Enhancing American Indians'/Alaska Natives' Knowledge, Confidence, and Community During the Medical School Application Process: Findings From the Northwest Native American Center of Excellence.

PURPOSE: To describe a Medical School Applicant Workshop (MSAW); present lessons learned about its impact on American Indian/Alaska Native (AIAN) participants' knowledge, confidence, and sense of community; and report on participants' medical school application progress 1 year after workshop completion. METHOD: The Northwest Native American Center of Excellence at Oregon Health & Science University developed and implemented an annual 1-day AIAN MSAW in 2018. The main objectives of the workshop are for participants to gain insights into the medical school application process; learn strategies to competitively apply; receive feedback on their personal statement and mock interviews; and discuss the medical school application process with AIAN faculty, admissions deans, and peer-mentors. Recruitment of AIAN participants occurred via email; social media; text messaging; medical association contacts; and AIAN and science, technology, engineering, and mathematics organizations. Two surveys were administered: one immediately after and another 1-year after the workshop. RESULTS: Forty AIAN MSAW participants were accepted in 2018-2020. Findings indicate statistically significant increases in participants' self-reported knowledge of the medical school application process and in their self-reported confidence. Participants reported meeting other AIAN students was highly beneficial and feeling connected to a community of AIAN health professionals after attending the workshop. Among the 25 participants who completed the 1-year follow-up survey, 12 (48.0%) indicated applying to medical school; all 12 of these participants were invited to interview, and 11 were offered acceptance to at least one medical school. CONCLUSIONS: Completing the MSAW increased participants' knowledge, confidence, and sense of community. If other programs and institutions were to consider using the MSAW model to reduce barriers and provide supports specifically designed for AIANs before and during the medical school application process, medical schools may stand to further increase AIAN representation in the physician workforce and ultimately to decrease health inequities among AIANs.

Seasonal deposition of marine debris on an important marine turtle nesting beach in Costa Rica.

Marine debris pollution poses a threat for wildlife and can negatively impact the economy of communities whose livelihoods depend on tourism. Playa Norte, in northeastern Costa Rica, is an important nesting ground for four marine turtle species identified as vulnerable or endangered on the IUCN Red List. It is highly polluted but has low human occupancy. We conducted accumulation rate surveys following a standardized marine debris protocol from March 2016 to January 2018. Macro-debris was categorized by size and material type. Of the 191,030 debris items retrieved during the two-year study period, 96.2% of them were plastic. Debris accumulation was higher during the dry season (January - September). This study contributes towards understanding the drivers of marine debris pollution in critical wildlife nesting habitats; and informs managers and the local community on possible strategies to prevent and reduce marine pollution, thereby aiding in tourism derived economies.