Addressing Health Care Needs of the Latino Community: One Medical Schoolʼs Approach

Abstract

The Program in Medical Education for the Latino Community (PRIME-LC) at the University of California-Irvine (UCI) School of Medicine was designed to improve health care delivery, research, and policy in underserved Latino communities. Specialized training develops strongly committed physicians with linguistic skills and cultural understanding, enabling them to serve Latino patients. Presently, the health care system's shortage of providers with this expertise renders it unable to address the Latino community's needs adequately. The UCI School of Medicine realized they were proposing a radically different type of program at the onset of this project -- one designed to address the health care needs of a specific ethnic group. Developed with dual goals, PRIME-LC aspires to provide the Latino community with culturally sensitive, Spanish-speaking physicians who are well aware of medical and social conditions prevalent among Latinos, in addition to physicians with a broad understanding of community medicine who are well versed in advocacy and able to become leaders within and outside the Latino community. PRIME-LC must be placed within the context of predicted physician shortages in the United States attributable to the projected population increase in general and, more specifically, within the context of a growing Latino population nationwide. As medical schools prepare to increase their output, programs like PRIME-LC that address society's special needs deserve serious consideration.

The Urban Medicine Program

“…Findings related to the acquisition of skills and behaviors that align with leadership roles in underserved urban communities are difficult to contextualize to previous work because most studies evaluate outcomes at the point of graduation-rather than later, during graduates' careers, when leadership roles would be more likely. 6,8,9,13 On the basis of the results of the pre/post assessments, we found that programmatic content in the seminars resulted in significant improvements in knowledge and self-efficacy by UMed students. On the basis of students' LCP progress reports, we believe that the LCPs have become the cornerstone of our program.…”

“…[4][5][6][7][8][9][10][11][12][13][14][15][16][17] Among these, the majority focus on serving underserved rural communities 5,8,9,12,16 and increasing the number of primary care physicians in underserved areas. [11][12][13][14]16 We identified only two schools that require community-based education for all medical students.…”

Community-based distributive medical education: Advantaging society

“…In addition, medical schools will necessarily rely on institutional funds, clinical cross-subsidies and private support to fund new or expanded education. In recent years some states have provided one-time start-up funding to increase class size, but ongoing operating costs have been excluded (17, 25). Collins and Davis (26) outlined a number of inherent challenges and corresponding opportunities/solutions that today's community-based medical schools, in particular, might profitably pursue during this era of diminished state and federal support.…”

Provider Perspectives About Latino Patients: Determinants of Care and Implications for Treatment

“…Trainings in public health and public policy (e.g., Manetta, Stephens, Rea, & Vega, 2007) would also assist providers with acquiring familiarity with some of the more common and unique Latino community health care needs and priorities. Training that engages students in conversations about culture, explanatory models of mental health, perceived barriers to care, and communication facilitators in the clinical encounter would be especially valuable (Manetta et al, 2007; Paez et al, 2008). In particular, the providers in this study offered that practice, role-plays, and discussion of clinical case studies, rather than didactic lectures on these topics, would allow application and development of skills and knowledge ultimately useful in practice.…”