What’s needed for Valley medical school? About $25 million, feeder programs and more

The San Joaquin Valley Coalition for Medical Education held a meeting Wednesday October 16, 2019 at the Doctor Medical Center conference center in Modesto, Calif. to discuss a medical school serving the Valley.
The San Joaquin Valley Coalition for Medical Education held a meeting Wednesday October 16, 2019 at the Doctor Medical Center conference center in Modesto, Calif. to discuss a medical school serving the Valley. kcarlson@modbee.com

A coalition for medical education convened in Modesto on Wednesday and discussed what it will take to establish a University of California medical school serving the San Joaquin Valley.

Once proposed as a medical school at UC Merced, the plan would commit UC facilities in Merced and Fresno for a medical school to address a severe physician shortage in the Valley.

Expanding the UCSF medical education program in Fresno from 12 to 50 students would be a transitional step toward a school turning out home-grown doctors for communities in the Valley. Stretching from Stockton to Bakersfield, the Valley is one of the poorest and least healthy regions in California and has long-standing shortages of physicians, nurse practitioners, registered nurses and counselors.

Expansion of the Fresno program, a branch of the University of California, San Francisco, School of Medicine, would cost $20 million to $25 million. The medical students could possibly take the first three semesters of classes at UC Merced.

Assemblyman Adam Gray, D-Merced, convened the San Joaquin Valley Coalition for Medical Education at the Doctors Medical Center conference center on McHenry Avenue to forge ahead with planning. Assemblyman Joaquin Arambula, D-Fresno, and state Sen. Cathleen Galgiani, D-Stockton, took part in the discussion along with UC Merced and USCF Fresno executives, staff members of California Sens. Dianne Feinstein and Kamala Harris, and other politicians and members of the medical community.

Wednesday’s meeting on the medical school proposal, which dates to 2002 or earlier, had a roll-up-the-sleeves quality and will lead to smaller committees to discuss education pipelines to prepare students for medical careers and consider a huge endowment for funding the medical school. Coalition members stressed that expansion of residency programs is essential for training the medical school graduates.

A proposed UC Merced medical school was once in competition with Riverside, which got the nod from UC regents but then had to grapple for funding to support its medical school. Members of the San Joaquin Valley coalition want to avoid that fate and one suggestion is a large endowment to produce ongoing funding for the Valley medical school.

With less than 10,000 students, UC Merced may need more capacity and faculty support for teaching medical students.

Kate Kearns, director of the Valley Family Medicine Residency in Modesto, said that without more slots at Valley residency programs, the medical school graduates will run into a bottleneck, forcing some to leave the state for training in primary care.

Kearns said the Modesto-based family practice residency typically receives 1,100 applications for the 12 open slots every year. Students graduate from medical schools with medical knowledge and basic skills, but require additional years of training to work as doctors.

Physicians from more affluent areas have chosen not to practice in the eight-county Valley, dotted with poor and ethnically diverse communities like Modesto, Merced, Fresno and Tulare. A key strategy is developing home-grown physicians who will want to stay and practice in the Valley.

Dr. Kenny Banh, assistant dean of UCSF Fresno, said 100 percent of the medical students in Fresno are from the Central Valley and 80 percent are students of color or from under-represented minority groups.

The effort to found the medical school could involve more programs like the Doctors Academy for Fresno-area high school students who are interested in medical careers. “That is how you get the doctors to stay — by taking these students and growing your own,” Bahn said.

A University of California report, “Improving Health Access in the San Joaquin Valley,” noted that advanced practice nurses, such as nurse practitioners, play a big role in broadening access to care and improving health outcomes in other states. But California has some of the strictest “scope of practice” regulations for nurse practitioners.

Speakers at Wednesday’s planning meeting urged members of the medical community to use their connections with the California Medical Association to seek support in Sacramento for the medical school. Dr. Sukhjit Samra, president-elect of the Stanislaus Medical Society, promised to broach the subject with the society’s board of directors.

Gray and other elected officials said state legislative leaders have focused most attention on access to health coverage for California residents, but it’s just as important to prepare more health care providers to replace physicians who are leaving the field due to burnout and retirement.

“This has been a major priority that is not a No. 1 priority on anyone’s list,” Gray said.