Advancing GME in American Indian and Alaska Native Communities
September 9, 2026 at 1:00:00 PM
Graduate Medical Education (GME) represents one of the most promising long-term strategies for addressing persistent physician workforce shortages across Indian Country. Despite serving more than 1.7 million American Indian and Alaska Native people, the Indian Health Service (IHS) continues to face high physician vacancy rates that limit access to care and contribute to poorer health outcomes. This presentation reviews the current workforce challenges, highlights evidence supporting GME as a proven recruitment and retention strategy, examines barriers to expanding residency training in Tribal, IHS, and Urban Indian health systems, and outlines policy recommendations to strengthen the physician pipeline. The AIMES Alliance, an organization focused on expanding physician GME opportunities in Tribal communities, is introduced. By investing in culturally grounded residency programs, sustainable funding, academic partnerships, and pathways for American Indian and Alaska Native students, IHS and Tribal health systems can build a stable, representative physician workforce that improves health outcomes and advances Tribal self-determination.
Michael Toedt, MD, FAAFP, FACHDM, RDML, USPHS (Retired) and Chris Fore, PhD (Choctaw)
Dr. Michael Toedt is the CEO and founder of Toedt Health Solutions, LLC, with a mission to eliminate health disparities and improve the quality of life for vulnerable populations. Dr. Toedt retired as an Assistant Surgeon General and USPHS Rear Admiral, serving as the Chief Medical Officer of the Indian Health Service. He was IHS’s lead expert on medical and public health topics, testifying before Congress and providing national leadership for the clinical and community-based health programs of the agency, and serving as the primary liaison and advocate for IHS health professionals. He led the development of a new IHS 5-year strategic plan, the first for the Agency in almost a decade, a major milestone in establishing a culture of accountability within the Agency and played a key role in establishment of the IHS Headquarters Office of Quality. He provided leadership and oversight of all 12 Area Offices and a network of 46 hospitals and 330 health centers in 37 states, comprising at the time the 16th largest healthcare system in the U.S. He has also served previously as the Nashville Area CMO and as the Clinical Director of the Cherokee Indian Hospital.