Expanding the Primary Care Pipeline in the Golden State

June 25, 2018 12:27 pm David Mitchell

California is facing a dire shortage(www.mercurynews.com) of primary care physicians and other health professionals, and that shortfall is expected to climb to 4,700 clinicians by 2025. Jo Marie Reilly, M.D., M.P.H., is doing her part to draw more medical students to the field.

[headshot of Jo Marie Reilly, M.D., M.P.H.]

Reilly is a professor of family medicine at the Keck School of Medicine at the University of Southern California, Los Angeles, and founded and directs the school's Primary Care Initiative.(primarycare.usc.edu) The initiative launched seven years ago with a grant from the Health Resources and Services Administration and a mission to nurture, support and develop students and educate the campus community about primary care. The initiative's capstone strategy, the primary care program, began with 12 first-year students who were interested in primary care. The program has since expanded to include 24 students per class, meaning there are almost 100 students participating in any four-year period.

Since the initiative's launch, 36 participants have graduated from Keck. Of those, 82 percent have matched into primary care residencies, including more than 60 percent in family medicine. In the past five years, the school has doubled the number of its graduates who have chosen family medicine.

The primary care program trains med students in community health settings, providing them with opportunities to build longitudinal relationships with patients and mentors.

"This shows students what primary care doctors do in the community and the skills they need," Reilly said. "There are few primary care role models in our school. This program gives students exposure to the breadth and depth of primary care, and it becomes less of an enigma to them."

The first-year curriculum includes nutrition and diabetes education. Students work with a bilingual chef and a community wellness center to provide food, exercise and meal preparation classes in English and Spanish for underserved patients. Second-year participants are immersed in an interdisciplinary geriatric home-visit program intended to prepare students for team-based primary care.

"They're getting training not just in medical school but also in the community, so students see the relationships that particularly our family physicians have with our patients," Reilly said. "They see the valuable and rewarding health care delivered to patients and that physicians are happy with the work they do."

In addition to clinical experience, the program teaches students leadership and advocacy skills and provides opportunities to participate in primary care research, which Reilly said is especially important at a quaternary care center.

Reilly said the program immerses students in a "like-minded community of passionate med students who want to do primary care, especially family medicine."

The initiative also provides a larger context in which to educate the campus community about primary care careers, particularly in family medicine. Lunch talks, a primary care week, a primary care website, focused advising, travel grants and community service are all strategizes utilized.

In addition, Reilly keeps a sharp eye out for opportunities for students to work with vulnerable populations, including the homeless and people seeking asylum. She also works with Homeboy Industries,(www.homeboyindustries.org) which offers training and support to former gang members and adults who are trying to rebuild their lives after leaving prison.

Reilly learned how to perform tattoo removal and has since trained medical students, residents and other faculty to do so. The process helps thousands of former gang members reassimilate into society and become productive members of the community.

"The med school is somewhat siloed, as many med schools are, but family medicine is community-based," Reilly said. "By bridging the academic institution with community needs, our educational mission becomes service-driven, and we train, grow and inspire the next generation of family physicians to help marginalized communities receive needed services."