When a high-profile team of health and education leaders examined how California’s future workforce can better meet the state’s evolving health needs, it pointed to a thriving program at UC Davis School of Medicine.
Earlier this year, leaders of the California Future Health Workforce Commission reported that the University of California’s PRIME programs at six campuses are successfully boosting the number of physicians from underrepresented groups and placing them in communities of need, which is critical for achieving health equity and access to care.
Indeed, more than 150 UC Davis School of Medicine PRIME graduates over the past decade are transforming the physician workforce in medically underserved cities and towns between Bakersfield and the Oregon border, and throughout the Western United States.
Students selected for PRIME (short for, Programs in Medical Education), choose to study in one of four medical education pathways that include rotations in hospitals and clinics unique to a geographic area or primary care setting.
PRIME is a popular program for students with deep connections to vulnerable communities — and it’s making a difference.
Preparing the workforce for diverse patients
“UC Davis has made significant contributions toward solving a critical challenge facing millions of Californians struggling to access health care by preparing physicians to serve the state’s increasingly diverse population in rural, urban and Valley communities,” said UC Davis School of Medicine Dean Allison Brashear.
“Although we still have a way to go to achieve health equity, the School of Medicine is enormously proud of the emphasis we place on PRIME and I’m grateful for all the students, faculty and staff that are dedicated to improving the health of all communities,” she added.
About a quarter of UC Davis’ approximately 450 medical students are enrolled in a PRIME pathway; nearly all are training for careers in primary care or other needed specialties such as obstetrics/gynecology, general surgery, and psychiatry.
PRIME was initially conceived by the University of California Office of the President and started at UC Irvine in 2004. By 2008, each UC medical school had its own program, tailored to meet the needs of the populations that campuses were committed to serving.
UC Davis’ PRIME tracks include:
- REACH (Reimagining Education to Advance Central California Health). The newest of the PRIME tracks started in 2018 for students who desire to work in the Central Valley north of Merced. REACH is an offshoot of an earlier, successful program called San Joaquin Valley-PRIME, now run by UCSF, from its Fresno campus.
- ACE-PC (Accelerated Competency-based Education in Primary Care). It was launched with a grant from the American Medical Association in 2014 and is the only training program in California that puts students through medical school in just three years. The main purpose of ACE-PC, which operates in partnership with Kaiser Permanente, is to more quickly prepare primary care doctors to fill workforce shortages, particularly in Central and Northern California.
- TEACH-MS (Transforming Education and Community Health for Medical Students). It started in 2012 and seeks to train students in primary care medicine for urban underserved settings. Among the locations where students rotate for longitudinal experiences include the Sacramento County Health Center, a federally-qualified health center.
- Rural-PRIME. Started in 2007, it is designed to produce physician leaders who are committed to serving rural communities. Rural-PRIME students participate in 6-week rotations in rural settings and receive additional training on the use of telemedicine and simulation.
PRIME students must first be admitted into the UC Davis School of Medicine, then go through a secondary application process for a specific track.
The program, which prioritizes care to underserved communities, such as the Central Valley or rural Northern California, often attracts students who were raised in those regions. And when students are from a particular area, or do their residency there, they are more likely to eventually practice medicine in the same place, thus filling critical workforce shortages.
“I was raised in Modesto and my husband is from Lodi; there was no doubt in our minds that we were going to come back eventually,” said Sidra Seuss, a 2015 San Joaquin Valley PRIME graduate in her first year of practice as an internal medicine physician at Kaiser Permanente Stockton Medical Offices.
The PRIME program is critical, she said, for supporting and encouraging medical students to work in communities that historically have suffered severe physician shortages.
“With how quickly the Valley is growing, we are going to face a very big gap between the amount providers we have and the amount providers we need,” she said. “I definitely think it’s a very big first step toward decreasing disparities.”
Seuss added that San Joaquin Valley PRIME’s focus on community health made a “huge” impact in “shaping me into the type of doctor I always wanted to be.”
Boosting UC Davis' national stature
As the PRIME program has flourished, so has the school’s focus on primary care training. The latest U.S. News and World Report ranking of top medical schools lists UC Davis as 9th in the nation for primary care training.
“I do believe there’s a relationship between the ranking and the growth of our PRIME program,” said Tonya Fancher, associate dean for Workforce Innovation and Community Engagement and director of the Center for a Diverse Healthcare Workforce.
Another reason PRIME has been successful, Fancher said, is because students are paired with faculty members with similar backgrounds, interests and desire to serve the underserved.
PRIME also tends to draw students from socioeconomically disadvantaged backgrounds and communities underrepresented in medicine. Many PRIME students started higher education in community colleges or grew up in households where English was a second language, which the school’s admissions office counts as valuable lived experience that will enhance the next generation of doctors.
Future plans for UC Davis PRIME include strengthening outreach to regions where there continues to be a mismatch between the existing medical workforce and the state’s increasingly diverse population, Fancher said.
Mark Henderson, associate dean for admissions, said that over the past 12 years, PRIME has been a vital pathway for the UC Davis School of Medicine to help transform the physician workforce.
“Our PRIME program has firmly established the school’s national reputation for training students to care for the underserved and achieve the social mission of medicine,” he said. “With the continued success of our incredibly diverse graduates, the future of medicine seems bright indeed.”