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The role of medical education in reducing health care disparities: the first ten years of the UCLA/Drew Medical Education Program.
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- Author(s): Ko, Michelle; Heslin, Kevin C.; Edelstein, Ronald A.; Grumbach, Kevin
- Source:
JGIM: Journal of General Internal Medicine; May2007, Vol. 22 Issue 5, p625-631, 7p, 3 Charts, 1 Graph- Subject Terms:
MEDICAL education; PROFESSIONAL education; MEDICAL care; COMPARATIVE studies; HEALTH services accessibility; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; MEDICALLY underserved areas; RESEARCH; RESEARCH funding; UNIVERSITIES & colleges; PROFESSIONAL practice; EVALUATION research; RETROSPECTIVE studies - Source:
- Additional Information
- Subject Terms:
- Subject Terms:
- Abstract:
Background: The University of California, Los Angeles (UCLA)/Charles R. Drew University Medical Education Program was developed to train physicians for practice in underserved areas. The UCLA/Drew Medical Education Program students receive basic science instruction at UCLA and complete their required clinical rotations in South Los Angeles, an impoverished urban community. We have previously shown that, in comparison to their UCLA counterparts, students in the Drew program had greater odds of maintaining their commitment to medically disadvantaged populations over the course of medical education.Objective: To examine the independent association of graduation from the UCLA/Drew program with subsequent choice of physician practice location. We hypothesized that participation in the UCLA/Drew program predicts future practice in medically disadvantaged areas, controlling for student demographics such as race/ethnicity and gender, indicators of socioeconomic status, and specialty choice.Design: Retrospective cohort study.Participants: Graduates (1,071) of the UCLA School of Medicine and the UCLA/Drew Medical Education Program from 1985-1995, practicing in California in 2003 based on the address listed in the American Medical Association (AMA) Physician Masterfile.Measurements: Physician address was geocoded to a California Medical Service Study Area (MSSA). A medically disadvantaged community was defined as meeting any one of the following criteria: (a) federally designated HPSA or MUA; (b) rural area; (c) high minority area; or (d) high poverty area.Results: Fifty-three percent of UCLA/Drew graduates are located in medically disadvantaged areas, in contrast to 26.1% of UCLA graduates. In multivariate analyses, underrepresented minority race/ethnicity (OR: 1.57; 95% CI: 1.10-2.25) and participation in the Drew program (OR: 2.47; 95% CI: 1.59-3.83) were independent predictors of future practice in disadvantaged areas.Conclusions: Physicians who graduated from the UCLA/Drew Medical Education Program have higher odds of practicing in underserved areas than those who completed the traditional UCLA curriculum, even after controlling for other factors such as race/ethnicity. The association between participation in the UCLA/Drew Medical Education Program and physician practice location suggests that medical education programs may reinforce student goals to practice in disadvantaged communities. [ABSTRACT FROM AUTHOR] - Abstract: Copyright of JGIM: Journal of General Internal Medicine is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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