Native Hawaiian kupuna, 'aina and health, traditional healing integration, community consent.

Neighbor island specialty access, flight-to-care decisions, dialysis or chemotherapy on Oahu.

Micronesian migrant health access, COFA Medicaid history, Chuukese or Marshallese patient care.

Vog and respiratory disease, climate and island health, food security and taro sovereignty.

Hawaii ties, Asia-Pacific health interest, Indigenous health commitment, why JABSOM.

'Aina (land) is not just cultural background — for Native Hawaiians, disconnection from land is a health determinant. Relocating a kupuna from their island severs this connection.

Ohana (family/community) is the decision-making unit for many Native Hawaiian patients — shared decision-making means the family, not just the individual.

Kuleana (responsibility/privilege) and mālama (stewardship) are values that shape how Native Hawaiians relate to health and healthcare providers.

Citizens of Micronesia, Marshall Islands, and Palau (COFA nations) can live and work in the US under the Compact of Free Association — but were excluded from Medicaid from 1996 until 2020.

This 24-year exclusion left a large community in Hawaii medically underserved. Many delayed care, arrived with advanced disease, and built deep distrust of the US health system.

Since 2020 restoration, COFA migrants can access Medicaid in Hawaii — but system navigation and trust barriers remain.

A patient on Molokai who needs dialysis three times a week must fly to Oahu — this is a $700+/week transportation burden on top of the clinical burden.

The ethical question is not whether to provide care, but how to honor the patient's right to remain on their island while ensuring medically necessary services.

Explore creative solutions: mobile dialysis units, telehealth monitoring, family support networks, community health worker home visits.

"Since 2011 I've sat on MMI panels across Canada, the USA, and the UK — scoring thousands of candidates across medicine, dentistry, PA, and nursing. Universal MMI is built on everything I've learned sitting on the other side of that table."

COFA is a treaty giving citizens of Micronesia, Marshall Islands, and Palau the right to live and work in the US. However, from 1996 to 2020, they were excluded from Medicaid, creating a large uninsured population in Hawaii. Congress restored Medicaid eligibility in 2020.

Hawaii's 1974 Prepaid Health Care Act requires employers to provide health insurance to employees working 20+ hours/week. This gives Hawaii one of the lowest uninsured rates in the US — a very different coverage landscape than mainland states.

Vog is volcanic smog produced by Kilauea's continuous eruptions — sulfur dioxide and particulates that cause respiratory disease, particularly in downwind communities on Hawaii Island and occasionally statewide. It's an ongoing environmental health issue JABSOM faculty research.

'Aina means land in Hawaiian — but also encompasses a deep relational connection between people and their natural environment. For many Native Hawaiians, health is inseparable from connection to 'aina. Clinical decisions that disconnect patients from their land (relocation for dialysis, hospice off-island) affect health beyond the medical.

Yes. As Hawaii's public medical school with only ~70 seats, JABSOM admits approximately 90% Hawaii residents. Hawaii ties, Pacific Islander community connections, and Asia-Pacific health interest are important.

Recent entering classes have median MCAT around 511 and median GPA around 3.7. The small class size means the holistic review is intensive — mission fit, community ties, and Pacific health commitment carry significant weight.

The Hawaiian Islands outside Oahu (Maui, Hawaii Island, Kauai, Molokai, Lanai) have limited specialty care infrastructure. Patients may fly to Oahu for chemotherapy, dialysis, cardiac procedures, or neurology — with all the financial and social disruption that entails.

Fa'afafine is a Samoan cultural gender identity — third gender, raised female in a male body. Pacific Islander LGBTQ+ identities like fa'afafine have distinct health needs and face specific stigma within conservative Pacific Island communities, requiring culturally informed care.