The Role of Medical Education in Reducing Health Care Disparities: The First Ten Years of the UCLA/Drew Medical Education Program
- Michelle KoAffiliated withDepartment of Health Services, UCLA School of Public Health Email author
- , Kevin C. HeslinAffiliated withResearch Centers in Minority Institutions, Charles R. Drew University of Medicine and ScienceDavid Geffen School of Medicine at UCLA
- , Ronald A. EdelsteinAffiliated withAcademic Affairs, Charles R. Drew University of Medicine and Science
- , Kevin GrumbachAffiliated withDepartment of Family and Community Medicine, University of California
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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.
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.
Retrospective cohort study.
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.
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.
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.
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.
KEY WORDSmedical education health care disparities UCLA/Drew program
- The Role of Medical Education in Reducing Health Care Disparities: The First Ten Years of the UCLA/Drew Medical Education Program
Journal of General Internal Medicine
Volume 22, Issue 5 , pp 625-631
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- medical education
- health care disparities
- UCLA/Drew program
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- Author Affiliations
- 1. Department of Health Services, UCLA School of Public Health, CHS 31-269, Box 951772, Los Angeles, CA, 90095-1772, USA
- 2. Research Centers in Minority Institutions, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
- 3. David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- 4. Academic Affairs, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
- 5. Department of Family and Community Medicine, University of California, San Francisco, CA, USA