In Fresno County, located in the heart of California’s Central Valley, about 50 percent of the residents — but only five percent of the doctors — are Latino. That glaring cultural divide results in potential misunderstandings between doctor and patient that can translate into poorer health outcomes.
As the child of migrant farm workers, I witnessed firsthand the often tragic consequences of this divide. My own grandfather lost his leg to gangrene, complicated by diabetes, because he couldn’t afford the prescribed medications and couldn’t adhere to the treatment plan. I believe that had the doctors inquired more about his specific living conditions and environmental circumstances, they might have approached his care differently, which may have led to a better health outcome.
Today, there is clear evidence that increasing the diversity of the healthcare workforce will improve access to health care and reduce health care disparities. That evidence and my own experiences, as well as those of others, guide our work at the Latino Center for Medical Education and Research (LaCMER). Through our LaCMER programs, we are inspired to see local students preparing for medical careers with the desire to return to the Central Valley, where we desperately need them.
The program is known as the Doctors Academy. It began in 1999, in partnership with the University of California, San Francisco’s Fresno campus and multiple community partners, including Fresno Unified School District, Fresno County Office of Education, California State University, Fresno, State Center Community College, Community Medical Centers and the California Area Health Education Center.
The goal is to recruit students from low-income families beginning in seventh grade and support them through high school and college. We provide academic and career guidance, academic support with tutorial services and tiered mentoring, mentoring with a health professional, service-learning opportunities, summer programs with leadership development and exposure to the health professions.
The Academy focuses on building self-confidence and teaching time-management skills, analytical thinking and how to study in order to prepare students for the rigors of college and health professional schools. It also focuses on parent empowerment (most of whom never attended college), offering help in securing financial aid and advice about how to support their child’s academic journey.
In a school district where a quarter of students drop out by senior year, the Doctors Academy is achieving some much-needed results. Every student in the program has graduated from high school, and every student who has finished the program has been accepted to college. The program’s alumni have gone on to medical school at Brown University and the University of California, San Francisco, among others.
We all recognize how long and difficult the road to higher education can be. Having been raised by immigrant grandparents, and being a farm worker myself, I found myself struggling as an undergraduate at Stanford University. Social and emotional support from two classmates, also from “low-performing” high schools and from immigrant families, helped pull me through. My dream was to return to the Central Valley as a physician to help smooth the way for others in similar circumstances to be successful in college and achieve their professional dreams.
Today, the Doctors Academy is preparing students to succeed even at Ivy League schools, providing them with mentors and other resources to make the adjustment. At the same time, the Academy instills a sense of community service so that its students will, hopefully, return to the region one day as doctors, nurses, dentists and other health workers and provide culturally appropriate services.
By supporting high school health professions pathways — pathways that are academically challenging and focused on the health professions — we can improve student achievement, expand career choices for young people, as well as develop a more culturally sensitive healthcare workforce for each of our communities.
Dr. Katherine Flores is the director of the UCSF Fresno Latino Center for Medical Education and Research and a 2010 recipient of the James Irvine Foundation Leadership Awards.