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Program Puts Sidelined Doctors Back in the Game

As medically underserved Hispanic communities cry out for doctors, a new program puts physicians in their midst back into practice.
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After spending seven years studying to become a doctor in her native Mexico, Nidia Payan found herself having to sell tamales to make ends meet when she first arrived in Los Angeles.

Later, just to be considered for a part-time job as a medical assistant, she had to start as a volunteer. "It was very hard," says the now 30-year-old, recalling those early months in the U.S. "This was a big transition. It was like starting at the bottom again."

Other equally well-trained Hispanic doctors have found themselves driving taxis or working in lowly medical jobs, unable to practice in the United States without the necessary licenses and board certifications.

This comes even as the Pew Hispanic Center reports that, "More than one-fourth of Hispanic adults in the United States [30 percent among the foreign-born] lack a usual health care provider, and a similar proportion report obtaining no health care information from medical personnel in the past year."

Today the medical careers of close to 40 such professionals are firmly back on track thanks to a pioneering program being run by the University of California, Los Angeles.

The International Medical Graduate Program targets the more than 2,000 Hispanic doctors, trained in Mexico and other parts of Latin America who are living in the U.S. legally but not licensed to practice medicine.

The program, administered by UCLA's Department of Family Medicine, helps these foreign-trained doctors prepare for and pass their licensing exams with courses polishing their workplace English and basic science skills, as well as their medical and clinical skills.

The program also opens the door to sophisticated technology, research databases and new drug treatments that these doctors may not have experienced in their own poorer, less well-equipped health systems.

Students spend up to 15 months completing the full-time program, which costs around $50,000 for things like course fees, books and living expenses. The money is paid by the privately funded program, which recently received a $2 million boost from health care provider Kaiser Permanente.

Successful candidates, who must commit to careers in family medicine, leave the program with a letter of recommendation from UCLA paving the way to paid, three-year family medicine residencies across California." Last month, Payan, who originally graduated from the Universidad Autonoma de Sinaloa School of Medicine, joined a residency in Fresno.

They emerge as board-certified family physicians, licensed to practice in California and are contracted for another 18 to 36 months to serve medically underserved communities.

Launched in 2006, this unique program has so far placed 20 students in residencies with 19 others currently working through the course. The first two freshly minted U.S. physicians are due to graduate next January, followed by a further seven in 2011.

The program does more than just prevent talented overseas doctors languishing in jobs for which they are way over-qualified: It's also offering a solution to the state's severe shortage of Hispanic physicians — especially among immigrant communities. "Foreign-born and less-assimilated Latinos — those who mainly speak Spanish, who lack U.S. citizenship, or who have been in the United States for a short time — are less likely than other Latinos to report that they have a usual place to go for medical treatment or advice," according to Pew.

Drawing on statistics from the U.S. Census Bureau, Michelle Anne Bholat, the program's executive director, said Hispanics account for one-third of California's 36.5 million population but only 5 percent of physicians. Plus, a third of the state's Hispanics live in those medically underserved areas, according to the program.

"We predict California will face a physician shortage of up to 17,000 by 2015, and this shortage disproportionately affects underserved communities," said Patrick Dowling, Department of Family Medicine chair and co-founder of this program.

The program hopes to redress linguistic and cultural imbalances that research shows can create barriers between patients and doctors, and may impact compliance levels and resulting health quality.

"Speaking and understanding Spanish well allows the doctor to understand the details of their patients in a manner it wouldn't be possible to obtain otherwise," program graduate Isabel Gonzalez, who studied in Barcelona originally, told the EFE news service last year. She's now in practice in Riverside.

"Language and culture matter," Bholat said. "It's a benefit to have someone who fully understands the nuances of a patient's language and culture. Ninety percent of diagnosis is from history, so we have to get that story."

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