In the late 1960s, Robert Montoya walked onto the campus of the USC School of Medicine, today the Keck School of Medicine, near Boyle Heights and quickly realized that he was among a handful of medical students of color.
“There were two Latinos: me and one other Latino in my class and two black guys,” he said. “It was a real distinct difference between my class and the patients we saw.”
Today, Montoya is 76 and a retired preventive medicine doctor. But retirement hasn’t stopped his fight to get more Latinos into the medical field.
“I’m a child of the 60s, you know, activist, anti-war and all kinds of stuff,” Montoya said.
Latinos are the largest ethnic group in California, but only make up 6% of the state’s physician workforce and 8% of its medical school graduates, according to 2019 and 2020 California Health Care Foundation data. Given the dearth of Latino doctors in the state, experts are looking to policy for solutions.
“My goodness, we’ve been talking about this for decades. We haven’t made much progress,” said Sergio Aguilar-Gaxiola, M.D. and Director for the University of California, Davis’ Center for Reducing Health Disparities.
In interviews with CALÓ NEWS, experts across California agreed that the best solutions lie in revamping the California State University system and more to better track promising students with academic support and system navigation.
In 2017, public and private leaders convened The California Future Health Workforce Commission and in 2019 listed 27 recommendations that would eliminate California’s primary care provider shortage.
The commission reported early this year that the state has invested “over a quarter of the nearly $3 billion of investments recommended by the Commission for its highest priority recommendations.”
AB-133 was signed in 2021 and provides $16 million to universities and colleges to amp Health Professions Career Opportunity Programs (HCOP). HCOP will be prioritized on campuses in medically underserved areas or with student bodies underrepresented in medicine to provide academic enrichment, career development and more.
LOOKING TO THE CSU SYSTEM
A 2019 UCLA Latino Policy & Politics Initiative report showed that hardship with college navigation, lack of guidance, academic disadvantages and lack of finances pose the common barriers for Latinos and other people of color hoping to enter the medical profession. Thus, experts look to the California State University System – where Latinos, by far, comprise the bulk of student bodies and where educational barriers start to appear.
Latinos make up 45% of enrollees at more than double the rate of whites, per CSU data. In addition, a 2008 Academic Medicine longitudinal study and a similar 2010 study found that, disproportionately, underrepresented students of color and women became discouraged from premedical studies after having negative experiences with chemistry classes.
Tons of students of color graduate from CSUs each year, Montoya said. “They just do not survive the pre-med process and then apply to med school. It’s a real lousy yield,” he said. Pre-medical studies refer to the undergraduate studies in a science major, often needed to be considered for medical school entry.
Such is why experts believe that CSUs should better proactively support apt students, tracking them with academic support and navigation for success, including for community college transfers.
The Joint Admission Medical Program (JAMP) in Texas serves as an important model, said Dr. Consuelo Casillas, president and CEO of Alliance in Mentorship/MiMentor and executive board member of Latinx Physicians of California.
Created by the Texas legislature, the program involves 13 Texas medical schools and 68 public and private colleges to provide a slew of perks, which can include scholarships for undergraduate studies and medical school, student stipends, major assistance with Medical College Admission Test preparation, mentorship and guaranteed medical school admission.
California is adopting something similar to JAMP, Casillas said, via the California Medical Scholars Program. The $10.5 million pilot program seeks to recruit 200 community college students a year for multi-year support as they transition from four-year universities to medical schools.
Boosting support for diverse students in such a way may help level the playing field, considering the stark inequality among different students competing for limited seats in medical schools. Many medical students, Casillas said, emerge from the top-income families, attend elite colleges and access private tutoring and expensive prep classes.
“It’s not allowing our students to compete at an equal level,” Casillas said. “It’s the same thing if you were an athlete and you were getting private coaching, right? You’re going to be able to perform at a higher level.”
The University of California system has Programs in Medical Education (PRIME) among its six medical school campuses, providing targeted student recruitment, mentorship and more. About 64% of PRIME students are from underrepresented communities and graduates go on to work in California’s more underserved regions.
Aguilar-Gaxiola said that these programs need to be funded more.
“There is a tremendous need for primary care physicians to go and prepare them to care for underserved populations, especially in rural areas,” he said.
Sonja Diaz, founding director of UCLA’s Latino Policy & Politics Initiative, proposes taking things further with CSUs. Why not have CSU medical schools, she asks.
“The CSUs will do much better at recruiting talented and qualified medical students than their University of California counterparts who have not moved the needle in increasing the state’s supply of primary care doctors,” Diaz said.
CSUs are also in more diverse and under-resourced areas, like CSU Fresno and CSU Bakersfield, rural areas hardest hit by the doctor shortage.
“We don’t need more doctors in San Francisco per se or more doctors in Beverly Hills or Bel Air,” Diaz said. “What we need are doctors that are going to go into majority-minority communities that are socioeconomically disadvantaged.”