Indigenous Australians are under-represented in the health workforce, with large disparities between rates of Indigenous and non-Indigenous people in every health profession, including nurses, medical practitioners and all allied health practitioners. Yet Indigenous people have long requested to have Indigenous practitioners involved in their health care, with this increasing the likelihood of culturally safe care. To address the shortage of Indigenous health practitioners, it is important to not only recruit more Indigenous people into health courses, but also to support them throughout their studies so that they graduate and have realistic expectations of the demands they will face working in their chosen health profession.
The aim of this systematic review was to identify literature describing the enablers and barriers to the retention of Indigenous health students studying at university and explore strategies that have been reported to support Indigenous students and assist their retention and successful completion.
Programs and initiatives by nursing, health and medical science faculties are attempting to improve graduation rates for Indigenous health students, instead of focusing just on increasing enrolment rates. Successful strategies described in the literature included: appropriate selection of students; recruiting a cohort of Indigenous students for peer support; comprehensive preparation programs for students before they commence their studies; appointing Indigenous academics; building a culture that is supportive of Indigenous people within the schools and faculties; embedding Indigenous culture and health issues throughout the curriculum; flexibility in course delivery and assessment; encouraging support networks among students; targeted mentoring and tutoring programs; and social and financial support. Addressing exposure to racism, graduated exit points and celebrating success at graduation are important.
Universities have an important role to play in improving health care and increasing cultural safety for Indigenous people. Pathways into health studies and support structures for Indigenous people need to be developed and incorporated at multiple points across the health workforce pipeline.