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In November 2022, The U.S. Supreme Court heard arguments on two cases that could prevent medical schools from positively considering race and ethnicity when deciding which applicants to admit. This could impact students in all programs of higher learning, not just undergraduate admissions. One student population this policy could affect, if enacted, is medical school admissions. The University of California (UC) system found a unique way to combat this potential threat while also fighting healthcare inaccessibility.
The growing shortage of physicians is becoming a real threat to healthcare accessibility for low-income populations across the country. The UC system decided to tackle this issue in January 2007 while also helping to increase enrollment in UC medical schools. The UC Programs in Medical Education (UC PRIME) was created to meet the needs of California’s underserved populations in both rural communities and urban areas that were becoming increasingly medically under-resourced. The PRIME program combined specialized coursework, structured clinical experiences, advanced independent study, and faculty mentoring specific to PRIME program students.
Each UC school has different programs dedicated to specific demographics and different areas of focus that have the ultimate goal of supporting PRIME graduates in their efforts to work with underserved communities and populations. According to the University of California, Office of the President (UCOP), one of the most powerful parts of the PRIME program is that it acts as a social mobility ladder for students, and 64% of students in the PRIME program come from medically underserved backgrounds themselves and go on to support their own communities.
Before the inception of PRIME, The California Health Care Foundation reported that “the way physicians were trained until 2004 lacked focus on special populations, didn’t give them the big picture of health care that comes with their master’s degree, and didn’t have the opportunity to develop leadership skills.”
The History of the First PRIME Program
The University of California, Irvine (UCI) established the first-ever PRIME program in 2004 and had a focus on the clear lack of healthcare accessibility to the growing number of Latino communities in the area. UCI specifically recruits Spanish-speaking medical school applicants each year who are committed to serving the under-resourced Latino community in the area. The medical students in this program have a tailored approach to learning through a curriculum that involves a summer immersion program that helps students understand how to care for the specific health issues of Latino communities. They travel to places like the Central Valley and California’s Mexican border, and Mexico City to understand the specific needs of this patient population while learning about policy and ethical issues these communities face. Between the third and fourth year of medical school, students obtain a master’s degree in science or public health to help them further their career in caring for the underserved.
UCI now also has the Leadership Education to Advance Diversity-African, Black, and Caribbean (LEAD-ABC), which is a program aimed at producing future physicians who are committed to addressing the health needs of African, Black, and Caribbean (ABC) communities in the region.
A Glimpse at Other UC Schools
Today, the UC PRIME Programs consist of five different initiatives, each with its own focus and goals. These programs include:
- Rural PRIME (Rural California) at UC Davis
- PRIME ABC at UC Irvine and UC Riverside
- PRIME-LA (Leadership and Advocacy) at UC Los Angeles
- San Joaquin Valley PRIME and PRIME-US (Urban Underserved) at UC San Francisco
- PRIME-HEq (Health Equity) and PRIME-TIDE at San Diego which focuses on healthcare for Native populations.
While each program is unique, they all share a common mission of increasing diversity in medical school, promoting success among underrepresented students, and working toward supporting underrepresented patient populations in the area they are studying.
The success of the UC PRIME Programs is reflected in the achievements of the students who have participated in the programs. San Francisco native Jamila Harris attended UCSF Program in Medical Education (PRIME). According to the UCSF, “Through PRIME, Harris has toured San Quentin prison, helped organize a health career fair for Oakland elementary students, and done rotations at Maxine Hall Health Center in San Francisco’s Western Addition, the very neighborhood where she grew up.”
Many of these students have gone on to become leaders in their fields, working as doctors, researchers, and healthcare professionals. Their success not only demonstrates the effectiveness of the programs but also serves as an inspiration to other students who may be considering careers in the healthcare field.
The Future of PRIME
The UC PRIME programs are an exceptional model for how other medical school institutions can look to increase diversity and promote success among underrepresented students. The programs demonstrate that with the right resources and support, and a very specific mission, it is possible to overcome the barriers that have traditionally prevented underrepresented students from pursuing careers in STEM and especially the medical field.
If the Supreme Court decides to enact a policy against considering race and ethnicity in admissions, the PRIME program is a way to combat the issue of diversity and inclusion which may increase based on this ruling. Other programs should consider adopting some form of PRIME program if they want to foster diversity and support communities that need it.
