Pilot Medical Education Program Addressing Underserved to Become Official

By Sharon Brock

Currently in its pilot year, a medical education program that focuses on the health care needs of the underserved will become an official part of the UCSF School of Medicine curriculum next fall, when 10 students will be added to the class size. PRIME-US, or Program in Medical Education for the Urban Underserved, is a four-to five-year medical education program that focuses on meeting the health care needs of indigent, inner-city communities and inspiring future leaders in the field. Students will be accepted into both the UCSF School of Medicine and the UC Berkeley-UCSF Joint Medical Program. PRIME-US is one of four such programs in the University of California system, each focusing on a different underserved population. The UC Regents recently approved the program, which received some state support through the voter-approved Proposition 1D last November. "UCSF is a leader in addressing issues of the medically underserved," says PRIME-US Interim Associate Director Elisabeth Wilson, MD, MPH. "With PRIME, medical students have the opportunity to tap into all the work that UCSF faculty is already doing." The overall goal of the program is to improve access to quality medical care for urban underserved populations in both the short and long terms. The PRIME-US curriculum includes first- and second-year bimonthly seminars addressing not only specific medical needs of this population, but topics related to research, education, policy and social activism. In the seminars, experts from community-based organizations provide insight into real-world issues and how they are being addressed in society. Students partner with a community-based organization and develop a project which addresses a need in that community, such as an after-school health program.

These students were the first to be enrolled in PRIME, a pilot program which will become part of the medical education curriculum next fall.

"When prison and jail health care experts came to talk to the students last fall, they did not just talk about providing care and policy. They also described what they do on a daily basis and how they got there, so they serve as role models," says Wilson. "After the seminar, we took the students to San Quentin to meet with the inmates. We did this because it's important for students to have firsthand experiences with underserved populations, so that they really understand the issues and can grapple with them." In terms of clinical experience, PRIME students are exposed to a variety of underserved populations by working in local community health clinics, San Francisco General Hospital and hospitals in the Fresno area. These diverse, hands-on experiences are intended to fuel the commitment students have toward caring for the underserved and to inspire students to become experts in the field. As part of the University of California Programs in Medical Education, students also will learn how telemedicine can be employed to address the unmet needs of underserved populations. With the use of two-way video cameras installed at UCSF and at public health clinics, telemedicine will be used for both medical education and clinical care to urban underserved communities. "Our job is to provide the experiences, support and resources, and help students realize how important, exciting and viable this career is," says Wilson. "We want UCSF to be known as a medical school which specializes in effectively serving the urban underserved and is producing doctors who are the future leaders in caring for this population." PRIME received initial support in part by Proposition 1D, the bond measure approved by California voters last November. Proposition 1D will provide a total of $10.4 billion in bond financing to build and renovate school facilities over a two-year period. UCSF will get $35 million of the $200 million that the bond measure will provide to the UC system for medical education aimed at boosting access to health care for underserved populations. Any expansion of the medical school class will help address the critical health care needs of California, UC official say. The UC Health Sciences Committee's report noted a significant and growing need for physicians in the state. Among the committee's conclusions: California is expected to face a shortfall of up to 17,000 physicians by 2015 due to overall population growth, an aging physician work force and the lack of growth in California medical education programs for more than three decades. Read the final report. The UC President's Advisory Council on Future Growth in the Health Professions recommended last November that UC increase medical student enrollments by 34 percent through the year 2020. Specifically, the council recommended that this growth begin with PRIME on all five UC campuses with medical schools. Related Links: UC Health Sciences Education: Workforce Needs and Enrollment Planning (PDF)
April 2005 Medical Education and the University of California: Final Report of the Health Sciences Committee (PDF)
December 2004