UC Davis findings from nationwide evaluation contradict results of previous investigations.

Anthony Jerant, UC Davis

Female doctors’ patients do not use health care services more or die less frequently than patients treated by male doctors, a prospective, observational study by researchers at UC Davis Health System has found.

The study, published in the March-April issue of The Journal of the American Board of Family Medicine, is the first large, nationwide evaluation of the association between provider gender and patients’ use of health care services and mortality.

“Our findings suggest that if the goal is to contain costs and the risk of death, there is no reason to differentially recruit or train physicians of either gender,” said lead author Anthony Jerant, professor of family and community medicine at UC Davis. “We should instead focus on factors such as patients’ cigarette smoking and diet, which are known to influence health care utilization and mortality.”

Jerant and his colleagues analyzed the responses of a representative sample of 21,365 patients aged 18 years and older who participated in the U.S. Medical Expenditure Panel Surveys from 2002 to 2008. They found that the genders of the participants’ usual sources of health care, regardless of specialty field, did not affect patient health care or prescription drug expenditures, deaths or the number of visits to hospitals, emergency rooms and medical offices. A usual source of care was defined as any medical professional, doctor’s office, clinic, health center or other place the patient would go if sick or needing health advice.

The authors noted that their outcomes contradict the results of previous investigations suggesting that patient-centered communications and related medical-practice behaviors frequently associated with female providers may lower patients’ use of health care services and costs. In addition to being smaller than the current study, those prior investigations did not account extensively for patient health behaviors and characteristics, including weight and tobacco use, which could influence the frequency of medical visits.

“We suspect that failing to comprehensively account for these factors might have made it appear that provider gender is independently associated with health care utilization,” Jerant said.

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UC medical schools make progress in attracting underrepresented minority students.

Nicholas Orozco

>>Motion graphic: California medical school first-year enrollments of underrepresented minorities

By Alec Rosenberg

Nicholas Orozco grew up in urban, predominantly Latino East Los Angeles, where obesity rates are high and access to health care is low.

Laura Jordan grew up on the Hoopa Valley Indian Reservation in rural Humboldt County, where tribe members face health issues from diabetes to heart disease but the nearest hospital is 90 minutes away.

While their backgrounds vary widely, they share a common passion: wanting to practice family medicine in an underserved community such as their hometowns. Both are first-generation collegians who received a head start through University of California postbaccalaureate programs aimed at preparing disadvantaged students for medical school. And now both are UC medical students participating in PRIME programs that train physicians to meet the needs of California’s underserved rural and urban populations – Orozco at UC Berkeley-UC San Francisco and Jordan at UC Davis.

UC’s postbaccalaureate and PRIME programs are two contributing reasons that UC has steadily increased medical student diversity. Among first-year UC medical students, underrepresented minorities have risen to more than 24 percent of students this year, up from 14 percent in 2001 and topping rates at California’s private medical schools and the national average. That’s still short of matching the state’s diverse population, but UC medical schools come closer than many other graduate and professional schools.

“PRIME may serve as a model for other professions that are laboring to achieve more diversity in their student bodies,” said Dr. John Stobo, UC Health senior vice president. “Here’s an exemplary case of what education can do in the context of legislation that prohibits affirmative action.”

UC can’t consider race or gender in admissions after a policy passed by regents in 1995 and California voters passed Proposition 209 in 1996, but it can have programs aimed at students from disadvantaged backgrounds. More than half of PRIME students are from groups traditionally underrepresented in medicine. The systemwide initiative, launched in 2004 at UC Irvine, has grown to 336 students and now involves eight UC campuses – the first substantial increase in UC medical school enrollment in 40 years.

“PRIME is a major innovation in medical education,” said Dr. Charles Vega, director of UC Irvine’s PRIME program. “I believe it’s the way to spread well-being across the state in a meaningful way.”

Orozco faced many challenges growing up in East Los Angeles, including his family lacking health insurance. He earned a bachelor’s degree from UCLA but struggled academically, working 60 hours a week while also attending to family issues. He participated in UCSF’s postbaccalaureate program, receiving support that led to enrolling in the UC Berkeley-UCSF Joint Medical Program in PRIME.

Now a second-year student, Orozco has observed prison health care at San Quentin, received training at an urban clinic in Oakland and established, in partnership with another PRIME student and the Pacific Center, an LGBT free drop-in clinic in Berkeley. The clinic provides primary care to low-income clients and tries to connect them with relevant social services. “The PRIME program and postbaccalaureate program represent opportunities to work with different communities and create an environment for people to give back and affect change,” Orozco said.

Laura Jordan

Inspiring others

Jordan became interested in rural medicine while working in high school at the medical clinic on her hometown Indian reservation, where family and community members suffered from chronic conditions and had limited access to specialty care. “I saw a need,” she said.

Mentored by the clinic’s medical director and encouraged by her parents, Jordan graduated from Humboldt State University and then participated in UC Davis’ postbaccalaureate program for help in preparing for medical school. Despite being the only Native American student in her class at the time, she chose to attend medical school at UC Davis for its Rural PRIME program and its support network.

“I knew medical school was going to be difficult,” Jordan said. “They tell you it’s like drinking water from a fire hose, and it is. Once I got used to the pace, it got easier.”

Jordan helped inspire five other Native American students to attend the UC Davis School of Medicine. Now in her third year, she is hitting her stride, receiving a scholarship from the federal Indian Health Service and getting hands-on experience working at rural health clinics in Redding.

“Laura’s a good example of what we’re trying to do, which is raise people who are going to go back to the communities that need them,” said Dr. Mark Henderson, associate dean for admissions and outreach at the UC Davis School of Medicine.

Henderson praised the PRIME programs – UC Davis offers a rural program and a San Joaquin Valley program with UC Merced – along with TEACH-MS, a four-year federally supported program for medical students with a strong interest in primary care and care for the urban underserved. “The focus is on continuity of care,” he said, noting that UC Davis’ medical school also has increased its support staff and broadened the way it reviews applicants.

“We have to look holistically at each candidate,” Henderson said. “We have to evaluate whether we are choosing the right kinds of students to meet the physician workforce needs of California.”

(Click image for larger view)

A broader approach

UC Davis has joined UCLA in using the multiple mini interview, or MMI, with medical student candidates. The short assessments take into consideration communications skills, critical thinking and cultural sensitivity – a broader approach that has helped attract more diverse students, administrators say.

“I call it speed dating,” said Dr. Neil Parker, senior associate dean for student affairs and graduate medical education at UCLA’s medical school. “It doesn’t take you long when you meet somebody to get the gestalt of, ‘Hey, I’d like to know this person.’”

Diversity begets more diversity, Parker said. Through programs like PRIME and supporting student groups, UCLA has created a comfortable environment for diverse students, he said.

Still, barriers exist. A big one is cost. The average U.S. medical student’s debt load has risen above $166,000. Entertainment executive and philanthropist David Geffen donated $100 million to establish a fund that will award merit-based scholarships to up to 33 UCLA medical students a year, which should help address that issue. “I think some of the students we normally lose will come here,” Parker said. “I think our applicant pool will become larger and more diverse.”

A new model

Meanwhile, UC Riverside – the eighth-most diverse campus in the nation – is making diversity a cornerstone of its new medical school, which is opening this fall. It’s viewed as part of its mission to improve the health of the Inland Empire, whose population is nearly half Latino.

“I think there’s real value in diversity,” said UC Riverside medical school founding Dean G. Richard Olds. “Having health care professionals that come from our communities is a desirable thing. It’s what the patients want. It results in better health care.”

“The two main determinants of where doctors practice are where they grow up and where they do their residencies,” Olds said. The medical school will provide campuswide pre-med advising and is setting aside 24 slots of its initial 50-student class for UC Riverside undergraduates. Admissions will use the MMI and look at four measures designed to enhance diversity: students who are local, from disadvantaged backgrounds, are first generation collegians and speak English as a second language.

UC Riverside also will be building its own local residency programs. Using a new model, UC Riverside will be California’s first public medical school to open in four decades, the sixth in the UC system and the only community-based medical school in the West Coast. While UC Riverside won’t have a PRIME program per se, “Our entire program looks like the PRIME program,” Olds said.

Martín Escandón

A positive influence

A UC San Diego study of applicants to its medical school found that underrepresented minorities and disadvantaged students were more likely to be interested in a curriculum designed to train them to work with underserved communities. The findings, published in the journal Academic Medicine, suggest that programs such as PRIME may influence the application decisions of diverse students.

That’s certainly the case of second-year UCSF medical student Martín Escandón.

After graduating from the University of Washington, Escandón worked for AmeriCorps in Seattle’s predominantly Latino South Park neighborhood. He saw that many health issues were related to social problems, such as treating a 4-year-old asthmatic boy who lived in an industrial area filled with bad air. “The doctor said, ‘Why did he get asthma in the first place?’ It was hard to ignore.” Driven by a passion for family medicine, a sense of social justice and a belief that health care is a human right, Escandón called UCSF’s PRIME program “a perfect fit.”

“PRIME is the best part of medical school,” Escandón said. “PRIME is a place to focus on what I think are the most important things – community health, preventive medicine, advocacy for patients.”

Making a difference

“PRIME really speaks to students about why they’re going into medicine,” said Dr. Alma Martinez, UCSF medical school outreach director and PRIME executive director.

Martinez said the campus climate is more welcoming now than when she was a UCSF medical student. She credits the students, leadership and programs such as PRIME, postbaccalaureate efforts and the Doctors Academy, founded by UCSF Fresno Dr. Katherine Flores to prepare disadvantaged Fresno County high school students for college and for health science careers.

But all of those programs struggle financially. UCSF medical school’s postbaccalaureate program had 15 students at its peak. It has fallen to eight students, but will rise back up to 12 students, thanks to funding from Kaiser Permanente.

“We’re always fighting to find money,” Martinez said.

The next step is to expand these types of programs not only in California, but nationally, she said.

“It’s not enough to just attract diverse students to one location without increasing the entire pool,” Martinez said. “I think all schools should be working on outreach and postbaccalaureate programs to get more students. Every medical school needs to develop a postbaccalaureate program. If each school had eight to 12 students, that would make a difference.”

Related link:
UC San Diego to host medical education for diverse students conference Jan. 26

Data collection on patients’ sexual orientation and gender identity to help improve care.

UC Davis clinical social worker Julie Weckstein uses a rainbow sticker on her ID badge to show competency in LGBT health.

UC Davis Health System is poised to become the first academic health system in the nation to have its physicians ask sexual orientation and gender identity questions as part of a patient’s routine clinical assessment. By standardizing the collection of this information through the electronic health record, UC Davis officials say its health care providers will be able to reduce health disparities among lesbian, gay, bisexual and transgender (LGBT) populations by having a better understanding of each patient and being able to provide more well-informed medical advice and care.

“The LGBT community suffers heartbreaking levels of health problems in part because most physicians don’t ask about sexual orientation or gender identity, and many patients don’t tell their health providers,” said Ed Callahan, associate dean of academic personnel, who is leading a health system task force to address the issue. “We already ask questions about race, ethnicity and preferred language to help make our health care services appropriate and responsive to the needs of very diverse patient populations. Adding LGBT questions to the clinical conversation can lead to more positive health outcomes for those populations, too.”

Beginning this week and continuing over the next several months, the health system will accelerate its LGBT-care initiative. The effort includes a questionnaire that will be sent throughout the health system to enable physicians to identify themselves as LGBT-competent providers. The questionnaire will be accompanied by additional information and helpful resource links regarding sexual orientation and gender identity issues. A Web-based list of UC Davis physicians who are LGBT-competent is also being developed.

“Identifying LGBT-competent providers is an important step for us,” said Suzanne Eidson-Ton, associate clinical professor of family and community medicine and a task force member. “We don’t expect these providers to necessarily have all the expertise in LGBT health conditions, but they will be comfortable, or committed to becoming comfortable, talking with LGBT patients about their lives, their families and, most importantly, their health. We want all patients to feel welcome and included here at UC Davis.”

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UCSF center offers support, programmatic services surrounding diversity issues.

At the UCSF Multicultural Resource Center pre-grand opening event, are (from left) Tatiana Torres, Renee Navarro, Misty Loetterie, Paul Day and Mijiza M. Sanchez.

The UC San Francisco Multicultural Resource Center has opened its doors to the campus community, to promote a culture of inclusion and offer a gathering place for discussions about diversity.

The pre-grand opening was celebrated last month at the new center, which is featuring a special photo exhibit called “100% You,” a collection of 82 portraits by UCSF School of Dentistry photographer David Hand of multiracial members of the campus community. Attendees of the July 17 opening event viewed the artwork, inspired by artist Kip Fullbeck’s “Hapa Project,” and were invited to write on a board what multiculturalism means to them.

Mijiza M. Sanchez, M.P.A., the center’s director, said its mission is to offer support and programmatic services surrounding diversity issues, such as recruitment and retention of underrepresented students, faculty and staff and provide culturally competent education and patient care. Sanchez said she also hopes the center will be a space where everyone feels welcome to share their experiences and challenges.

The Multicultural Resource Center is located in the space formerly occupied by the Synapse student newspaper office in Millberry Union at the Parnassus campus. The center is part of the Vice Chancellor Renee Navarro’s Office of Diversity and Outreach.

The center’s official grand opening will take place on Wednesday, Oct. 24, from 4 to 6 p.m. All are welcome to attend.

Growing UCSF program’s latest graduates grew up in a dozen different countries.

UCSF Global Health Sciences graduate Jessica Gu, center, and her classmates laugh during a slideshow at their commencement ceremony.

The newest graduates of UC San Francisco’s Global Health Sciences masters program are idealistic but well aware that they don’t live in an ideal world. They’re not going to let that stop them.

“There’s a lot of momentum now,” said Jessica Gu, 26, who spent April and May in Zanzibar on a malaria prevention project.

Gu was among 35 students who received their master of science degrees Aug. 3 at Genentech Hall on the Mission Bay campus. The commencement ceremony marked the end of the fourth year of the program, which graduated only seven students in its inaugural class but will have 42 next year – paralleling the prodigious growth of the field as a whole.

The program is the oldest of its kind in the nation, but it’s still very young, said keynote speaker Haile Debas, M.D., founding executive director of UCSF Global Health Sciences (2003-2010) and former chancellor of the university as well as past dean of the medical school.

“We believe therefore it needs to be nurtured and cared for most tenderly,” said Debas, who provided a “highly partisan overview” to the audience in Byers Auditorium.

Program Director John Ziegler, M.D., M.Sc., who gave the welcoming address, said he admired the prescience of Debas and his ability to have foreseen a growing interest in global health.

Jaime Sepulveda, M.D., M.P.H., Dr.Sc., executive director of Global Health Sciences at UCSF, referred to this phenomenon over the past 10 or 15 years as “an expansion — I would call it an explosion — of global health will to transform the world.”

Debas said he frequently is asked what gives him the most hope in the face of constant turmoil all over the planet.

“For that, I do not hesitate a second,” he said. “The answer is the young generation, the millennial generation, the first generation to consider itself truly global. It is undeterred by space and time. Just look at your class.”

Students in the class of 2012 grew up in a dozen different countries, speak at least 11 languages and arrived from many distinct disciplines, with research paths that have taken them to no less than 16 countries, he noted.

“This is true globalism,” said Debas, adding that the students’ varied backgrounds, passion, energy and commitment have infused the program with vitality and have made it “a unique environment of intellectual discourse, friendship and sharing.”

Diversity will further increase with the class of 2013. Of the 42 students, more than half are from the United States, but six are from Africa, three from the United Kingdom, two from South America, and one each from the Middle East, Canada, the Pacific Islands and Mexico. The class will have 38 women and four men.

Megan Barry, who helped present a slideshow of the students’ year, described her class as a “tightly knit crew.” The camaraderie was evident repeatedly during the high-spirited gathering.

After the ceremony, Gu, the daughter of immigrants from Taiwan, said there had been “lots of peer leadership” during the yearlong program and that “everyone had something under their belt” when they showed up at UCSF.

For example, Kathryn Chomsky-Higgins, who at 32 is one of the older students in the program, already had completed three years of medical school. She’ll return for a fourth year and then do a residency. Eventually, she wants to be a general surgeon, combining fieldwork with policy pursuits and project management.

During the ceremony, Sepulveda said UCSF wants to create agents of change and urged the students to have a social conscience, defend the vulnerable, follow their instincts and passions, and sustain a sense of urgency.

“There are many people right now suffering in many places around the world,” Sepulveda said.

Graduate Jacob Zannou plans to focus his efforts in Africa as president of World Action Group, a nonprofit that he hopes will generate funding and infrastructure for a viable health care system.

The 39-year-old Benin native, the son of a fisherman, has worked as a bedside nurse for almost 12 years – the last two at Kaiser Permanente in Oakland. He’ll concentrate first on French-speaking West Africa, which he said is disconnected and often overlooked by funders because of the lack of English.

In trying to figure out what was most needed in that region, he asked the woman who delivers 40 to 50 babies a month in his own village what would be most helpful. The simple answer: gloves and alcohol.

“That’s the reality of rural Africa,” Zannou said.

Program engages students’ families and friends.

Andreea Seritan with a client

UC Davis has launched an innovative new effort to help its students navigate the rocky shoals of medical education by engaging some of their biggest and most ardent and important supporters: their families and friends.

The program, launched by the UC Davis School of Medicine Office of Student Wellness, is aimed at helping medical student families, friends, spouses and partners understand the pressures inherent in attending medical school.

Medical school is highly rewarding. But it also is an intellectually, emotionally and even physically demanding experience, with very long hours, an overwhelming workload, and academic pressures all taking their toll, according to Andreea L. Seritan, assistant dean of student wellness in the School of Medicine.

“It’s important to have an open channel of communication between our school and student parents, spouses and friends — anyone who is close to the student, to help them know what the student may be facing,” Seritan said.

The program may especially benefit families of students who are members of communities underrepresented in medical education, such as African-American and Hispanic students, she said.

The students inducted into the UC Davis School of Medicine class of 2016 consist of 60 women and 49 men. Almost half identified themselves as coming from disadvantaged backgrounds, and 42 percent are from populations that are underrepresented in medicine.

Underrepresented populations include American Indian/Alaskan Native, Black or African American, Hispanic/Latino, Native Hawaiian or Pacific Islander, and Asians who are not Chinese, Filipino, Japanese, Korean, Asian Indian or Thai.

A first step, Seritan said, was holding a 1-1/2-hour long workshop for new students’ families immediately follow the new student induction ceremony, where families learned firsthand about what it’s like to be a medical student. More than 200 family members and friends attended, she said.

The workshop outlined some of the issues new students’ families may face, including:

• Students have no control over schedules, so families may feel no control

• Trying to balance family members’ schedules and avoid competing deadlines

• Family may feel “left behind”

Students also may struggle with the transition in their roles within their families:

• Concerns over being first in the family to attend college or medical school

• Ethnic minority students feeling that they have to give back to their communities

• Balancing their own desire to attend medical school with their family’s need to experience their achievements

“We wanted to help families understand that their extremely bright, determined students will experience tremendous personal growth,” Seritan said. “But they might feel as though they’re distanced from their families,” because of the demands of the medical education program, she said.

“We provided the family workshop so that they could be aware of the resources available to support their students and their families,” she said. “So it’s not like they’re handing their loved ones over and they don’t know what’s going to happen.”

The effort is being supported by a three-year, $102,000 per year grant from the federal Substance Abuse and Mental Health Services Administration. The grant supports work by Seritan and her colleagues, who include Hendry Ton, health sciences associate clinical professor in the Department of Psychiatry and Behavioral Sciences; Silvia Garma, associate professor of Psychiatry and Behavioral Sciences; Darin Latimore, assistant dean for student and resident diversity in the Office of Student and Resident Diversity; Sergio Aguilar-Gaxiola, professor of clinical internal medicine and founding director of the Center for Reducing Health Disparities; Debora Paterniti, associate adjunct professor of internal medicine and sociology with the Center for Healthcare Policy and Research; and Ana-Maria Iosif, assistant adjunct professor in the Department of Public Health, Division of Biostatistics.

Seritan said another part of the grant will help develop programs to support students who are active and former members of the United States armed forces. She said that there currently are about 15 such students enrolled.

The Office of Student Wellness was established in 2009 to foster an institutional culture that promotes student wellness, identify and enrich resources for student wellness, and provide a point of triage for supporting students with mental health difficulties.

Class of 109 students starts Aug. 6.

Leopoldine Matialeu receives her stethoscope as part of UC Davis School of Medicine's Induction Ceremony on July 28.

Six years ago, Leopoldine Matialeu didn’t speak English that well and was living in a shelter with her younger sister after her mother had lost her job. Today, she is one of 109 UC Davis medical students dedicated to improving health who will begin classes on Aug. 6.

“My desire to pursue a higher education was a priceless gift that my dad instilled in me,” said Matialeu, “Growing up, I was taught to value religion, education and hard work. I came to the U.S. in 2005 when I was 18 to live with my mother to study in California. When we became homeless, I had already started taking pre-med classes at Cañada College and was studying to improve my English. The school, shelters and nonprofit organizations were a tremendous resource. These experiences reaffirmed my interest in giving back to the community and becoming a physician who cares for underserved populations. I am honored to be a part of the class of 2016.”

Matialeu immigrated from Bandja, a small village in the West African country of Cameroon. Fluent in French and Fefe, her native language, she studied and became fluent in English. In 2008, she graduated from community college with honors and was valedictorian. She received a UC Regents scholarship to attend UC Davis and graduated with an undergraduate degree in biochemistry in 2010. As an undergraduate student, she helped raise money to send to Sudan for medical supplies through the nonprofit group Doctors Without Borders and volunteered at the Imani Clinic in Sacramento, a community clinic that provides free non-emergency health care to the uninsured African-American community in Sacramento.

“My background and experience allow me to understand the urgent health care needs of underserved communities,” said Matialeu. “In Bandja, many people die from malaria and AIDS, and there are only two doctors and one hospital for about 100,000 people. The lack of resources at the hospital, high level of poverty and corruption, and scarcity of physicians affect the quality of health care. My goal is to help alleviate suffering in communities within and beyond the U.S.”

Matialeu is one of seven students enrolled in the school’s Rural PRIME program, a special curriculum developed to attract and prepare future physicians for careers in medically underserved and diverse communities around the state.

According to Darin Latimore, assistant dean for student and resident diversity at UC Davis Health System, Matialeu’s path to medical school is unique, but her strong character, compassion, leadership ability and focus on improving health is characteristic of the class of 2016.

“Our students have demonstrated their ability to overcome challenges and their commitment to helping create a better world for all,” Latimore said. “They dream of becoming leaders in medicine and reducing the disparities that characterize today’s health care system.”

Jessica Buchanan, a Folsom native and UC Berkeley graduate, is keenly aware of social determinants of health and is committed to being a part of the solution. As an intern and volunteer for two years with the Share Institute, a small nonprofit organization based in Fair Oaks, Calif., she focused on improving the health and well-being of women and families in India and Nicaragua. While on a medical mission to Tamil Nadu, she helped deliver babies in one of the country’s busiest maternity hospitals and designed a first-aid clinic for rural mothers to increase awareness of the symptoms and treatment for dehydration, a major cause of child mortality. In Nicaragua, she ran a project with the Women in Action nonprofit organization, teaching single mothers to crochet small crafts to earn income and help support their families.

“These experiences opened my eyes to extreme poverty, social injustice and inequality in access to resources and health care,” said Buchanan, who declined a full scholarship to another nationally-ranked medical school to attend UC Davis. “I saw firsthand how compassion can change a community and how anyone can make a difference if they are willing to try.”

Central Coast native Fabian Alberto is committed to becoming a primary care physician who serves rural residents. The son of farm workers, Alberto worked in Soledad with his family in the fields on weekends and during the summer and fall harvest when he was in middle school and high school. He rarely saw a physician as a child, and it wasn’t until his grandmother was diagnosed with diabetes when he was in high school that he realized a career in medicine was possible. He is the first in his family to graduate from college. As a student in the UC Merced San Joaquin Valley PRIME program, he wants to learn how to provide care in medically underserved communities and lead efforts to improve access and the quality of services.

“It was such a privilege to work with farm workers and to know the challenges that they overcome on a daily basis,” said Alberto. “My goal is to establish a practice where patients feel comfortable about sharing what is ailing them and to go back to the community to ensure youth know about the same opportunities to further their education that I have had. I want to be a leader and mentor to help others become the physicians that the Central Valley needs.”

The school received nearly 5,200 applications for this year’s incoming class and interviewed 503 potential students. The class of 2016 consists of 60 women and 49 men. Almost half (43 percent) identified themselves as coming from disadvantaged backgrounds, and 42 percent are from populations that are underrepresented in medicine. (Underrepresented populations include American Indian/Alaskan Native, Black or African American, Hispanic/Latino, Native Hawaiian or Pacific Islander, and Asians who are not Chinese, Filipino, Japanese, Korean, Asian Indian or Thai.)

School of Dentistry science ed program has benefited 58 L.A. area high school students.

Marvin Marcus, UCLA

A couple of years ago, Lakewood high school senior Cameron Stevenson-Moore had a hard time picturing himself pursuing a career in the sciences. But since he’s been part of a pre-college science education program at the UCLA School of Dentistry, he’s got greater aspirations.

“At first I was apprehensive about participating, since I would be doing something I wasn’t very familiar with and I didn’t want to mess anything up,” said Stevenson-Moore, 16. “But I’ve loved the experience. Not a lot of people can say that they’ve worked next to scientists in a research lab at UCLA.”

Stevenson-Moore is one of 12 participants in a two-year program co-funded by the Howard Hughes Medical Institute (HHMI) and the Dean’s Office at the UCLA School of Dentistry, one of the leading oral health research institutes in the nation. The program, which has benefited 58 Los Angeles area high school students and is in its final year, exposes gifted and disadvantaged high school students like Stevenson-Moore to oral health and scientific research and, potentially, a promising career in the health sciences field. Fourteen faculty members from UCLA’s School of Dentistry have contributed their time and knowledge to enrich the students’ experience. Cutting-edge research projects have covered topics in bone biology, bioengineering, immunology, stem cell and cancer research.

“Since the start of the program in 2007, 58 students from either College Bound of Greater Los Angeles or Project GRAD Los Angeles have participated. So far every one of them has gone on to college, with a partial or full scholarship, to some of the top universities in the country,” said Dr. Marvin Marcus, who, with Dr. Carl Maida, heads the program.

“I couldn’t be happier with the success of this program and the impact it’s made,” Marcus said.

UCLA School of Dentistry’s dean, No-Hee Park, said that Marcus and Maida “have gone beyond my expectations for this pre-college science education program.”

“In addition, the school’s faculty members have changed the lives of numerous young people over the past five years with their guidance and support,” Park said.

Among the students is Michaela Scott, a 20-year-old UCLA psychobiology student who was part of the first group and hopes to pursue a degree in medicine. “Being part of this program prepared me for college, and I believe it set me apart from other college applicants,” she said.

The program begins during the students’ junior year of high school with 10 Saturday meetings followed by an intensive six-week summer research experience at the School of Dentistry. During the summer portion of the program, research faculty members take time out of their busy schedules to mentor the students in laboratory techniques in the health sciences.

Year two of the program consists of a Saturday academy that prepares the now-senior high school student participants for a scientific presentation of their research at the American Association for the Advancement of Science (AAAS) Pacific Division’s annual meeting. The grant supporting the program, which was originally set to end in August, has been extended with unexpended funds so that the 12 current participants can complete their research.

“I have thoroughly enjoyed mentoring the students in science research and answering their questions,” says Dr. Ichiro Nishimura, a participating faculty member. “I’m glad that we can complete the second year of the program with the current students and bring their experience full circle.”

As for Stevenson-Moore, he said that the most valuable thing he’s learned is to ask questions. “Before, I didn’t have the confidence and was too shy to speak up,” he said. “But now I’m not as nervous and am really looking forward to asking even more questions in college.”

The participating School of Dentistry research faculty members have included Drs. Shen Hu, Anahid Jewett, Mo Kang, Ichiro Nishimura, Takahiro Ogawa, No-Hee Park, Wenyuan Shi, Ki-Hyuk Shin, Igor Spigelman, Sotirios Tetradis, Cun-Yu Wang and David Wong.

The UCLA School of Dentistry is dedicated to improving the oral health of the people of California, the nation and the world through its teaching, research, patient care and public service initiatives. The school provides education and training programs that develop leaders in dental education, research, the profession and the community; conducts research programs that generate new knowledge, promote oral health and investigate the cause, prevention, diagnosis and treatment of oral disease in an individualized disease-prevention and management model; and delivers patient-centered oral health care to the community and the state.

UC Davis’s IMPART program addresses state’s critical need.

IMPART resident Angie Yu evaluates a patient.

An innovative physician education program that combines psychiatry with either family practice or internal medicine training has received $1.2 million in additional funding from the California Department of Mental Health to extend the program through 2014.

Established in 2009, the Integrated Medicine/Psychiatry Ambulatory Residency Training (IMPART) program at UC Davis is the largest combined program of its kind in the country, and the only one that combines residencies in internal medicine with psychiatry in the western United States. The program currently includes 18 physicians in training but, with the supplemental funds, four new physicians began their five-year program in July to become board certified in two specialties.

“The grant is a clear recognition of the importance of integrated medicine in health care today,” said Robert McCarron, an associate professor in the Department of Psychiatry and Behavioral Sciences and the Division of Pain Medicine. He is also the immediate past president of the Association of Medicine and Psychiatry and the Central California Psychiatric Society.

“We are not only training physicians who mostly come from underrepresented or culturally diverse backgrounds themselves but who will also work in underserved settings and be future residency directors, policy makers and thought leaders in this critical area,” he said.

Research shows that underrepresented minority physicians are also more likely to work in health workforce shortage areas and to care for medically underserved populations, patients of their own ethnic group and Medicaid recipients.

Integrated health care has emerged as a much needed new movement in the United States to help address mental and physical health needs in primary care settings. Under health care reform, the demand for primary care doctors is expected to increase substantially; in addition, more than half of all mental health care now is delivered in the primarycare setting. Personnel trained through the IMPART program will be counted on in the near future to help alleviate a projected severe shortage of physicians in California and throughout the nation.

Individuals with serious mental illness can expect to live 25 fewer years than the general population, and physicians miss nearly half of co-morbid chronic disease conditions in people with serious psychiatric disorders.. The combined residency programs not only train primary care doctors to better recognize and address mental health issues, but they also train psychiatrists to practice better preventive medicine and improve care to improve health outcomes for all patient populations.

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LGBT survey names 3 UCs as leaders.

The nation’s largest lesbian, gay, bisexual and transgender civil rights organization has recognized three University of California medical centers as “Leaders in Healthcare Equity.” UC Davis, UC San Diego and UC San Francisco medical centers earned top marks for their commitment to equitable, inclusive care for LGBT patients and their families, who can face challenges in accessing adequate health care.

The Human Rights Campaign Foundation’s 2012 Healthcare Equity Index reviewed 407 health care institutions for policies such as nondiscrimination, visitation, employment and benefits, and inpatient care. Seventy-one respondents representing 234 facilities were designated as leaders.

UCSF Medical Center became the only institution in the United States to receive a perfect score for five consecutive years.

Read more:

• UC Davis release
• UC San Diego release
• UCSF release
• Healthcare Equity Index

Questionnaire distributed during LGBT Pride Month.

Margie Wells

Afraid that she would be misunderstood or treated poorly, Margie Wells put off seeing a gynecologist until she had no choice because of a growth that required treatment. She was 24 years old.

As it turned out, Wells had reason to worry. Despite her insistence that she could not be pregnant because she is a lesbian, the doctor insisted on a pregnancy test and use of a monitoring device to detect a fetal heartbeat. Wells was later diagnosed with an ovarian endometrioma requiring an open surgery and a subsequent biopsy to rule out cancer. Her experience spurred her to actively seek a physician sensitive to her sexual orientation.

Wells, of Sacramento, said her experience is not unusual among many lesbians, gay men, bisexual and transgender individuals, who may be reluctant to get regular prevention screenings or to seek medical help when they suspect a problem. The results are disparities in health care and disease outcomes, including cancer.

Lesbians have a higher incidence of breast cancer and gay men have a higher incidence of anal, rectal and prostate cancer than their heterosexual counterparts. Complicating higher rates of disease is the fact that many LGBT people also deal with other health conditions such as HIV/AIDS, IV drug addiction and mental health issues, with few relevant services or resources. Wells notes that lesbians, in particular, also are at higher risk for obesity, tobacco and alcohol use – all of which can increase cancer risk.

The UC Davis Comprehensive Cancer Center and Sacramento State Partnership, working with the Lesbian, Gay, Bisexual and Transgender (LGBT)  Cancer Health Task Force, wants to address those disparities, starting with a broad survey of Sacramento-area LGBT individuals about their experiences with health care generally and with cancer, cancer screening and treatment more specifically.

The anonymous survey, now available online, asks individuals general demographic questions and questions about their health status, insurance coverage, frequency of medical care as well as more detailed questions about gender identity, sexual orientation and whether that information is shared with health-care providers. The survey goes on to tackle specific questions about whether individuals get screenings for cervical, breast, colon, testicular, prostate and skin cancers.

Marlene von Friederichs-Fitzwater, founder and chair of the task force and director of the UC Davis Comprehensive Caner Center’s Outreach Research and Education Program, said that beyond disparities in rates of disease, the LGBT community must overcome other unique hurdles.

“They have to decide whether to come out to their oncologist and treatment team, and find out if their LGBT family members will be welcome in the doctor’s office or hospital,” she said. “They also have to cope with the effects of treatment on their sexuality and sexual functioning.”

Von Friederichs-Fitzwater explained that results of the survey will be used to identify community needs that can be addressed with additional research and outreach to health-care providers and members of the LGBT community.

Wells, who was diagnosed and treated for breast cancer in 2005, said the information collected from the survey could pave the way toward development of more tolerant, sensitive and informed health-care provider community, and a healthier community of LGBT individuals no longer afraid to get the preventive screenings or health-care they need.

To participate in the survey, visit www.surveymonkely.com/s/NV77JBS.

Recognized for its work in diversity management and strengthening the workforce.

UC Davis Medical Center last week was honored for achievements in promoting diversity at the 2012 National Leadership and Education Conference in Nashville, Tenn.

The Institute for Diversity in Health Management hosted the conference, which honored hospitals from across the country that scored highly in “Diversity and Disparities: A Benchmarking Study of U.S. Hospitals.” The survey recognizes high-performing hospitals and highlights the advancements they are making in key areas that can promote equitable care, such as the collection of key demographic data, cultural competency training and the promotion of leadership diversity.

The survey results provide a snapshot of some common strategies used to improve the quality of care that hospitals provide to all patients, regardless of race or ethnicity.

“We are committed to ensuring that all patients receive the very best care for their particular needs,” said Ann Madden Rice, CEO of UC Davis Medical Center. “Our medical center is in one of the most diverse cities in California, and collecting accurate race, ethnicity and language data is critically important for improving the health of the patients and communities we serve.”

The institute recognized UC Davis Medical Center as “Best in Class” for its work in one of four categories assessed by the survey: Diversity Management and Strengthening the Workforce. Recognition for this category is based on hospitals’ reported efforts to improve diversity management through efforts to recruit, retain and promote minority individuals within their workforce.

Among the key findings of the institute’s report are data regarding the accurate collection of demographic data, which can help hospitals tailor the delivery of care to their patients and develop appropriate quality-improvement interventions. Since launching an initiative almost 18 months ago to systematically collect race, ethnicity and language data from its patients, UC Davis Medical Center now is successfully retrieving that information from nearly 75 percent of patients.

The institute sent its survey to the CEOs of all U.S. registered hospitals, and received responses from 924 of them. The institute is an affiliate of the American Hospital Association.