California medical schools tailor programs for diverse populations

The University of California is in the midst of rolling out new educational avenues geared to produce physician leaders for communities that historically have had poor access to health care.

The effort is part of an overall expansion of the university's five medical schools.

Cathryn Nation, MD, academic health sciences director for the University of California, said the university needed to address a physician shortage.

"Not only should we grow to address this issue, but we need to grow in ways that are in line with what the public needs," Dr. Nation said.

Each of the university's medical schools will add a five-year MD/master's degree program aimed at specific medically underserved populations.

For example, the University of California, Irvine, School of Medicine will focus on the Latino community. Urban underserved are the center of the San Francisco program. The Davis program will emphasize rural and telemedicine.

San Diego will have a flexible program that matches students with their area of choice, such as the city's large deaf community, nearby American Indian communities or other area ethnic and racial groups. Los Angeles' program will focus on equipping medical students to manage health systems and clinical operations with large financially disadvantaged and multicultural populations.

Each school's track will be limited to 12 to 15 students per class.

The University of California's approach has many unique aspects, said M. Brownell Anderson, senior associate vice president of the Assn. of American Medical Colleges' medical education division. However, it is not unique in its mission.

Many schools have rural tracks, and entire medical schools have been dedicated to improving health care access for their surrounding underserved communities.

Of the University of California medical schools, Irvine is the furthest along. Its Latino-focused initiative, called the Program in Medical Education for the Latino Community or PRIME-LC, is in its fourth year. The other schools are expected to start PRIME ventures next year.

Gabe Rivera is a fourth-year PRIME participant at Irvine and is working on an MBA to fulfill his master's degree requirement before finishing his clinical training next year.

"I could have gone to UCLA and come out as a physician and simply served the Spanish community," Rivera said. "The difference that PRIME offers is the opportunity to equip yourself with leadership skills."

In addition to following the same curriculum as the general medical student class, Rivera and his classmates started their first year with a language-immersion course in Mexico. During their first and second years, the school added on courses in Latino history and culture. Their third year was focused on health care disparities.

The students also routinely meet with school and outside officials to build their professional networks.

Rivera said these encounters, along with his MBA courses, have helped him develop his presentation and public speaking skills. He sees himself advocating for systemic change and working with policymakers while practicing medicine within the Hispanic community.

Charles Vega, MD, director of the PRIME-LC program, said its goal is to continue to provide support for graduates into residency and throughout their careers.

Dr. Vega said that if graduates stay at Irvine as residents, their program directors will work to continue their Latino expertise development. He also sees the potential for reciprocal relationships with outside programs where graduates match.

Dr. Vega and the PRIME faculty plan to keep in touch long term by holding annual meetings for students, residents and practicing PRIME graduates.