TAHLEQUAH, Okla. — Ashton Glover Gatewood decided to give medical school a second try after learning about a new campus designed for Indigenous students like herself.

Gatewood is now part of the first graduating class at Oklahoma State University’s College of Osteopathic Medicine at the Cherokee Nation. Leaders say the physician training program is the only one on a Native American reservation and affiliated with a tribal government.

“This is the school that is everything that I need to be successful,” said Gatewood, a member of the Choctaw Nation who also has Cherokee and Chickasaw ancestry. “Literally, the campus, the curriculum, the staff — everything was built and hired and prepared and planned for you.”

The program in Tahlequah, the capital of the Cherokee Nation, aims to increase the number of Indigenous physicians. It’s also focused on expanding the number of doctors from all backgrounds who serve rural or tribal communities.

Natasha Bray, a physician and dean of the program, said most medical schools teach about barriers that can make it hard for rural or Indigenous patients to get adequate health care.

But she said students in Tahlequah get to see these barriers firsthand by studying on the Cherokee Reservation and doing rotations in tiny communities and within facilities run by the federal Indian Health Service.

“Unless you are living in that community, you’re part of that community, you’re seeing patients from that community — you can’t begin to understand what those barriers to care are,” said Bray, who is not Native American.

For example, Bray knows that one town on the reservation is a 50-minute drive to the nearest delivery room, and that some patients trying to eat more healthily don’t live near supermarkets, so they settle for convenience store food.

Rural America has a shortage of health care providers. The Indian Health Service, which serves Indigenous patients in mostly rural areas, has also struggled to recruit and retain staff.

Rural residents make up about 14% of the U.S. population but fewer than 5% of incoming medical students, according to a study of 2017 data. Native Americans are 3% of the population but represented only 0.2% of those accepted to medical school for the 2018-19 school year, according to the Association of American Medical Colleges.

Gatewood, who grew up in a city between the Chickasaw Reservation and Oklahoma City, first attended medical school at the University of Missouri. The program didn’t match her learning style, she said, and with few Native American students, she felt disconnected from her culture.

She left after three semesters. Gatewood went on to become a nurse and earned a master’s degree in public health.

Then, in 2019, six years after dropping out of the Missouri medical school, Gatewood learned about Oklahoma State’s new campus in Tahlequah. Once more, she pursued her dream of becoming a doctor. After taking classes in Oklahoma, she’s getting hands-on experience through a family medicine rotation in Baltimore.

Half the 202 medical students in Tahlequah are from rural areas, and nearly a quarter are Native American. Most of the Indigenous students are from Oklahoma tribes. Others come from tribes from states like Alaska and New Mexico.

Osteopathic physicians, or D.O.s, attend separate medical schools from allopathic doctors, or M.D.s. The schools have similar curricula, but osteopathic colleges also teach how to ease patient discomfort through physical manipulation of muscles and bones.

The Cherokee Reservation spreads across roughly 7,000 square miles in eastern Oklahoma. It’s home to about 150,000 Cherokee citizens, most of whom live in rural areas, said Principal Chief Chuck Hoskin Jr. Hoskin grew up in a town that was once served by a doctor who traveled across the reservation, treating patients in a vehicle.

The Cherokee Nation now operates 10 hospitals and clinics to ensure that all citizens live within a 30-minute drive of care. Hoskin said this means the reservation has better access to health care than much of rural America.

“There are not many communities in this country in which you would see that sort of investment,” he said.

Still, access to care remains challenging for some residents on the reservation, Bray said. There is significant poverty, and some people lack transportation, or cellphone or internet service. Cherokee residents have high rates of diabetes, obesity, addiction and heart disease, Bray said.

On a recent afternoon, students practiced osteopathic manipulative therapy on one another in a classroom at the Tahlequah medical school. Next door at the hospital, medical student Mackenzie Hattabaugh checked on Chyna Chupco, who was recovering after giving birth to her first baby.

Hattabaugh, who is not Native American, grew up in Muldrow, a town of about 3,300 on the reservation. She said the town sometimes had a doctor but never a hospital or urgent care clinic.

“I would like to go back to around my hometown and perhaps be a staple in my community, to become a physician and provide people health care who usually have to drive 30 minutes or more to get it,” Hattabaugh said.

The medical program helps students understand what health issues are more common among Native Americans, Gatewood said. She said her previous medical school taught about the high rate of diabetes among Black patients, but not the rate for Native Americans, which is the highest of all U.S. racial groups.

Students said they’ve learned to ask Indigenous patients not just what prescription drugs they’re taking, but also whether they’re using traditional medications or working with a healer.

Native Americans have long received inadequate, discriminatory, unethical health care. Children died of infectious disease outbreaks during the boarding school era. The Indian Health Service sterilized thousands of women in the 1960s and ’70s. Today, the agency remains chronically underfunded.

This has led some Indigenous people to mistrust the health care system. But several Tahlequah students said they’ve bonded with patients who share similar backgrounds.

“It really comforts patients to know that someone like them is taking care of them,” said Caitlin Cosby, a member of the Choctaw Nation.

The 24-year-old said she once had a patient who asked, “ ‘Are you Native?’ And I said, ‘I am!’ ”

The patient told Cosby he was proud of her.