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Harvesting doctors for the Valley

(Published Tuesday, July 26th, 2011 09:39AM)

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MERCED -- A car accident brought Agustín Morales face to face with the health care challenges people in poor communities experience.

When his Spanish-speaking mother couldn't understand doctors or the complicatons of insurance coverage, Morales had to step in. Now, he's preparing to ensure that others don't face the same obstacles.

About 16 years ago, Morales, the second-oldest of seven children born to Salinas farm laborers, was traveling with his family from Salinas to San José, and their car spun out of control. He emerged with one stitch in the back of his head, but his mother, an immigrant from Tierras Blancas, Michoacán, México, broke her leg.

As his mother received treatment, Morales, who was just a teenager at the time, became an interpreter between the doctors and his family. He also helped guide his mother through the complicated process of applying for, and using, Medi-Cal.

"I was an interpreter, who knew nothing about medicine, but there I was, trying to take medical terms, and put it into Spanish that my mom could understand," Morales said.

The experience, he said, caused him to reflect on what he could do to improve people's access to high-quality, equitable medical care.

"Throughout that process of her (recovery) and the accident, the kind of care and access she received as a patient was inadequate," said Morales, now 35, and a graduate of the University of California, Santa Cruz. "It's not fair, and nobody deserves to be treated like that.

"That incident really forced me to analyze myself and what I could do with my life."

Last week, Morales joined a new medical school program that will empower him to improve San Joaquín Valley residents' access to health care and overall life quality.

He is one of five medical students in the first cohort of the UC Merced San Joaquín Valley Program in Medical Education, a collaboration between the University of California, Merced, and the UC Davis School of Medicine.

The program is designed to deal with the critical physician shortage in the Valley by increasing the number of doctors specially trained to address the region's unique health needs.

Morales said he is thrilled about the opportunity.

"I think that the level of quality and access should be the same, whether you are the CEO of a company or you are a farm laborer, just like my mom or any of my relatives," Morales said. "We all deserve to be treated with dignity."

The program participants will play a vital role in improving the health of Valley residents, UC Merced Chancellor Dorothy Leland said during an event July 19.

By studying a curriculum that highlights the specific needs of the Valley, students will acquire the skills to reduce health disparities -- like the region's high rates of obesity and diabetes -- and to care for the area's diverse population.

"These students are the future of adequate and superb health care in the Valley," Leland said. "They will be role models for future students, and they will have an education that contextualizes their knowledge to the needs of this region."

The program, she said, is an excellent way to address the Valley's physician shortage, in advance of a medical school opening at UC Merced. The Valley has fewer primary care physicians and specialists than recommended by nationally recognized benchmarks, according to a 2010 California Health Care Foundation report.

"I am extremely pleased that we don't have to wait until that medical school comes online to begin addressing the health care needs of the San Joaquín Valley," she said.

Students in the program will spend their first two years studying medicine on the UC Davis School of Medicine campus and will participate in educational and research projects in the Valley. During their third and fourth years of medical school, they will conduct clinical rotations in Valley clinics and hospitals.

The program is modeled after existing specialty programs at other UC campuses that prepare medical students to work with diverse and medically underserved communities. But this is the first program that will focus on the specific needs and disparities of one region -- and for good reason, said Dr. Kenny Banh, co-director of undergraduate medical education at UC San Francisco Fresno Medical Education Program -- a branch of UC San Francisco's School of Medicine.

"You name it, there's a need," Banh said.

The opportunity to study health issues affecting Valley residents and to treat Valley residents drew Sidra Ayub of Modesto to the program.

"There is no better way to make doctors for the Valley than to teach them in the Valley and train them in the Valley, with the patients of the Valley," said Ayub, a UC Davis graduate.

Kelly Fujikawa of Fowler also entered the program with a strong desire to serve Valley residents.

"Hopefully, through this program, I will become a better advocate, a better doctor and a better teacher to the patients and the people of the San Joaquín Valley," said Fujikawa, a UC Berkeley graduate.

Program participant Christina Thabit of Bakersfield said she hopes to inspire other Valley students to pursue medicine and to practice in the region.

"I thought that medicine was out of my reach -- that it was too far ahead, it was too big, it was something I wouldn't be able to accomplish," said Thabit, a California State University, Long Beach, graduate.

Now that she's enrolled in the program, she said, "I want to inspire the kids in our area to also do the same thing."

For Morales, the program provides an opportunity to study medicine and discover where he can best use his knowledge and experiences -- as the Mexican-born son of immigrant strawberry pickers and the father of two children -- to make a difference in people's health and lives.

"The way I see things is, poor is poor, and underserved is underserved," Morales said.

"What I hope to gain from this program is clinical skills and leadership skills to really become an advocate, whether that is here in the San Joaquín Valley or the Salinas Valley. Whichever location can really utilize what I can provide as a physician, that's where I want to be."

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