$2.6 million funding supports PRIME programs on health equity and Native American health

University of California San Diego School of Medicine will receive $2.6 million to expand its existing Program in Medical Education (PRIME) on healthy equity, and launch a new PRIME program focused on Native American health. The funding is part of a larger $12.9 million budget to fund all UC PRIME programs, approved in the new California state budget by Governor Gavin Newsom on July 12.

Alec Calac, Alexandra Pryor, Sofia Aedo, and Katherine Garcia were the first students to participate in the Tribal Ambulatory Healthcare Experience, a new course at the UC San Diego School of Medicine.

UC PRIME is a collection of medical school programs designed to support medically underserved populations and address the growing shortage of health care providers in California. Most PRIME students are from communities underrepresented in medicine, and often go on to practice medicine in underserved areas.

UC San Diego will use the funds towards student financial support and program development, starting as early as fall 2021. Class sizes in the School of Medicine will also increase from 134 to 140 students, with the first cohort of the program on Native American health joining in fall 2022.

PRIME-Health Equity is now fully funded

"The goal of the PRIME-Health Equity program is to help educate and promote physician leaders who will provide competent and compassionate care to underserved and vulnerable populations, and address health inequities in the community, state and nation," said Maria Rosario (Happy) Araneta, PhD, MPH, professor in the Department of Family Medicine and dean of Diversity and Community Partnerships at UC San Diego School of Medicine, and professor in the Herbert Wertheim School of Public Health and Human Longevity Science.

PRIME-Health Equity medical students study the family, community, cultural and sociopolitical influences on health, and learn strategies for developing community-based intervention programs. They also participate in hands-on training through the school's Student-Run Free Clinic, and lead the Doc-4-A-Day outreach program at local middle and high schools.

Students typically complete the program in five years, including four years of medical education and one year completing a master's degree in a related field such as public health. While the program previously funded only the one year of master's studies, the new budget will instead allow for substantial scholarships throughout the four years of medical education.

I intentionally selected PRIME-Health Equity for my medical education because I hoped to learn ways to serve communities that have historically been and continue to be excluded from exceptional medical care."

Cecilia Rangel-Garcia, MD, a recent graduate of the program

In alignment with the PRIME mission, Rangel-Garcia recently moved back to Fresno to care for her community while completing a residency in psychiatry.

"Exceptional medical care takes the whole person into account — their background, community, family, school, work experience and more," said Rangel-Garcia. "Through PRIME-Health Equity, I was exposed to providers who are doing this work to appropriately care for and support these communities."

New PRIME program on Native American health

The state budget also provides funding for two new PRIME programs focused on the needs of Native American and Black communities. UC San Diego School of Medicine was selected to host the program on Native American health in partnership with UC Davis, with each school hosting six students funded by this program per year.

"UC San Diego was built on the unceded territory of the Kumeyaay Nation," said Michelle Daniel, MD, professor of clinical emergency medicine and vice dean for medical education at UC San Diego School of Medicine. "As a land-grant institution, we have an obligation to promote greater inclusion of American Indian students in medicine, and support the health care of our local tribes."

"The PRIME funding will significantly expand our current efforts to address, and hopefully reduce, the relative shortage in physicians who provide health care to Native populations across the different environments where they reside," said Matthew Allison, MD, MPH, professor and chief of the Division of Preventive Medicine at UC San Diego School of Medicine, and member of the Chickasaw Nation. "Importantly, this program will provide specialized training on the unique needs of Indigenous citizens."

PRIME-Health Equity medical students visit Daniel Calac, MD, at the Indian Health Council in 2019.

Students in the new program will enroll in a curriculum similar to the PRIME-Health Equity program, with additional opportunities to shadow physicians at local Indian health clinics and run the Native Doc-4-A-Day program.

"All of the leg work for this started more than two years ago," said Luis Castellanos, MD, MPH, clinical professor of medicine and director of PRIME-Health Equity at UC San Diego School of Medicine. While drafting the proposal for the new program, UC San Diego students and faculty were already hard at work recruiting Native American students and developing courses on Native American health care. "Thanks to these efforts, we have been accepting the most Native American students across all UC medical schools. This made us competitive and poised to receive these funds."

California is home to the largest American Indian and Alaskan Native population, with San Diego County having the highest number of Indian reservations in the country. Yet less than 1 percent of the state's medical students identify as American Indian or Alaskan Native.

"To my knowledge, I am the first medical student from a tribe in California in our school's history," said Alec Calac, MD-PhD student, national president-elect of the Association of Native American Medical Students and member of the Pauma Band of Luiseño Indians. "I know my representation is important, and I have worked tirelessly to bring attention at the state and national level to our continued underrepresentation in the physician workforce. The past three years have been transformative regarding our community engagement, and our representation in the student body has increased 300 percent since 2018."

According to Kama Guluma, MD, clinical professor of emergency medicine and associate dean for admissions and student affairs, UC San Diego School of Medicine is "committed to removing barriers to the recruitment, retention and advancement of talented American Indian medical students, and seeks to always respect their heritage."

"I could not be more excited and hopeful for the expansion of funding to PRIME and I look forward to welcoming future colleagues into this family," Rangel-Garcia said.