 years, nearly four years in addition to the obligated service period of 2.21 years.
To learn more, visit the IHS Scholarship Program Web site.
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IHS Extern Program
The IHS Extern Program is designed to give IHS scholars and other health professions students the opportunity to gain clinical experience with IHS and Tribal health professionals in their chosen discipline. The program also allows students the opportunity to work at sites they may want to apply to for employment after they complete their health professions training. This program is open to scholars and non-scholars. Students are employed up to 120 days annually, with most students working during the summer months. In FY 2008, the Extern Program funded a total of 133 health professional, pre-graduate and preparatory students. A total of 94 (or 71 percent) were Health Professions students, 7 (or 5 percent) were pre-graduate students and 32 (or 24 percent) were preparatory students. Twenty-four (or 18 percent) of the 133 externs were IHS scholarship recipients (19 were Health Professions scholars, 3 were Pre-Graduate and 2 were Preparatory). Ninety-five (or 71 percent) of the 133 student externs were American Indian or Alaska Native.
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IHS Loan Repayment Program
IHS offers educational loan repayment assistance to qualified health care professionals recruited to work in Indian health programs. IHS awarded 582 loan repayments totaling $21,560,565 in FY 2008 (includes additional funding from sites), comprising 384 new two-year awards; 198 contract extensions (one-year awards) and 264 continuation awards (funded in the previous fiscal year).
Not all health care professionals who applied for loan repayment could be funded. A total of 326 health care professionals appyling for $16,741,728 in loan repayment did not receive funding in FY 2008. A total of 231 of these health professionals work in Indian health programs (listed as Matched Unfunded on the table). An additional $11,858,724 would have been needed to fund all eligible applicants working at Indian health programs in FY 2008. A total of 95 health professionals were listed as Unmatched Unfunded (health professionals who applied for loan repayment but did not choose to accept a position) could not be funded in FY 2008. An additional $4,883,004 would have been needed to fund all the Unmatched Unfunded applicants in FY 2008.
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Recent IHS Loan Repayment Program (LRP) accomplishments include:
- The review of 908 new applications and funding of 384 new and 198 continuing (582 total) with 231 matched unfunded. The average award for 2008 was $37,051.
- Implementation of a new loan repayment database application.
- Review of 1,300 Loan Repayment recipient records from 1989 to 2003 to find a baseline retention rate. Figures show average retention period for loan repayers was 7.44 years, 4.79 years beyond their average service obligation of 2.65 years.
To learn more, visit the IHS Loan Repayment Program Web site.
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IHS Recruitment
IHS Recruitment (referred to as Public Health Professions or PHP) offers opportunity, adventure and purpose to qualified health care professionals seeking to serve AI/AN communities. Employees of the Indian health system enjoy meaningful, challenging work as they raise the physical, mental, social and spiritual health needs of AI/AN people, many of whom experience certain serious health problems at far higher rates than the general US population.
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Over the past five years (FY 2003 - FY 2008), the recruiting of healthcare professionals has become increasing difficult. In some categories for full time permanent employees, the numbers of healthcare professionals have declined (e.g., physicians, dentists and optometrists). The nursing category has barely maintained its 2003 numbers, while only one profession has been able to increase.
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The number of IHS health professions will cease to grow and continue to decrease unless a significant overhaul of its recruiting system is implemented on a service unit/healthcare center level. This includes placing strict emphasis on recruiting with flexibility in hiring, incentives, schedules and pay scales.
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Recent IHS Recruitment accomplishments include:
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The Health Professions Recruitment Branch continues to develop and update recruitment and marketing materials including advertisements, recruitment materials and Web sites. These advertisements were placed in professional journals and on recruitment Web sites. The IHS Public Health Professions Web site at http://www.careers.ihs.gov/ has been updated and a new physician Web site will be available in Spring 2009. The new physician Web site will allow physicians and medical residents to request materials and ask questions of recruiters. IHS Health Professions Support Branch continues to work with IHS Human Resources staff and with the Office of Commissioned Corps Operations (OCCO) to identify ways to shorten the time required to hire new health professions staff (in both civil service and Commissioned Corps). The IHS and OCCO have a joint recruiter position assigned to the IHS Health Professions Support Branch to assist in recruiting health professionals into IHS. The second OCCO/IHS recruiter is expected to start in March 2009.
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IHS Grants
The Indian Health Service administers three competitive five-year grant programs to encourage Indians to enter health care professions and pave the way for these professionals to enter IHS and private practice in Indian communities
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In FY 2008, the Quentin N. Burdick American Indians into Nursing Program awarded six new grants, the American Indians into Medicine Program continued two grants, and the American Indians into Psychology program continued three grants.
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Grant Type |
# of Grantees 2008 |
2008 Funding Level |
Quentin N. Burdick American Indians into Nursing Program (Section 112) |
6 |
$ 1,713,624 |
American Indians into Medicine Program (INMED - Section 114) |
2 |
$ 1,126,253 |
American Indians into Psychology Program (INPSYC - Section 217) |
3 |
$ 757,386 |
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