Meet Two Nonprofits on a Mission to Diversify California Doctors

MiMentor and California Medicine Scholars Program are breaking barriers as they work to diversify California’s health workforce. (Photo: California Medicine Scholars Program)

The COVID-19 pandemic laid bare the structural racism and health inequities baked into our health care and public health systems. Infections, hospitalizations, and deaths had a disproportionate impact on Black, Indigenous and other people of color. While many complex and interdependent factors contribute to racial disparities in health outcomes, one is the lack of diversity in our health care workforce—in particular, our physicians.

The California Wellness Foundation has been a major funder of racial equity in the health workforce for decades, first as part of our Equity in Access portfolio, and now as part of our Economic Security and Dignity portfolio.

Before the pandemic sounded the alarm, the 2019 report by the California Future Health Workforce Commission showed us the true extent of the workforce diversity and physician scarcity problems: More than 6 percent of Californians are Black, but only 3 percent of our physicians are. Latinx people make up almost 40 percent of the state’s population, but only 7 percent of the state’s physicians. If the graduation rates remain the same for Latinx students, it will take them 500 years to reach parity in the state’s physician workforce. That’s five centuries, double the lifetime of our republic.

The 2019 report by the California Future Health Workforce Commission outlined some of the most promising initiatives to address these intractable problems including expanding advising and mentorship programs for low-income college students and funding post-baccalaureate training programs for people from disadvantaged backgrounds.

At Cal Wellness, we've been making grantmaking decisions inspired by the 2019 report’s findings and recommendations. In the last few years, we have funded cutting edge nonprofits that are focusing on mentorship across the lifecycle, and on integrated, systemic solutions to recruiting and supporting college students from underrepresented and low-income backgrounds. Two of those extraordinary grantees are California Medicine Scholars Program and MiMentor.

Latinx Physicians In California

40%
of California residents are Latinx
7%
of California physicians are Latinx
500
years before we can achieve parity

It's urgent to invest in the next generation of diverse physicians

A diverse physician workforce means better health outcomes for underserved and minority patients and better paid jobs for minority health care providers. On the one hand, research has shown over and over again that patient heath outcomes are significantly better when there are racial, ethnic and language similarities between them and their medical providers. On the other hand, people of color—especially women of color—are overrepresented in low-paid, hazardous roles in health care.

The fact is, we are facing a looming physician workforce crisis. California does not have enough primary care physicians to meet the needs of its growing, aging, and increasingly diverse population. To meet the demand, we will need approximately 4,700 additional primary care clinicians in 2025 and 4,100 additional primary care clinicians in 2030.

In addition to increasing the number of physicians overall, we must prioritize increasing the number of physicians in minority communities. An estimated 7 million Californians, majority of them Latino, African American, and Native American, already live in provider shortage areas. Without intervention, this shortage will intensify.

Furthermore, diversifying the physician workforce is an economic justice issue. Since its inception, the medical system has excluded minority, low-income students from the economic and professional opportunities that come from becoming doctors. Medical school is outrageously expensive. As a result, low-income minority students often choose to pursue other, lower-paid roles in the health care system.

Data consistently shows that most medical school graduates come from upper-middle and wealthy economic classes: roughly three-quarters of medical school graduates come from the top two household-income quintiles. This trend has not changed in three decades. Meanwhile, only 5 percent of medical school graduates come from low-income background.

This data tells us that we urgently have to address the economic inequities inherent in acquiring a medical degree, and increase the opportunities for all Californians to enter this health profession. If we don't, people from low-income communities and communities of color will continue to be overrepresented in low-wage health care jobs.

What’s game changing is that this is a streamlined and connected pathway between institutions and people.
Dr. Robles, California Medicine Scholars Program

Our Grantee is Prioritizing Community College Students and System-Wide Collaboration to Achieve Equity

To diversify the physician workforce and ensure that underserved communities have equitable access to primary care providers, we must invest in programs that prepare minority students for medical school. California Medicine Scholars Program (CMSP) is doing just that by focusing on recruiting, advising and supporting community college students interested in medical careers.

“Community college is where most minority students have their start,” said Dr. Rowena Robles, executive director at California Medicine Scholars Program. "By focusing on providing support to community college students, you are actually speaking to a group of students statewide that is majority minority. A lot of our Latinx, our Black, as well as our Southeast Asian students, such as Cambodian and Vietnamese and Laotian, are in the community colleges. By targeting community college students, we are addressing these racial gaps in education equity.”

CMSP's approach is revolutionary because it focuses on system-wide collaboration. Currently based in four regional hubs, CMSP facilitates connections, collaborations and coordination between local community colleges, four-year institutions, medical schools and health clinics. Each hub is led by a medical school in its region, including UC San Francisco-Fresno, UC Davis School of Medicine, UC Riverside School of Medicine, and UC San Diego School of Medicine.

"What’s game changing is that this is a streamlined and connected pathway between institutions and people,” explained Dr. Robles. “We have seen many effective solutions in the past, but they have not collaborated, which may have affected our success. With our coalition, and the $10.5 million in funding we received from the state as well as $5.2 million in private funding from health funders like Cal Wellness, we’re able to get all the institutions and systems to collaborate, increasing our success,” she added.

The goal of the four regional hubs is to ensure that the community college students have a "soft landing” when they get to their four-year schools and then medical schools. The program is creating a “warm handoff from one institution to the next. There are point people. There are services that are ready to receive them, people ready to point them to the resources that they need and people prepared to support them academically and professionally,” said Dr. Robles.

A major goal behind this program is to grow the number of physicians who are willing to work in underserved communities. More often than not, physicians who end up working in underserved communities come from those communities themselves. Dr. Robles explained that many minority physicians who started their post-secondary education at a community colleges often go back to their communities to live and practice.

"If we are looking to close the health equity gap in terms of access to care, this is one direct path. Minority physicians bring with them cultural and linguistic competency and a familiarity with the community. Patients feel comfortable with them."

Historical racism is embedded in all institutions, including medical schools. That's one of the top reasons why we continue to see inequities in the workforce.
Dr. Consuelo Casillas, MiMentor

Mentoring the Next Generation of Latinx Physicians Is Key to Diversifying California Doctors

At 40 percent, Latinx are the largest racial/ethnic group in California. By 2060, they are projected to comprise nearly half of the state's residents. However, only 7 percent of our physicians are Latinx. If we wish to improve the health of our Latinx population and empower Latinx students to enter high-paying medical careers, we urgently need to focus on growing the number of Latinx students entering and graduating from medical schools.

MiMentor is a grassroots, student-led network that empowers Latinx and other underrepresented in medicine (URiM) students from socioeconomically disadvantaged backgrounds to realize their dream of becoming healthcare professionals. They create innovative and unique monitorship opportunities to help minority students pursue health professional careers.

Student leader Vanessa Alvarado explains MiMentor’s mission, vision and approach.

The path to becoming a doctor is long and difficult, especially for students of color who are low-income and first in their families to pursue a medical degree.

“Medical school is a longer commitment than four years. It's not just a ‘you' thing. It’s a family thing. If you have to put food on your plate, if you have to pay rent, pay mortgage, and your parents have invested in you, it's not an easy decision,” explained Keila Perez Horowitz, one of MiMentor's student leaders. “For me personally, it's been 10 years, and I still believe that God is going to open that door, because it's in his timing.”

The roadblocks to becoming a doctor are many, and most Latinx students do not have the social capital, connections, guidance, or resources to pursue this difficult career. But the MiMentor network makes it easier. It comprises Latinx physicians from around the state, current medical students, representatives from Latino Medical Student Associations, and student volunteers on different points on their medical career journey, all of whom are ready to lend a hand.

“What makes us really unique and agile is that we have students on the ground who know exactly what the students need, so they are able to build programs in an intentional way that truly works," explains Dr. Consulelo Casillas, executive director of Alliance in Mentorship, which operates MiMentor.

Student leader Sienna Martinez shares a story of a nontraditional student pursuing pre-med with MiMentor's help.

MiMentor offers free educational resources such as webinars to prepare URiM pre-med students for their medical school interviews. Everything is free because cost has historically prevented qualified minority students from becoming doctors. Simply applying to medical school can cost thousands of dollars. MiMentor challenges the old gatekeeping model by making every resource freely accessible to all students, regardless of when or where they graduated from college. Everyone is welcome.

Student leader Mario Eusebio explains why MiMentor is unique.

Ultimately, the mission of MiMentor is to train the next generation of URiM health care leaders who will support underserved populations in California. The mentoring program itself is proof of concept, based on holding the door open for the person coming after you, while showing gratitude to those who came before you.

“MiMentors want to give back to the community. We want to make sure that the next person also gets the resources, and the connections to be more sustainable long term,” explained student leader Johanna Gonzalez.

One thing is for certain: What MiMentor is doing is ambitious and extremely challenging. "It takes a lot of work and time to build pipelines. It's very labor intensive, and it requires a lot of human resources, and social input," explained Dr. Consuelo Casillas.

MiMentor and its student leaders are playing the long game to transform medical school admissions and the physician workforce. By building long-term, high-touch relationships, they are creating a supportive community that’s in it for the long haul, through trials and tribulations that are inherent to applying, attending, persisting and graduating medical school.

Equally as important, MiMentor student leaders are being trained to become future health care leaders who will continue transforming the existing, inequitable health system.

“We put a lot of hope, and a lot of stake, into these future leaders. That's what we are really trying to build—future health care leaders. We need folks to be able to make transformations in our health care system, because it’s untenable at the moment.”

Meet Two Nonprofits on a Mission to Diversify California Doctors

Latinx Physicians In California

It's urgent to invest in the next generation of diverse physicians

Our Grantee is Prioritizing Community College Students and System-Wide Collaboration to Achieve Equity

Mentoring the Next Generation of Latinx Physicians Is Key to Diversifying California Doctors

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