Easing Medical School Debt

Loan Repayment Program Keeps ‘Community Treasures’ at Work in Underserved Communities

By David B. Littlefield

Ask young people growing up in the United States or in many other parts of the world “what they want to be when they grow up,” and a popular response will surely be “doctor.” It is clear to see the impact medical professionals have on people’s lives and on the health of our communities – and pursuing a medical career is an appealing option to make a difference.

Those who actually make it through college, medical school and residency programs have dedicated years to study and training – all of which are extremely costly. For many young people coming from low-income communities, the primary means to finance this education is to take on student loans. In California, it’s not uncommon for new physicians to complete their educations and enter the workforce with debts of $300,000 or more.

This is a significant challenge for primary care physicians who want to practice in community-based settings, providing care to those with limited access to the health care system. Loan payments alone can swallow up much of a physician’s salary at a community clinic. Without assistance, many doctors who dreamed of returning to their communities and making a difference are unable to realize that goal.

Uncommon Good, a Los Angeles County-based nonprofit, launched its Adopt An Angel loan repayment program to enable these physicians to fulfill their goals. In June 2009, the program received a two-year, $200,000 grant from TCWF to provide educational loan repayment assistance to culturally and linguistically diverse physicians and dentists working in underserved communities in Southern California. The amount of debt relief it provides is calculated on a case-by-case basis but, typically, Uncommon Good helps its “Angels” pay off their loan balances over a number of years.

“A loan repayment program like Adopt An Angel benefits not only the individual practitioners but the communities where they work because physicians who speak the languages of their patients and understand cultural nuances are important assets,” said Saba Brelvi, TCWF program director. “Making it economically feasible for them to practice at free or community clinics helps to close gaps in the health care safety net.”

Brelvi pointed out that 28 physicians and dentists currently receive assistance from Adopt An Angel’s path-breaking program, thought to be the only privately funded program of its kind.

Uncommon Good’s first venture into loan repayment was targeted at attorneys working in areas like Los Angeles’ Skid Row. Executive Director Nancy Mintie said it quickly became apparent that student loan burdens were a problem for young physicians also working in that area.

Uncommon Good approached the Community Clinic Association of Los Angeles County (CCALAC) to act as a partner to help identify health care providers eligible to receive loan repayment assistance. Participants are typically bilingual or multilingual, ethnic minorities who have demonstrated leadership in their field and a long-term commitment to public health work.

“These health care providers are community treasures,” Mintie said. “They have compassion for the needs of patients and underserved communities and possess a passion for what they do.”

They have compassion for the needs of patients and underserved communities and possess a passion for what they do.

they have compassion for the needs of patients and underserved communities and possess a passion for what they do.

Dr. Jose Luis Perez’ path to medical school at the University of Southern California (USC) was probably not typical of that of many of his classmates. Born in Managua, Nicaragua, his family was first uprooted by an earthquake that severely damaged the city in 1972 and then by the civil war that rocked the country during the 1970s and ‘80s. He and his brothers were able to escape to the United States, but he was separated from his mother and ssters for 18 years.

Arriving in Los Angeles and speaking no English, Perez attended Los Angeles’ Manual Arts High School. He credits one of the school’s counselors with encouraging him to think about attending college, something no one in his family had ever done.

He attended Los Angeles City College and then transferred to UCLA. Upon graduation, he returned to his high school – this time as a teacher, helping other immigrant children succeed in education.

It wasn’t until he found himself helping his mother and grandmother navigate the medical system that he committed to becoming a physician.

He told Uncommon Good: “Seeing how very caring the staff was at the county hospital, I knew I wanted to be like them, serving the Spanish-speaking immigrant community. I was thrilled when I was accepted to USC Medical School, my first choice.”

When he finished his medical training in 2002, his loans totaled more than $230,000. That year, he secured a job as a physician at the Central City Community Health Center, where he is now the medical director. He sees and takes care of patients – his first love – but also manages and directs health care resources for the organization (including a $1 million expansion and renovation project) and participates in wider public health roles, impacting the availability and delivery of health care to uninsured, low-income patients in South Los Angeles. Adopt An Angel helps him with his monthly loan payments.

And what excites and inspires him about his work? “Everything!” Perez said with infectious enthusiasm.

“This is my culture, really my people, and they know it. My classmates from medical school tell me their patients give them boxes of Godiva chocolates. Mine, give me home-grown avocados,” he said. “It’s much more than speaking the language. My patients know that I understand their culture, and it really opens them up.”

For more information, visit: www.uncommongood.org