By RACHEL LIVINAL
The San Joaquin Valley has a shortage of doctors. But local students who aspired to build careers in medicine long have known they would need to leave the Valley to do so. Now, new programs are beginning that aim to train the next generation of Valley MDs close to home.
Among the new freshmen who recently started classes at UC Merced are the first 15 students admitted into SJV Prime+, a new program to support future doctors from their first years of undergraduate education all the way through to becoming doctors of medicine.
It follows SJV PRIME, or San Joaquin Valley Programs In Medical Education, a program that for decades has helped Valley students pursue medical degrees at UC San Francisco after completing their bachelor’s degrees
The need for doctors is acute in the San Joaquin Valley, where there are only 47 primary care physicians for every 100,000 residents, according to the California Health Care Foundation. That is far below the state average of 60 physicians per 100,000 residents and the second-lowest for any of the state’s geographic regions, above only the Inland Empire with 41 per 100,000 people. Meanwhile, the Bay Area sees the highest ratio with 80 doctors for every 100,000 people.
Health outcomes for a wide range of issues are worse in the San Joaquin Valley, including rates of premature death and frequent physical distress, compared to the rest of California, according to a 2022 report from the San Joaquin Valley Public Health Consortium.
Gov. Gavin Newsom, during a visit to UC Merced in 2021, noted the region “has been living with unfair health outcomes for too long. ZIP codes shouldn’t be a pre-existing condition.”
Fostering community doctors
Alyssa Rivera is two years away from completing her medical education through SJV PRIME, attending UCSF’s satellite campus in Fresno.
The 24-year-old is following a pathway set by her older brother, Lemuel, who in 2023 was among the first students to graduate from a new stage of SJV PRIME focused on students from the Valley.
Rivera said she was inspired to pursue medicine after seeing her mother go through cancer treatments, with the family having to make the long drive from Fresno to UC Davis for her care.
“We had to travel two to three hours, often on a school day, and so I would miss school sometimes for her to go see her oncologist at a different institution,” Rivera said.
Rivera said she and her brother initially struggled to navigate the educational system, which was new to their immigrant family. That experience is common for many students from the San Joaquin Valley and programs like SJV PRIME and SJV PRIME+ are designed to give them the tailored support they need to succeed.
Rivera currently helps prepare pre-medical students at Fresno State and UC Merced for work they would do as medical students and doctors.
“UC Merced is really getting kids from the Valley to come back and serve the Valley and serve their home,” Rivera said. ‘It's kind of this generational thing that we’ll have to keep working at.”
Kenny Banh, the assistant dean and emergency medicine physician at UCSF Fresno, believes that, when it comes to boosting the number of doctors practicing in the Valley, it will be more fruitful to provide educational opportunities for local students than to try to recruit new doctors from elsewhere in California.
“It's just not realistic to take somebody who grew up in L.A. County who has never left the big city,” Banh said. “It's not about being able to be a doctor, but those students are just very statistically unlikely to ever do that kind of practice (in a place like the Valley.)”
But to grow the number of medical students here, the work needs to begin even before the students enter college, he said.
“We have to start supporting them in their high school levels, through college, through transfer programs and into medical school because that's where the success is shown,” Banh said.
The 15 students in the first cohort at UC Merced for SJV Prime+ were all recruited from Valley high schools and recruitment for the next class is already underway. Applicants must demonstrate deep ties to the region as well as an intention to stay in the Valley, which includes the counties of San Joaquin, Stanislaus, Merced, Madera, Mariposa, Fresno, Kern, Kings and Tulare.
The program allows students to complete their entire eight years of education and medical training right here in the Valley.
“It is very much our hope that these students will then want to stay and do residency in the Valley and subsequently practice in the Valley,” said Dr. Margo Vener, interim director of medical education at UC Merced and a local physician.
Moves for a medical school
Over the long term, UC Merced is working to develop a medical school. The goal is to have the Medical Education Program serve approximately 2,220 undergraduates by 2030, according to the governor’s office.
The goal of providing a complete medical education in the Valley is essential to improving health access for local residents, noted Adam Gray, a former state assembly member who teaches at UC Merced and helped secure $200 million dollars in 2021 for the Medical Education Building. It won’t happen if students need to move away to become doctors, he said.
“Get a map of California and put a dot where all the medical schools are, and I think you'll have your answer,” Gray said.
Currently, the medical schools closest to the Valley that confer MDs – schools known as allopathic programs – are at Stanford and UCLA.
“If you can get a young person who grew up in the Valley, get them an education in the Valley,” Gray said, “the chances that they're going to stay are really high.”
Vener also noted that having care providers who are from the Valley will, hopefully, set an example for future generations of health professionals.
“People look around and they see, ‘Oh, you know, here's somebody from my community who's now a nurse practitioner or a dentist. That's someone I know. Maybe I could do what they did. They stayed local, I could do it too!’”