Program at UC Riverside aims to deliver more doctors to Inland Empire

The Inland Empire has a doctor shortage, but a program at UC Riverside intends to help solve the problem.

The UCR School of Medicine recruited 37 community college students from across the Inland Empire into its inaugural class under the California Medicine Scholars Program.

Launched in 2022, its goal is to improve the healthcare for communities of color by “increasing the diversity of primary care physicians” who are educated in and practice in California, the website states. The program was also funded for the schools of medicine at UC Davis, UC San Francisco’s medical school campus in Fresno and UC San Diego. 

It follows scholars from community colleges to universities, and helps them apply to — and complete — medical school, Executive Director Rowena Robles said in an email.

Students get help with academic advising, clinical placements, networking and mentoring from medical school faculty, medical professionals and medical students, Robles wrote. Those who don’t ultimately apply to medical school receive guidance to set new goals.

The state set aside $10.5 million to start the program, which also has seen donations from foundations, Robles said.

“A huge push with this initiative is to really get more doctors into primary care, which fits right into our UCR School of Medicine mission for more homegrown physicians who want to be addressing that shortage,” said Teresa Cofield, director of Pathway Programs at the UCR School of Medicine.

The shortage can be seen in two areas: the number of doctors — especially primary-care physicians — and the diversity of those in the profession.

The recommended number of primary-care physicians is 60 to 80 per 100,000 residents, but the Inland Empire has about 35 per 100,000, according to the federal government’s Council on Graduate Medical Education. 

California ranks 20th in the number of physicians per capita, according to a 2022 report by the Association of American Medical Colleges. Dr. Anthony Hilliard, chief of cardiology at Loma Linda University Health and COO of its faculty medical group, said that if the Inland Empire were its own state, “we would have the lowest number of physicians per capita in the United States.”

Access to primary care is important, Hilliard said, because otherwise patients turn to urgent cares and emergency rooms once a health concern is “bad enough.” He gave the example of catching cancer early, through preventative care, versus waiting until it has metastasized.

“If we can ID and screen those patients early on, we will have a much greater impact on their longevity and quality of life later on,” he said.

As for diversity, there are about 405.7 Non-Hispanic White physicians per 100,000 White Californians, but about 45.8 Latino physicians per 100,000 Latino Californians, a 2018 paper from UCLA’s Latino Policy and Politics Initiative found. 

Kenneth Encarnacion, a Riverside City College student from Perris who’s in the program, sees the importance of diversity among doctors.

“I live in kind of a lower-income area,” Encarnacion said. “A lot of times, people are hesitant to seek out medical services, because there’s no real familiarity. There’s a sense of fear.”

Undocumented people risk additional consequences if they seek medical services, he added.

“I think having a diverse upcoming generation of physicians is really important,” he said. “My family, they’re a lot more comfortable with people who understand their cultural backgrounds, and definitely (who) speak the same language.”

Jhoana Govea, a Chaffey College student from Ontario, echoed the sentiment.

“When I go to doctors, I barely see any that look like myself,” Govea said.

Govea, who wants to practice medicine, believes the program can help her learn more about medical school.

Alexi Quinones, a first-generation college student from Victorville who attends College of the Desert, said her desire to go into medicine came from a childhood interest in biology and veterinary care.

“I got to dissect a fish,” Quinones said. “Then I knew I wanted to do surgery.”

Having seen barriers to treatment in her community, Quinones hopes to help underserved communities that have less access to medical care.

One cause of the Inland Empire’s doctor shortage is its rapid population growth.

Between the 2000 Census and its 2022 estimate, Riverside County grew by 928,515 people; San Bernardino County’s population rose by 484,222. The Inland Empire’s population is predicted to climb by 20% between now and 2048.

Population isn’t the only factor.

In the U.S., medical school graduates must complete a residency at a hospital or doctor’s office to become licensed to practice medicine. Dolores Green, executive director of the Riverside County Medical Association, said there aren’t enough residency positions nationwide to meet the demand. That limits the number of new physicians, she said.

In 2022, 47,675 students sought a residency in the U.S., but 39,205 positions were offered, a report from the National Resident Matching Program concluded.

Students who don’t land a residency typically wait a year to try again, which puts their education on hold, Green said.

The number of residencies available in the Inland Empire also impacts the number of doctors.

Having local residencies is important, Green said, because physicians are likely to stay in the area in which they did their residency. Green said that, in some cases, hospitals have begun funding their own residencies.

An additional factor is how much doctors will be paid in certain areas. 

A significant percentage of Inland Empire residents are on government-funded health insurance like Medi-Cal and Medicare, which Green said traditionally pay less for patient care than other insurance providers, and in Medicare’s case, pay less in the Inland Empire than in surrounding counties.

“It’s important that we ask the question of why there’s a shortage,” said Hilliard, adding that it could “continue to be an issue for years to come” unless issues such as physician wellbeing and work-life balance are also addressed.

The Medicine Scholars Program is one facet of the effort to curtail the doctor shortage and reach underserved communities in the Inland Empire.

The California University of Science and Medicine in Colton was created in 2015 with a goal to help combat the shortage. In 2016, Loma Linda University established the San Manuel Gateway College, which offers training for positions such as medical assistants and medical scribes.

The nonprofit Neighborhood Healthcare established a residency program that aims to hire students after their residency, spokesperson David Oates said in an email, and five of its six inaugural graduates are now practicing in the Inland Empire. Last month, California Baptist University unveiled a mobile health clinic that will start bringing services to underserved communities in fall.

Last year, UCR created the Mission Award Scholarship Endowed Fund to pay 100% of a recipient medical student’s tuition and fees in exchange for a commitment to practice in Inland Southern California for at least five years. The Inland Empire Health Plan offers the Healthcare Scholarship Fund, which also assists students with medical expenses if they practice in the Inland Empire for five years.

Meanwhile, students in the program at UCR are looking forward to filling the gaps in care.

“I’m really interested in becoming an oncologist and helping out in the Palm Springs community,” said Merilyn Carias, who attends College of the Desert.

Carias said her interest in becoming a physician came about after her mother had a cancer scare.

“It’s something I want to do to give back,” she said.

Adrianne Toyer, who is from Riverside and attends Riverside City College, also hopes to stay in the Inland area, and said part of her interest in the program stems from the fact that it aims to help underserved communities.

“Everyone deserves an equal chance to be given care,” she said.