Resident/Student Rotation Information

Updated 10/23/2020

We welcome applications from interested and talented students and residents to do a rotation at our Tribal Health Organization in northwest Alaska. Norton Sound Health Corporation (NSHC) is a tribally owned and operated, independent, not-for profit health care organization, founded in 1970 to meet the health care needs of the Inupiat, Siberian Yup’ik and Yu’pik people of the Bering Strait region. NSHC is governed by a 22-member board of directors that represents all communities and areas of the Bering Strait region, a 44,000 square-mile section of northwestern Alaska.  Norton Sound Health Corporation puts the patient first. This principle applies equally at the new Norton Sound Regional Hospital and at the 15 village clinics managed by NSHC.  Every day, NSHC’s approximately 700 employees – about 72% of them Alaska Native – demonstrate their commitment to our mission: providing quality health services and promoting wellness within our people and environment.  Norton Sound Health Corporation is a model of how Indian Self-Determination is meant to work, with tribes taking responsibility for their own health and well-being.  The student and resident elective is an in-depth experience for those who would welcome a rotation focused on rural, Alaskan and/or indigenous health.  We welcome the applications of top learners who would like to contribute to and learn from our mission.

Details of the rotation are below.

Please let me know if you have any further questions which are not answered below.

We look forward to welcoming you here,

Marc Levin, MD
Hospitalist
Coordinator of Visiting Student, Resident and Fellow Rotations
Medical Director, Quyanna Care Center
Norton Sound Health Corporation
PO Box 966
Nome, Alaska 99762

907-443-3311

 

COVID updates:

We are unable to pay for students’ or residents’ housing in Nome at this time and anticipate this to continue through spring 2021.  We hope this will resolve by spring/summer next year.  Due to mandatory quarantine requirements, our housing is quite booked up.  Learners may still apply and rotate but you would need to find your own housing.  We would suggest the Dredge Inn or the Aurora Inn but expect to pay about $1500 per week.  We could still offer free housing during village trips (see below) but those would generally be a single trip Monday to Thursday as we sleep in the clinic there.  However, village travel is limited during COVID and all routine village travel is on hold for at least 60 days starting October 9, 2020 due to COVID.  If the above is not possible from your end, feel free to contact me in the spring when we can hopefully offer housing again.  Regardless of timing, we would still be able to cover food/per diem/village flight costs as noted below if village travel is occurring.  Residents from the Alaska Family Medicine Residency Program and students from the WWAMI Program are exempt from the above and we would still pay for housing for their rotation here.

Village trips to Native Alaskan villages are very limited due to covid and depends on each tribe’s leadership/travel regulations and the policies of NSHC leadership at that time and if an attending is going at a particular time while you are here.  Telemedicine visits to the villages are certainly available.  You would need to be in Nome for at least 1 weeks before a village trip (although at times this is a 2 week stay before going to the village).  Most of our villages still don’t have running water and are at very high risk for rapid spread of illnesses so preventing any possible transmission through travel is a high priority. We hope that you will understand the importance of this decision but will still consider a rotation with us.   All routine village travel is suspended for at least 60 days beginning October 9, 2020.

If coming from out of state, you would need to test within 72 hours before arrival in Alaska per AK state guidelines (or pay $250 at the Anchorage airport for one) and quarantine until results come back).  You would also need to complete an online form.  Details here:  http://dhss.alaska.gov/dph/Epi/id/Pages/COVID-19/travel.aspx

You would need to quarantine in Nome for one week and test on days 1 and 7 per Nome city and NSHC requirements.  Entry into Nome requires this form as well:  https://www.nomealaska.org/egov/documents/1600369489_30146.pdf

Your first day would have to line up with one of our orientation dates which are offered every other Monday.  We do have the option of an online orientation as a last resort.   I do not have our 2021 calendar yet.

Of course, all of the above may change at any time depending on the covid situation, state and city regulations and the leadership of NSHC and the tribal villages.

Requirements of rotation:

• Application from Norton Sound Health Corporation
• Students and residents can apply here: https://www.nortonsoundhealth.org/resident-student-rotation-application/
• We also need a letter of good standing from your program, 2 letters of recommendation and an essay which should address the following:
  • What are your professional goals?
  • Where do you plan to practice after you complete your educational requirements?
  • Why are you interested in an Alaska rotation? What type of site and placement are you seeking?
  • Do you have any ties to Alaska or have you traveled to Alaska previously? Please describe the town you reside in or grew up in as far as population, economy, geography, etc.
  • Please describe your commitment to the under-served population. Include any and all experience you may have gained from work or volunteer positions with youth, elderly, chronically ill or the disadvantaged. Also include any cross cultural experience.

We generally only take 2 learners at a time and applications are rolling (ie the earlier you apply, the more likely to secure a spot).  You should be notified of acceptance or not within 2 weeks of a completed application submission.

Health information:

• Documentation of vaccine complete series OR titers for MMR/varicella/Hep B/Tdap/Flu shot if coming during flu season (Oct-March)
• TB screening within the past 12 months:  ppd or quantiferon gold

It would be expected that you provide the appropriate documents within 2 weeks of acceptance to the rotation.  We consider it a privilege to do a rotation here and place the responsibility of obtaining all necessary documents entirely on the learner.  There are many more learners who want to rotate at tribal sites in Alaska than there are slots and we do not want to hold a spot if a student is unable to submit the required documents.  Unless there are outstanding circumstances, your acceptance to the rotation will be withdrawn if all required documents are not received in a timely manner.

• Interinstitutional agreement:  We prefer the AAMC Uniform Clinical Training Affiliation Agreement(available online) but will review a specific agreement from your school/residency if that is what you submit.  Please have documents signed by the appropriate officials at your school before submitting to us and we will return the final signed copy to your school.

It would be expected that you provide the appropriate documents within 2 weeks of acceptance to the rotation.  We consider it a privilege to do a rotation here and place the responsibility of obtaining all necessary documents entirely on the learner.  There are many more learners who want to rotate at tribal sites in Alaska than there are slots and we do not want to hold a spot if a student is unable to submit the required documents.  Unless there are outstanding circumstances, your acceptance to the rotation will be withdrawn if all required documents are not received in a timely manner.

• Background check: Ideally from your school/residency within 30 days of the start of your rotation.  If you cannot/do not provide this, we will do a background check/fingerprinting on-site once you arrive.  This must be completed before any patient contact..
• Students of foreign medical schools:   Must be a US citizen (ie we will not sponsor visas) and have US-based malpractice covering at least $3 million/occurrence.

Details of the rotation:

• Housing:  Please let me need to know your exact dates of arrival and departure.  Norton Sound Health Corporation will cover the costs of housing for students and residents.  In Nome, students will always have their own room but it may be in a shared apartment with someone of the same gender.  For transgender/gender non-conforming/gender diverse learners, please let me know if you need particular accommodation.  For accommodation in the villages, see 9b below.
• Travel: Norton Sound Health Corporation will not cover travel to/from Nome for students and residents but will cover costs of travel to/from Nome/Native villages – see below.  For arrival into Nome, we recommend you arrive on Alaska Airlines flight 151, departing Anchorage 9:45 am and arriving at 11:14 am from Anchorage the day before starting (or earlier) as flights are frequently cancelled/delayed due to weather here.  Alaska Airlines is the only commercial airline that flies from Anchorage to Nome.
• Food: Food is free in the Norton Sound Regional Hospital cafeteria when you are on hospital rotations (ER, OB, inpatient).  Per diem is provided for time in the village (see 9b below).
• Your start date here will need to line up with one of our orientation dates (offered bimonthly).  Orientation covers information about the hospital and organization as well as cultural training related to the Alaska Native communities we serve and EMR training.  We will let you know if your start date need to be adjusted to match up with orientation.
• Rating of your preferences for the following services and comfort with medivacs.  We generally have you rotate on 3-4 of your choice (for a 4 week rotation) but can design it however you want (ie have you on one service, with the exception of village travel which we can only offer one trip per rotation):
• ED (in Nome ED):  Generally 11 or 12 hour shifts during the day.  I tend not to have students/residents on night shift (13 hours) unless you specifically request that.  You would be on generally 4 shifts per week.  ER is run mostly by family physicians and one ER board certified doctor.
• Village travel:  Primary and urgent care in one of the 15 Native villages we serve.  You will fly on a small plane and stay in the clinic or school, depending on the village (bring a sleeping bag if possible).  Some of the village do not have potable drinking water in which case you will need to bring your own (can buy in Nome).  Travel is usually Monday to Thursday, although there are often changes due to weather conditions.  Norton Sound Health Corporation will cover costs of flights and housing in the villages for students/residents as well as a $75/day per diem as food is quite costly in the villages.  You will work with one of our family physician attendings in the villages and you may travel with them or meet them in the village later in the day or week (depends on travel availability).  Care will both acute and chronic care.
• Inpatient medicine/peds:  Work with one of our hospitalists on our inpatient unit.  Hospital service is run by family doctors with inpatient skills.
• Psychiatry/behavioral health:  Works inpatient and outpatient with psychiatrists and psych midlevels and behavioral health counselors and social workers
• OB team:  Family medicine doctors who offer prenatal care, OB triage care and inpatient deliveries in Nome inpatient unit as well as postpartum and newborn care.  You will usually be on call with attending for 1-2 nights in a week but can adjust schedules if you are called in overnight.
• Primary Care clinic in Nome:  Serving the primary care needs of Nome as well as the Native population of the region that may need a higher level of care than can be offered in the villages.  We also get frequent visits from specialists from Anchorage (ANMC) who come for a couple days every month to address non-urgent specialty needs.  There are often telemedicine visits around the region.  Primary care is provided by family doctors, midlevels and 2 pediatricians.  Care will both acute and chronic care.
• Medivacs:  We do have frequent medivacs of patients from the villages to the ER in Nome or Anchorage (and occasionally Seattle) and from the ER/inpatient unit to Anchorage/Seattle for emergencies.  In addition, medivacs are used when doctors need to go from Nome to the villages for emergencies (ie patient in early labor).   Let me know if you would like to participate in and be comfortable going on these.  These are all on small planes and weather and space-permitting.  A release form will be required and will be provided after acceptance to the rotation.
• Residents need an AK resident license which you could apply through from the AK Medical Board.  I would need to sign the acceptance of responsibility form which you can forward to me and I will forward to the AK Medical Board.  Students do not require a license.