As the other posters have already told you, you don't have to be a Native to work for IHS/BIA. I worked for them for a few years- on a couple different res's. You will get your loans paid off if you work for a few years for them. Now, you are not working for the Native American, but for the Federal Government. I have had good and bad experiences. I also have 2 other friends who came from the private sector, then went to IHS/BIA. Depending on what res you are on will dictate how they feel about you. There are res's that are well run, interested in the health of their people, and then there are some that hate your 'white guts' (if you are white(anglo)). I have been in places that appreciate help, and I have been in places that the natives would just as soon as stab you in the back, break into your housing and steal everything possible while you are at work- places where native nurses will tell any white nurses to their faces that they will run them off as soon as possible. There are hospitals with less than 40 beds that are using supplies of a 600 bed hospital, because the native staff is selling all the equipment right from the hospital as it comes in. I have seen violence within the tribes that is unimagineable. Of 10 of us that worked at the same site, there is nobody that lasted more than 5 years- none of us would ever consider going back (at least not to a particular res). We are all back in community hospitals/private hospitals/own our own business/. It was an eye opening experience. If you can do it for a few years, it is a good way to get your loans paid off. There are many public hospitals that will also pay off your loans also, so search. There are nurses who have stayed with IHS/BIA services for years- it depends on how your personality is. By the way- the care, treatment and the quality of the drugs, equipment available to this area is extremely good- the government gets the latest equipment available. Good luck.