Everything medical schools believe about us seems wrong. Medical schools call us “Native American,” but many of us dislike this word. The traditional among us refuse this colonial branding with every fiber of our being. Yet many people believe the media that says “Indian” is offensive and so they call us “Native American.” Ask yourself: Would a Ukrainian mother ever call herself Native Russian? Would a Palestinian man ever call himself Native Israeli? But I do not speak for political correctness or a medical school’s assumptions. I speak from the experience of my people, who carry thousands of years of memory and remember what was done to their villages.

Medical school application forms ask, “Which nation are you affiliated with?” and expect me to write Tohono O’odham Nation as if the word “nation” were not a bitter joke in our mouths. Are we a nation in the way the word is usually meant? Real nations have militaries. Will the Tohono O’odham ever be allowed to have one? Can we issue passports? Can we mint our own currency? Can my Tohono O’odham “Nation” open its arms to refugees from Somalia the way a fully sovereign people can? We are people who have lived here since time immemorial, and many of our youth and our elders resent the pseudo-nation framing the forms impose on us.

The AMCAS form asks whether I am an “enrolled member” of a tribe. Ask a traditional Indian if he is “enrolled” and he may laugh and wonder whether you think we are a church signing names in a ledger. We have lived with our blood, our stories, and our ancestors for thousands of years. This idea of enrollment, this bureaucratic marker, arrived with the White man and his rules. Remember that there are many full-blood Indians whose grandparents belonged to different tribes, so despite being full-blood, they lack the blood quantum to enroll in any single tribe.

The AMCAS form asks whether I belong to a “federally recognized” tribe. Consider this: The Lumbee Tribe of North Carolina received full federal recognition only in 2025. Does that mean the Lumbee were not a real people before 2025? Were Lumbee grandmothers and grandfathers less real until a federal agency recognized them?

The AMCAS form also asks whether we are part of a “state recognized” tribe. How can a state, or even a federal government barely two hundred and fifty years old, claim the standing to “recognize” or erase cultures that have lived on this land for thousands of years? The belief that federal or state recognition creates legitimacy is one worth questioning. There are full-blood people who look Indian, who carry the old ways, who speak the language fluently, but whose communities have never had the resources to pursue the long and expensive federal recognition process.

The AMCAS form asks for your country, state, and city of birth. In many Indian cultures, home is not where you were born. You may not truly know where you were born, because a mother may not have wanted to reveal an old relationship, and may not have told you the full story. But you always know where you buried your loved ones, and that place is what you call home. So it can be a serious taboo among traditional Indians to name your place of birth, especially if your mother is no longer alive. You may not want to revisit the story she chose to tell while she was living. Does the application system leave any room for this when it asks for a country, state, and city of birth?

And it is not only AMCAS. The TMDSAS, AACOMAS, and other systems can feel like a poor fit for Indigenous belief and value systems too.

I do not speak for interview scripts. I speak from the experience of my people, who still carry the memory of reservations and of children who never came home. In medical school interviews, you ask us whether we were disadvantaged. Anyone can ask an AI tool to draft a polished answer to such a question. The most disadvantaged Indians on reservations often carry the physical marks of hardship, including poor dental health from generations of hunger, bad water, and lack of access to care. A polished, AI-crafted answer does not capture that reality. The body carries a history that forms and interviews do not always reach, and it is worth asking whether the process can tell who truly suffered on this land and who is better at performing the expected story.

Application forms ask us for our telephone number. I speak from the experience of my people, many of whom are scattered across vast reservations where cell towers are rare. Many places on Indian reservations get no phone signal. To get a signal, a person may have to travel miles to the tribal office. So some of us do not have reliable phone numbers. Instead, some young people use apps like Session, Briar, or SimpleX, which do not require a phone number to sign up. These tools are worth knowing about, because they are private and, in the case of Briar, can even communicate without Wi-Fi or data. Yet the forms do not account for this. They ask for a phone number tied to a carrier, or they block a person from moving forward. While our elders travel miles under the desert sun just to make a call, the system asks for something that does not fit a way of life it never accounted for. We have adapted. We use tools that protect our words and our privacy. But the forms, as they stand, would rather exclude some of the most disadvantaged among us than update a single field. So, just to fill in one field on a medical school application, a person may have to sign up for a phone number that rarely works on the reservation. This is not inclusion. It reads as indifference dressed up as procedure.

The forms ask us for our pictures. But some of the most traditional among us, including those who still speak our language at home and those in sacred roles on the reservation, hold a taboo against having their picture taken. Some believe the camera takes something from the spirit. Others carry the memory of anthropologists and government agents who photographed our families like specimens, cataloged our pain, and then walked away with our images. Others simply follow old teachings that caution against capturing one’s own image. The people deepest in the old ways do not offer their faces so that strangers can measure their “diversity.” They guard what remains sacred to them. A cold demand for a headshot can trample a taboo the admissions office never took the time to understand.

I do not speak for comfortable assumptions. I speak from the experience of my people, many of whom live where the weight of poverty has pressed on generations. You ask us to travel for campus interviews. Many families on reservations have annual incomes under $5,000. That is not fifty thousand. That is five thousand, and it is not per person; it is the income for an entire family, for the whole year. How can families of grandparents, parents, and children who survive on so little be expected to buy plane tickets, hotel rooms, and formal clothes? This is the result of a long history of people pushed onto poor land, stripped of resources, and then told to lift themselves up. The demand to appear in person reveals how far the process sits from the reality of families deciding between bus fare and food. While admissions committees wait in comfortable halls for us to appear, entire reservation families weigh which sacrifice to make for a chance at the opportunity being offered.

Medical schools also ask for letters from our “tribal leadership” for scholarships. Tribal politics can be as bitter and divided as any other kind, and many people have strained or broken relationships with their current leadership. Some feel their leaders do not represent them or their families at all. Asking a student to secure a warm letter from a leader they are estranged from can place an impossible burden on the very applicants the scholarship is meant to help.

We do not speak for the mismatches inside systems that call themselves inclusive. We speak for the generations who never needed a card to know who they are, for the memory that predates these republics and their recognition processes. Medical schools can keep their checkboxes and their protocols. Many of us will keep asking them to see the people the forms leave out.

Paul Begay is an O’odham Indian with Navajo roots.