April 17, 2017
Area(s) of Interest: Medical School Physician Workforce 

Cheers erupted from a crowd of newly minted physicians at UC Riverside (UCR) School of Medicine on March 17 – Match Day – when the medical school's first graduating class of students opened envelopes telling them where they would spend the next few years as residents.

UCR School of Medicine, which welcomed its first class in 2013, was the first public medical school created in California in more than 40 years. This year it graduated 40 students, 33 of whom will stay in California for their residencies. Ten of these students will attend residency programs in the Inland Empire and serve the immediate community.

The medical school is dedicated to expanding and diversifying the physician workforce in inland Southern California, and to developing research and health care delivery programs to improve the care of the region’s underserved populations. In 2010, it was estimated that the region had a shortage of 3,000-physicians, with a primary care supply of just 43 physicians for every 100,000 people, according to the California HealthCare Foundation.

Despite the high numbers of candidates matching with residency programs this year, hundreds of qualified California students must leave the state to study elsewhere due to a lack of funding for graduate medical training (GME). California has invested in these medical students, but the lack of adequate funding for graduate medical education means another state will reap the rewards.

This is a big problem for our state – statistics show that physicians who leave the state for training are less likely to return to practice in California. And California has the nation’s highest resident retention rate. So, when they train here, they stay here.

UCR medical student Sarah Gomez is preparing to serve her residency at Desert Regional Medical Center in Palm Springs as a family physician. She emigrated as a child with her family from Mexico to the area; her plan is to stay and assist local residents. Forty-seven percent of the population in Riverside is Latino and lives in poverty.

“I would like to serve this population, perhaps in a county clinic when I finish my residency," she said.

Gomez is a strong supporter of the UCR medical school. She envisions serving on the faculty and helping other students with similar backgrounds get a good medical education and stay to practice in the immediate area. “I hope that more Latinos get into medicine,” she says. “We need to close the gap.”

The best way to do this is to make sure that California’s teaching hospitals have the money to increase the available residency slots so we can keep our home-grown physicians here in the state.

One step forward, two steps back
The California legislature last year passed a budget that included historic support for and expansion of primary care GME in medically underserved areas like Riverside. California committed to investing $100 million over three years ($33.4 million each year) to fund the Song-Brown Program.

However, just one year later, these funds are in jeopardy. Instead of giving these funds to schools like UCR, Governor Jerry Brown is proposing to eliminate $33.4 million for health care workforce expansion from the  2016-17 budget and does not include the second $33.4 million installment in his 2017-18 budget proposal. Gov. Brown's budget proposal also takes $50 million in tobacco tax revenues (from Proposition 56) that was intended to go to the University of California to expand GME programs and instead, backfills General Fund money that was cut from the UC’s base budget.

“This money matters. It matters to our school and is important for our community,” says Gomez.

Another graduating UCR medical student, Trina Mansour, has dreams that are similar to Gomez’s. As an Afghan-American and part of the first generation of her family born in the U.S., Mansour dreams of caring for women as an OB/GYN after hearing her mother’s tales of how women in Afghanistan suffered without care. “Women’s rights are not the same [in Afghanistan] as they are in America,” Mansour notes.

Mansour is thrilled that she will be staying at UCR to complete her residency. She also plans on staying in the Inland Empire to open a medical practice for those in the area that are underinsured.

A growing problem
California’s physician shortage is expected to get worse as the population continues to grow and our aging physician workforce moves toward retirement. California will require an additional 8,243 primary care physicians by 2030, a 32 percent increase. 

The funds that Gov. Brown wants to take for the general fund – some $83 million – are best spent expanding graduate medical education for the benefit of Californians who will need care.

“A robust, well-trained primary care workforce is essential to meeting the health care demands of all Californians,” said California Medical Association (CMA) President Ruth E. Haskins, M.D.

CMA believes Brown’s budget cuts are irresponsible and will make a bad situation worse. “’Access to health care’ is a hollow talking point when there aren’t enough physicians to support California’s patients,” said Dr. Haskins.

“I hope in the near future we have [these] funds available for [medical education in] California,” says fourth-year UCR medical student Doug Grover, who graduates this spring and will begin his residency in psychiatry at UCR this summer. “UCR needs these funds too. We want to see more residencies open up [here in our county].”

CMA is working through the budget negotiation process to restore this critical funding. We are also urging physicians, residents and medical students to ask their legislators to oppose Governor Brown’s budget proposal to eliminate the physician workforce funding.

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