As the application process for this elective is time-sensitive and competitive, interested physicians-in-training must expect announcements regarding the opening of applications at the beginning of M3 year and complete all application requirements by the indicated deadline. Late applications will not be considered.

Rotation Basics:
o 4-week outpatient rotation;
o No overnight or weekend call required;
o 8 AM to 5 PM outpatient clinic schedule, including a 1-hour lunch break;
o Supervision by a designated preceptor for all patient care;
o Time primarily spent in outpatient primary care clinics (Family Practice, Internal Medicine, and Pediatrics);
o Time scheduled with Native Medicine, Emergency Medicine, and Mobile Health Unit;
o Opportunity to work with other disciplines based on individual interest and availability. These include the following: women’s health clinic, adolescent medicine/teen clinic, radiology, physical and occupational therapy, nutrition, fracture clinic.

During rotations, physicians-in-training will:
1. See patients in various settings (outpatient clinic, inpatient, mobile health unit, emergency room) of the Chinle Comprehensive Health Care Facility;
2. Understand the resources available to this rural population;
3. Participate in a presentation during their rotation to the other rotators and providers about a topic that they found interesting during their time in Chinle (further details in the Chinle Rotation Guidebook);
4. Listen to podcasts, read books, or read research articles regarding this population. Alternatively, participate in a local experience such as a sporting event (rodeo, basketball), traditional ceremony, or hike in Canyon de Chelly. (Recommended sources are found in the Chinle Rotation Guidebook.) For at least 5 of these learning experiences, record what you learned on their log;
5. Keep a log of the patients they see on the various sites and document the conditions they observe, and reflect on how they are impacted either positively or negatively by the Dine’ culture or their rural geographic setting;
6. Reflect on their experiences both medically and socially through a final paper at the conclusion of their rotation;
7. Complete a final evaluation of the rotation to assist the clerkship director in further strengthening the elective rotation.

ELIGIBILITY
Though the application process for this elective will occur during M3 year, any physician-in-training accepted to the elective must have passed Step 1 and successfully completed all required third-year clerkships and be good standing to begin the elective in October of M4 year.

HOUSING
Housing is provided free of charge other than a $20 internet fee. There are basic kitchen supplies provided and a washer/dryer, but physicians-in-training should bring their own linens. Housemates and roommates are likely, and most physicians-in-training feel that this enhances their experience since they have other residents/students with whom they can explore the area.

COSTS
Housing is provided by the Chinle Comprehensive Healthcare Facility. There is a $20 wi-fi fee to be paid upon arrival in Chinle. As it is impossible to get around without a car, physicians-in-training may consider driving to Chinle in their personal car and using that car for the duration of the elective.

If physicians-in-training do not have a personal car or do not wish to use a personal car while in Chinle, then they need to consider flight expenses to/from Arizona as well as the cost of renting a car in Arizona for the duration of the elective.

All interested physicians-in-training are encouraged to create an estimated budget for this elective, based on their personal circumstances, before applying for the elective.

FUNDING
The Center for Community and Global Health (CCGH) may award up to $750, in the form of reimbursement for eligible expenses after the conclusion of the elective, to physicians-in-training who participate in the elective. A minimum of 60 days before the start of the elective, physicians-in-training accepted for the elective will share their estimated budget (see “COSTS”) with the CCGH to determine which expenses will be eligible for reimbursement and to establish reimbursement procedures to be followed the conclusion of the elective.

SCHEDULE
This 4-week rotation requires 40 hours per week according to the following schedule:
Monday - Friday 8:00 am - 5:00 pm (minus 1 hour for lunch)

Resources to Explore
o Exploring the Culture in Pine Ridge Reservation, South Dakota
o Inside an Indian Reservation Reeling from Poverty and the Pandemic 
Additionally:
o http://www.seventhpower.org/history-of-pine-ridge/
o https://www.re-member.org/pine-ridge-reservation
o Chinle Rotation Multimedia Recommendations