California should convene a special task force to develop a comprehensive, statewide plan for rural medical education. Medi-Cal Graduate Medical Education funds should include incentives for residency programs to provide educational experiences that prepare residents to care for underserved populations. Although policies that alter the composition of the classes entering medical school have the most delayed effects on service in shortage areas, they are critical elements of a comprehensive plan for addressing physician shortage because they increase the number of physicians predisposed to practice in medically underserved communities. Minority physicians are much more likely to practice in underserved communities, and physicians who grew up in rural areas are much more likely to practice in rural communities. The recent decrease in enrollment of underrepresented minorities in medical schools in California and the U.S. presents new challenges for the state's ability to train and recruit physicians to serve its neediest populations.
Similar trends are evident at private medical schools.
Individuals from disadvantaged backgrounds should have the opportunity to develop career interests in health care and to be competitive applicants for entry into professional schools. The state should provide support for at least one additional postbaccalaureate program to help prepare promising disadvantaged applicants who have not been accepted to medical schools. Medical school admissions policies must be sufficiently flexible and individualized to take full account of the variety of characteristics and life experiences that may predict an applicant's successful career in medicine and future professional contribution to the health of the public. This research was funded by CPRC's California Program on Access to Care and the U.S. Bureau of Health Professions. Another component of this research, focusing on declining medical school admissions among underrepresented minorities, was published separately by the investigators at the Center for California Health Workforce Studies, who prepared this report.