LHS+ Medical Student History and Heritage of the U.S. West Region

Abstract

The history of LMSA West begins in the 1960s with a small group of first-generation premedical Chicano students with a vision of serving those in need and dedicating their lives and careers to ensure everyone has access to basic human necessities including healthcare. When those same students started to enter medical school, they found few students like themselves and no role models. They had to pull themselves up by their bootstraps. They were the change they wanted to see. They created a new organization to provide a safe space for mentorship, support, and professional development for future generations of medical students like themselves. The organization evolved from a strong presence in California and other Western states to a unified network that could support students across the region. Influenced by their Latino heritage, generations of LMSA members have shared the values of comunidad, valor, liderazgo, conocimiento and compromiso. This is the story of the LMSA familia in the West region.

“True wealth is not measured in money or status or power. It is measured in the legacy we leave behind for those we love and those we inspire.”

—Cesar Chavez

El Movimiento: The Chicano Civil Rights Movement

In the 1960s, in parallel with the Civil Rights Movement of African-American communities, Hispanic Americans of various backgrounds organized to advocate around their own struggle for civil equality and fairness. Among Mexican Americans in the Southwest United States (U.S.), this struggle came to be known as the Chicano Civil Rights Movement [1]. The Chicano movement in California was known as El Movimiento (the Movement) and encompassed a variety of issues, including restoration of land grants; protection of farm workers’ rights; and equality in education, voting, and political rights. The dire needs for migrant farmworkers were also brought to light through the United Farm Workers Union (UFW), established in 1962 and led by revolutionaries like Dolores Huerta and Cesar E. Chavez. These needs included a minimum wage for migrant farmworkers, birthright citizenship for their children, and health protections, such as reducing the use of harmful pesticides and initiating unemployment and healthcare benefits [2]. In Arizona, the Mexican American Student Organization, which would later take the name Movimiento Estudiantil Chicano de Aztlán (MEChA), organized a sit-in at the President’s Office of Arizona State University to protest treatment of the Chicano community within the institution and its surrounds [3].

Around the same time, Executive Order 19025 issued by U.S. President John F. Kennedy—commonly referred to as Affirmative Action—opened doors to higher education for many Chicano students. Undergraduate students started to enter college in larger numbers and began to form various organizations. At the pre-medical level, these organizations included Chicanos for Creative Medicine, C.H.I.S.P.A., Stanford Chicano Pre-Medical Society, Los Curanderos, Chicanos for Community Medicine (CCM), and Chicanos for Health Education (CHE), among others [4, 5]. These students who later entered medical schools would subsequently form the corresponding medical student organizations, and later, the professional physician societies. Thus, the organizations and leaders that would eventually give rise to today’s Latino Medical Student Association (LMSA) developed during the Chicano Movement.

The influence of El Movimiento, specifically that of the farm workers’ movement, can be seen in the original logo of LMSA (Fig. 6.1a). The logo drew inspiration from the UFW logo (Fig. 6.1b) in the eagle wings surrounding the medical staff. The original logo was designed by a medical student at the University of California, Irvine (UCI) and, although updated for digital quality, it remained the same as the organization evolved (Fig. 6.1c). This logo was adopted as the LMSA National logo after the national unification movement started in 2007–09. When the logo was updated in 2011 to reflect its new structure, the wings of an eagle were maintained as a homage to the West region’s roots and to the UFW Movement (Fig. 6.1d).

Fig. 6.1

LMSA Logo Influence and Evolution (©LMSA). (a) The original LMSA (West) logo was designed by a medical student at UCI. It took inspiration from the United Farm Workers logo (b). (c) The LMSA (West) region logo was updated in 2005 with the organization name added around the graphic. It was then adopted by LMSA National (2009–2011) as homage to the West region during the process of national unification. (d) The LMSA National logo was redesigned in 2011. The Staff of Aesculapius replaced the Caduceus, five stars were added to represent each region, and the eagle wings surrounding the medical caduceus remained as a homage to the roots of the West Region’s logo

Las Raíces: The Roots of a New Organization

In 1968, there were 20 Chicano and 3 Puerto Rican medical students matriculating into medical schools across the country [6]. As these numbers increased in the 1970s, the National Chicano Health Organization (NCHO) was established and began organizing Chicano medical students in California [5]. Robert “Bob” Montoya, a student at the University of Southern California, and David Hayes Bautista, a graduate student at the University of California, San Francisco, were among the early NCHO student leaders. The organization sought and received federal funding to staff an office in Los Angeles. Subsequently, under the leadership of NCHO Executive Director Fred Lopez, additional federal funding was sought and received, allowing the establishment of additional offices in San Jose, Albuquerque, Denver, San Antonio, and Chicago. Frank Meza, a pre-medical student at California State University Northridge and CCM leader, also became a leading member of the NCHO Board [5].

In the second half of the 1970s, the La Raza Medical Association (La RaMA) became the leading force in the recruitment and retention of Chicano health students. There were several student leaders who were critical to the success of La RaMA, including medical students Frank Meza, Jose Arevalo, Max Cuevas, Hector Flores, Laura Solorio, and pre-medical students Raquel Arias, Tina Nevarez, and Elena Rios [5]. Rios, a graduate of the University of California Los Angeles School of Medicine, would go on to establish National Hispanic Medical Association (NHMA) in 1994 and help facilitate the growth of the National Network of Latin American Medical Students (NNLAMS) shortly thereafter [7].

Students from NCHO and La RaMA began meeting as an informal group in the Fall of 1982. Recognizing the mutual goals of increasing the number of Chicano/Hispanic/Latino students in the health professions, the organizations decided to coalesce and the Chicano/Latino Medical Student Association (CMSA) was established. The new CMSA was introduced as a network of medical students throughout the entire state of California during the National Association of Minority Medical Educators Conference in September 1984. The original founding schools of CMSA were the California medical schools (as reflected in Table 6.1), which were then divided into the Northern and Southern Regions of California. The organization soon would welcome a chapter in Arizona and eventually in other Western states, such as Utah, Oregon, and Washington.

Table 6.1 List of States and School Chapters (stand alone or connected) in the LMSA West Region (as of December 2022)

Affirmative Action

In 1977, Allan Bakke filed a lawsuit against the University of California with the argument that he was denied admission solely on the basis of race. Bakke, a Caucasian male, had twice applied for admission to the University of California, Davis (UC Davis) School of Medicine and was rejected both times. The school reserved sixteen places in each entering class of one hundred for “qualified” minorities, as part of the university’s Affirmative Action program, in an effort to redress longstanding, unfair exclusion of minority students from the medical profession. Bakke’s college grade point average and test scores exceeded those of any of the minority students admitted in the 2 years Bakke’s applications were rejected. In 1978, the U.S. Supreme Court ruled that Mr. Bakke should be admitted to medical school, yet still allowed the use of a student’s race as a factor in admissions criteria [8]. Minority students were thrust into the media spotlight, and several, including Frank Meza, testified in the hearings. The negative impact of this unwanted attention was felt by the students; however, it also made them a very tight-knit group and united in their mission.

Affirmative Action and a number of subsequent policies have continued to impact the communities and students for whom LMSA exists. A notable example includes California’s Proposition 187 (1994), which aimed to make immigrants residing in the country without legal permission ineligible for public benefits. California’s Proposition 209 (1996) eventually eliminated Affirmative Action, by prohibiting public institutions from discriminating on the basis of race, sex, or ethnicity. Arizona’s Proposition 200 (2004) sought to suppress voters by imposing additional requirements on proof of identification. Although some elements of this latter proposition were overturned in 2013, anti-immigrant and anti-Mexican rhetoric began to expand. Margarita Loeza, MD, MPH, reported, “We were very concerned about Prop. 187, [Gov.] Pete Wilson, and the end of affirmative action.” As a medical student and leader at the University of California, San Diego (UCSD), Dr. Loeza served as Medical Student Representative (MSR) of her school’s CMSA chapter, as well as Treasurer, Secretary, Southern CEO, and Conference Coordinator for the organization’s 1997 regional event. Her views were shared by many of her counterparts. Awareness of the impact such policies have on the welfare of their communities, their peers, and their patients has influenced generation after generation of LMSA members, as well as the activism in which these student and physician leaders have engaged.

Student Activism and Las Clínicas

The Brown Berets, founded by David Sanchez in 1967, represented a pro-Chicano community-based youth organization that advocated for social justice and played a significant role in El Movimiento [9]. Its members were largely motivated to protest by the police brutality faced by Chicanos in East Los Angeles; however, the Brown Berets would tackle a range of social and political issues that plagued Chicano neighborhoods, including political invisibility, educational inequality, and limited healthcare access. One major accomplishment of the Brown Berets was the establishment of El Barrio Free Clinic [10]. The Clinic was located on Whittier Boulevard in East Los Angeles, and operated from 1968 to 1970. It was operated by an all-volunteer staff headed by Gloria Arellanes, a prominent female leader among the Brown Berets. While clinic operations were run by the Brown Berets, the medical staff consisted of volunteers from various schools and hospitals—including pre-medical and medical student volunteers. Conflict within Brown Beret leadership led to a split in the organization in February 1970. The female members resigned from the Brown Berets and formed their own organization, Las Adelitas de Aztlán. Ultimately, the clinic closed its doors in December 1970. Las Adelitas then opened a clinic a short distance away on Atlantic Boulevard in March 1971 with a similar name, La Clínica del Barrio. Many of the same volunteers remained involved, including then pre-medical student Frank Meza. The clinic prospered and eventually became a community health center under the leadership of Dr. Cástulo de la Rocha. Subsequently, it became AltaMed Health Services, which has grown to be the largest federally funded Community Health Center in the country [5].

Students at the University of California, Davis established La Clínica Tepati in 1974 to provide healthcare to the underserved Mexican-American community of Sacramento [4, 5]. Deriving its name from Tepatli, the Nahuatl word for “healer,” the clinic was only the second student-run clinic in the nation. The clinic’s medical student leaders included Randy Clarke, Antonio Velasco, and Frank Meza, who was active in the Brown Berets and establishment of the Los Angeles-area clínicas. Still in existence at the time of writing, this free clinic is staffed each Saturday with physician volunteers and has provided services continuously to underserved Latino patients in the Sacramento area for over 45 years [11]. It has also provided clinical experience and support to hundreds of pre-medical students who have gone on to become doctors or pursue other health professions.

The clinic is one of the most important things I’ve done. I started as an undergrad as a “blueberry” or volunteer in blue scrubs. I was able to meet a lot of UC Davis medical students and get mentoring. I was able to learn about the medical journey and now I am a medical student. We have students who are in pre-law, interested in the arts, just people who want to help people. I’m able to practice with people who remind me of my family and a lot of the conditions I see are really similar to what I see in my own family.

—Dagoberto Piña, Medical Student, UC Davis & volunteer for La Clinica Tepati

Following the inspiration of Clínica Tepati, medical students at UCI established Clínica Cariño. The students were led by then medical student Mario San Bartolome, who completed undergraduate studies at UC Davis. The UCI students ran Clínica Cariño in partnership with Loaves and Fishes Soup Kitchen in Santa Ana, California, a city whose population of 300,000 was approximately 80% Latino at the time. The clinic started with health screenings and referral services and was held once a month with plans to expand to a full-service free clinic. In 2001, UCI administrators raised financial concerns about the sustainability of a free clinic, claiming that a full-service free clinic in Santa Ana was unnecessary, that there was adequate health care access in Santa Ana, and that undocumented immigrant patients would not come to seek healthcare services. Thus, student leaders under the direction of Dr. Emily Dow conducted a needs assessment report for the Santa Ana and greater Orange County communities, which concluded that “current evidence strongly suggests the 2001 administrative objections are either no longer valid or are surmountable.” [12] After the report, the students secured a site in Santa Ana for a more permanent home but, due to landlord issues, ended up having to settle in the adjacent city of Tustin. After 10 years in operation, Clínica Cariño evolved and was renamed UCI Outreach Clinics in 2009.

As the number of minority students grew, so did the number of minority physicians. CMSA student leaders graduated from medical school, advanced through graduate medical education into physicianship, and began to establish and lead professional physician societies aimed at serving the underserved communities from which they hailed. Such physician organizations include the Pacific Medical Association, which later became the Chicano/Latino Medical Association of California; the California Latino Medical Association (CaLMA, est. 1998); and the Arizona Latin-American Medical Association (est. 1993).

The issue is there are not enough culturally competent health-care professionals to meet the needs of the (Hispanic) community. Care is affected adversely because language and culture can create barriers for diagnosis and treatment,

—Dr. Juan Villagomez, Chairman of the California Chicano/Latino Medical Association [13]

From Chicano to Latino Medical Student Association

In 2003, CMSA changed its name to the Latino Medical Student Association (LMSA) to better reflect the makeup of its members. The name change to the more inclusive Latino term reflected the growing diversity within Latino subgroups in medical schools, the developing Latino identity among U.S. Latinos, and the growing recognition of the Hispanic/Latino community as a political and economic force.

The rebranded organization maintained the majority of the governing structure from CMSA, composed of two medical student representatives from each medical school chapter. This body met quarterly to discuss business and to plan the future directions of the group. These quarterly meetings were to be attended by the Executive Council, made up of chapter MSRs along with the Regional Co-Chairs, Treasurer, and Secretary. There was also an annual conference hosted by chapters and traditionally open to medical and premedical students at any institution. The first conference was held in 1984 and hosted by the University of California, Los Angeles (UCLA). The conference included a celebration banquet to honor its graduating medical students. In 1993, donning of sarape stoles was introduced at the graduation banquet by student leaders at the time and was made by the mother of Javier Romero (UC Davis). Both of these traditions remain in practice through 2022.

Two key changes were made in the transition from CMSA to LMSA. First, realignment of the schools into Northern and Southern regions occurred alongside the introduction of a requirement for one leader to be elected from each and function as Co-Chairs. Previously, Co-Chairs could be from any school, leading to the potential for over-representation of southern California chapters, which often contained greater student numbers. Moreover, with the establishment of new chapters outside the state of California, this change was made to ensure chapter diversity in top leadership. Of note, the Northern and Southern Co-Chairs promote communication among the region’s chapters and their MSRs, as well as with other health organizations as needed for project development. The second change was an accountability clause, which came about from the inconsistent involvement among the individual CMSA chapters. Prior to this clause, some of the chapters would have no regularly scheduled chapter meetings and intermittently participate in the CMSA board meetings. The change required each chapter’s leaders to submit a signed contract to LMSA that stipulated the requirements and expectations in order to continue being recognized as an active chapter (Fig. 6.2).

Fig. 6.2

LMSA Chapter Contract (©LMSA)

LMSA Inc. was incorporated as an official organization under the nonprofit public benefit corporation law for charitable purposes on January 22, 2005. Those indispensable to achieving this task included Ms. Emma Ledesma, UCI LMSA advisor, and the initial directors of the corporation: Jose Mayorga (UCI), Moses Salgado (UC Davis), Lucio Loza (UCLA), and Fernando Antelo (UCLA) (Fig. 6.3). The organization soon began to have influence by dual-degree student leaders, such as Eunice Rivas (Stanford), Efrain Talamantes (UCLA), Eric Sandoval (UC Irvine), and Omar Guzman (UC Irvine), and advisers such as Dr. Mario San Bartolome, who helped reshape the organizational structure with corporate titles such as Chief Executive Officer and Vice President for various aspects of the organization’s programming. The goal was to present LMSA Inc. as a forefront leader in professional development for Latino medical students and to facilitate communication with potential sponsors. These changes were reflected in the initial Bylaws when LMSA Inc. received its 501(c)(3) non-profit organizational status on May 16, 2007 (Fig. 6.4). The new 501(c)(3) status launched an era of increased fundraising that included small grants from the California Wellness Foundation and California Endowment, as well as corporate sponsorships from Southern California Kaiser Permanente and Molina Health Group. This allowed the organization to afford travel reimbursements for regional leaders, chapter development mini-grants, scholarships for pre-medical and medical students, and the new annual LMSA leadership conference at the beginning of the academic year.

Fig. 6.3

First Page and Signatures of LMSA Articles of Incorporation (©LMSA)

Fig. 6.4

LMSA Inc. 501(c)(3) Not-for-profit Corporation Bylaws (©LMSA)

Community, Continuity, Collaboration: The Formation of Regional Leadership Retreats

The first leadership retreat of the organization was created by leaders Omar Guzman (Southern CEO, UCI) and Natalia Isaza (Northern CEO, Stanford) and took place in 2007 at UCI. Ms. Emma Ledesma, the UCI Chapter advisor at the time, was instrumental in helping the LMSA leadership carry out the retreat. Medical student representatives and the various VPs of the organization were invited to attend this retreat and help plan out the organization’s agenda and priorities for the upcoming year, in line with the organization’s core values (Fig. 6.5). Recognizing the challenges faced by student leaders when they transitioned each year, the leadership was focused on maintaining the stability of the organization, preserving its non-profit status, building its infrastructure further, and continuing to improve its ongoing programming. The theme selected that year was presented as the 3 C’s: “Community, Continuity, Collaboration.”

Fig. 6.5

Core Values of LMSA Inc. (2006) (©LMSA)

In line with this theme, leadership retreats have been repeated and expanded in subsequent years, with students gathering for one weekend in the summer. Traditionally, these meetings started with a welcome social event on Friday night. A full agenda of meetings would follow on Saturday. During this time, leadership provided historical context of the organization and other professional development activities to the medical student leaders who were part of the executive board. Mentorship and guidance were usually provided by physician members of the organization’s Advisory Board, many of whom were alumni of LMSA or its antecedents. Once the theme was set for the year, it would be presented at the summer leadership conference. The co-chairs and MSRs of each chapter were invited to attend with reimbursement for their travel. The first leadership conference took place at UCI in 2003, again with the help of UCI Chapter Advisor Ms. Ledesma. In 2007, then-VP of Mentorship Alvaro Galvis, MD, PhD, added a pre-medical component to the existing leadership conference structure; through this, pre-medical student leaders in their own organizations were invited to take part in professional development activities and networking events with medical students.

LEAP Year: The Enactment of Longitudinal Initiatives for LMSA Inc. Growth

Listen to the call of your brothers and sisters. The chains of oppression are strong- be it the MCAT, a guidance counselor, a professor or an economic situation. They have been left behind while we have become medical students. I joined LMSA to give that helping hand and create an attitude that no man or woman will be left behind. This is the essence of LMSA’s mission.

—Alvaro Galvis, MD, PhD, Southern CEO, in his election speech delivered during the 2008 LMSA Inc. Conference at UCD

By 2008, LMSA Inc. had achieved a transformation into a professional development organization. The infrastructure was in place to focus back on its roots of activism and mentorship for pre-medical students while becoming a leader in the struggle for national unification. In 2008, the medical student leaders of LMSA Inc. launched a new initiative to leverage this newly developed infrastructure and create meaningful and sustainable programs for the benefit of fellow trainees. Deriving its theme from 2008 being a leap year in the Gregorian calendar, the initiative was named LEAP Year, for Leadership, Evolution, Accountability, and Professionalism (Fig. 6.6). The LEAP year leadership was largely influenced by medical students Mario Teran (Northern CEO); Alvaro Galvis (Southern CEO); Jose Anaya (Chief Financial Officer); Minerva A. Romero Arenas (VP of Scholarships); Tatianne Velo (VP of Mentorship); and Karen Espino, who held a newly created position (VP of Policy).

Fig. 6.6

LMSA Inc. LEAP Year, 2008–2009 (©LMSA), The logos shown were used as part of the LMSA Inc. Leadership Conference in 2008. (a) Front logo, as inspired by evolution theory. (b) Back logo defining the LEAP acronym

Becas y Reconocimientos

Keeping in line with building the pipeline, LMSA Inc. continued to focus on providing scholarships to pre-medical students. The Sí Se Puede Scholarship was established in 2004 in partnership with Kaplan, Inc. to fund preparatory courses for the Medical College Admissions Test (MCAT). The agreement with Kaplan, Inc. was originally agreed upon in the 1980s with Stanley Kaplan himself, although later agreements would be handled between the students and Kaplan’s executive leadership. The award was later renamed Janine Gonzalez, MD Scholarship, although the Kaplan courses remained as the award. The Amanda Perez, MD scholarship was established in 2008 and funded by Dr. Perez, an alumna of LMSA at the Charles Drew University Chapter. She served as MSR and later was in charge of the Scholarship Program when she served on the Executive Board for the Western Region. It would provide scholarships to high school seniors who were among the first generation in their families to attend college. Each year, at least 2 students were selected, though more could be awarded depending on annual fundraising. A third scholarship, the Sí Se Puede AMCAS/AACOMAS® Scholarship, was established and funded through proceeds of the annual conference. This scholarship was designed to assist pre-medical students mitigate the financial burden of applying to accredited U.S. Medical Schools and to increase the pool of underrepresented students entering the medical profession.

In addition, LMSA also established awards to recognize and offer some support to the medical student members of the organization. These awards included the LMSA Community Service Award, the LMSA Medical Student Representative of the Year, and the Richard Juarez Commitment to the Community Award. Richard Juarez was a UCLA-Drew medical student who died unexpectedly during his fourth year of medical school. He was very involved in his school’s chapter and a well-known student at other schools, as he held a medical student representative position on the regional board. Each chapter would submit its own nominees for the final vote by LMSA Inc. leaders, as organized by VP of Scholarships.

The year I took over, we voted in having a scholarship for medical students. Before that we only had an MCAT scholarship for pre-medical students. The scholarship was based on merit, leadership, [and] commitment to the mission of LMSA. Everything was under supervision and evaluation was done by the advisors - like the LMSA Faculty/Community Advisors. Dr. Zapanta, Dr. Frank Meza, Emma Ledesma, Dr. Hector Flores.

—Donald Portocarrero, DO, Western University; LMSA VP of Scholarship (2006–2007), MSR (2005–2006, 2007–2008)

Finally, the LMSA Faculty/Advisor Service Award was given to a faculty or administrator who was considered instrumental in supporting the goals and mission of LMSA throughout the year.

In 2006–2007, there were two new awards named after longtime LMSA mentor Bob Montoya, MD. He was an alumnus of the University of Southern California, where he was instrumental in establishing the Office of Minority Affairs (OMA) and the NCHO. He was known for his ability to work collaboratively with other groups, and this helped push for legislation at the federal, state, and local levels. He initiated and directed California’s Health Profession’s Career Opportunity Program and developed partnerships with the state’s nine medical schools, four dental schools, and three public health schools in existence at the time, directly contributing to the establishment of the OMA’s at the University of California medical school campuses. Dr. Montoya also initiated and directed the Minority Medical Education and Training Shortage Area Elective/Preceptorship and the California Shortage Area Medical Matching Programs, whose purpose was to prepare medical, physician assistant, and nursing students and residents for practice in medical shortage areas and then match them to jobs at clinics and practices in those areas. Dr. Montoya inspired and helped countless trainees with his efforts to strengthen the pipeline of medical education for minority students and bolster care provided to communities in need.

These awards were initiated by the 2006 leadership and the first awards were granted in 2007. The medical student award was to be granted to candidates who demonstrated a desire to advance the state of healthcare and education in Latino communities through leadership in extracurricular activities and/or membership in civic organizations and commitment to the mission of LMSA Inc. The Lifetime Achievement Award was awarded to senior physicians or other health professions faculty who demonstrated consistent dedication to the advancement of the Latino community and Latino medical students as voted by the LMSA Inc. chapters. The first award was presented to Dr. Montoya in 2007. The second was awarded to Dr. Frank Meza in 2008, who, in addition to being a tremendous mentor and earning many accolades as a physician, was a founder and served as National Chair of Chicanos for Creative Medicine (1972–1975), was on staff at the Brown Beret Barrio Free Clinic (1969–1970), and contributed to the organization tremendously. The third was to Dr. Hayes-Bautista in 2009.

Minerva Romero Arenas, VP of Scholarship (circa 2009), restructured the LMSA scholarship and award programs. These changes were meant to meet the changing needs of the students served and to increase the sustainability and quality of these programs. Such changes included revising application materials for pre-medical students to help use the LMSA scholarships as a test-run of their application to medical school, and providing detailed feedback to all undergraduate students who applied. The partnership with Kaplan, Inc. was also expanded to increase benefits to LMSA members and more undergraduate students.

Building the Pipeline: El Futuro

To create closer ties between LMSA Inc. and other pre-medical student societies, LMSA Inc. created new positions in its leadership team. These included the VPs of undergraduate relations (one each for the northern and southern regions of LMSA), who would work closely with the VP of Mentorship. These positions were filled by premedical students who served as liaisons between LMSA and the Latino pre-medical student groups, particularly the largest groups in California: CCM and CHE. These positions would help provide opportunities for leadership to pre-medical students and mentorship from current LMSA medical students. In addition, the VPs of undergraduate relations developed more mentoring opportunities locally and worked to increase participation in the pre-medical track at the LMSA conferences. Additional positions including the VP of Community Affairs, Newsletter, and Website were modified to allow leadership by premedical students. Moreover, any board position could have pre-medical interns that work closely with the board member in carrying out the duties of that office, again with the goal of providing opportunities for mentorship and leadership to the students who would eventually be applying to medical school themselves. The annual leadership conference created a completely funded and separate program for undergraduate/premedical student leadership development. In addition, selected premedical students from across the region were funded to attend the conference and registration was free for all pre-medical students.

La Política: LMSA Delves into Policy

In 2009, LMSA created the VP of Policy to oversee a full committee with 5 members and eventually initiate a policy summit in the fall. Karen Espino was the first person to hold that leadership position. The first step was to provide a Physician Advocacy Training and Action, which was done in collaboration with the American Medical Students Association. Student members of LMSA were invited to join the Policy Committee, which was charged with developing an agenda and set of stances for LMSA Inc. to support, with approval from MSRs across the region. In the following years, LMSA Inc. began to take formal policy stances ranging from endorsing universal health care as a right to affirming support for women’s right to choose abortion.

Activism flourished in the organization. Efforts were made to collaborate with organizations such as Border Angels and Flying Samaritans to help provide medical treatment for undocumented immigrants on the California border with Mexico. LMSA Inc. became a co-sponsor with the California Health Professionals Student Alliance (CaHPSA) for lobby day, an event in which medical students from across the state lobby in Sacramento in support of legislation towards healthcare equality and the establishment of a fundamental right to healthcare. The organization joined the Unite Here Local 2 union boycott of all Starwood Hotels in San Francisco. At that time, hotel workers that had a Latino majority were being asked to work without a new contract that had expired in 2004 without any health insurance benefits or raise in wages. LMSA had previously made contractual agreements with a Starwood Hotel to host the regional conference but the event was moved in solidarity with the union at the cost of losing a deposit of $5000 paid to the hotel. This new activism became a launching pad for the organization. As LMSA West coalesced with LMSA National, this would also influence the eventual creation of a National Policy Summit and the LMSA National Policy Chair.

National Unification: LMSA Inc. Becomes LMSA West

See the moment, seize the moment.

—Hector Flores, MD, at the 2008 NNLAMS GLAS and LMSA Inc. Leadership Conference

As LMSA Inc. in the West grew in their operations and programming, so did its counterparts in other regions of the U.S. Since the turn of the twenty-first century, regional entities had been collaborating with each other through a national consortium known as the National Network of Latin American Medical Students (NNLAMS). While an initial push for the creation of a unified voice for Latino medical students and physicians led to the establishment of NNLAMS, later pushes called for an even greater extent of national unification. As part of this later struggle, Dr. Phil DeChavez, NNLAMS executive director, and Ruben Font, Jr., then the National Coordinator of NNLAMS, attended the 2008 LMSA conference and met with the new regional CEOs to launch a concerted effort for national unification. At this meeting, leaders made arrangements to utilize LMSA as the national name and outlined the process of unification that was advocated for over the next few years. Additionally, the leaders arranged for the NNLAMS’ Garcia Leadership and Advocacy Seminar (GLAS) to take place in conjunction with the 2008 LMSA Inc. summer Leadership Conference hosted by UCSD in San Diego, CA.

By the end of March 2009, all other NNLAMS regions had voted in favor of unification under one common name and selected Galvis, then the LMSA Southern CEO, to serve as the first LMSA National Coordinator. LMSA Inc. leadership then voted at their 25th Annual Conference hosted by UCLA to change their name to LMSA-West, give the LMSA name, website, and entity to NNLAMS, and make the official name change effective at the end of the 2010 fiscal year. The 2011 conference, titled “Uniting our Voices for Justice in Healthcare,” represented a culmination of the unification efforts and celebration of all aspects of LMSA (Fig. 6.1). It was the first conference for which all regions and the national organization officially shared the LMSA name. This event also represented the 27th now LMSA West Regional Conference, as well as the 12th annual UCI LMSA-West chapter premedical conference—which, at the time, was the largest premedical student conference in California. The conference itself was the largest to date for LMSA, with 120 exhibitors; 250 high school students bused in from the Santa Ana Unified School District; 1100 premedical students overall; 500 medical students; 110 residents; and numerous physicians. There were conference tracks for high school, community college, college juniors and seniors, post-baccalaureate premedical students, medical students, and residents. By the end of the conference, everyone was part of the LMSA familia.

I had the opportunity to be elected as a Northern CEO during my last year of medical school. I was the first openly gay person elected to this position. I am very proud of how accepting and inclusive LMSA is.

—Manuel Mendoza, MD, LMSA Inc. Northern CEO (2009–2010)

Overview of LMSA West

The Latino Medical Student Association West (LMSA-West) was established in 2009, after a series of name changes and the formalization of a national unification movement amongst various medical student organizations catering to Hispanics/Latinos. The mission of LMSA West is to recruit and support individuals in the healthcare professions who will strive to improve the access and delivery of healthcare to Latinos and medically underserved populations. The LMSA West Region encompasses medical schools from Alaska, Washington, Oregon, Idaho, Montana, Wyoming, California, Nevada, Utah, Arizona, and Hawaii. As of the academic year 2019–2020, there were 19 active chapters, as shown in Table 6.1.

The LMSA West continues to carry out its mission with the LHS+ community through leadership, mentorship, and professional development. In addition to the chapter leadership and MSRs, the LMSA West Regional Board includes 17 leadership positions for medical students and 2 for pre-medical students (see Table 6.2). The CEO positions were renamed Co-Directors, though the designations of one for each of the Northern and Southern regions of LMSA West remain and the Director-Elect was added to help provide an opportunity to learn more about the role. Several positions have been doubled to allow for co-leadership, such as the VP of Policy (North/South), VP of Mentorship (North/South), and VP of Scholarship (Co-VP). The VP of Undergraduate Relations positions was renamed Northern and Southern Undergrad Representative (Table 6.3).

Table 6.2 Current LMSA West Regional Board Leadership Positions (as of December 2022)

Table 6.3 LMSA (West) Annual Conference with Titles, Host Institution, and Artwork. (All artwork property of LMSA) (©LMSA)

The regional executive board continues to encourage individual chapter events and programming. Chapters may apply for the mini-grants program through LMSA West to fund innovative projects and programs that help LMSA meet its mission. Each year, active LMSA-West Chapters are eligible to receive up to $1000 in mini-grant funding.

The region continues to hold two major annual events for professional development and networking: the Summer Leadership Conference and the Annual Regional Conference. Both are attended by several hundred premedical, medical students, and alumni. Many LMSA alumni seek to give back to the organization and have come back to serve on its Advisory Board to help provide advice, guidance, and organizational memory to LMSA West. Current Advisory Board Members include Drs. Amanda Perez, Margarita Loeza, Daniel Cabrera, Donald Portocarrero, Amy Garcia, and Lisa Montes. Other alumni who previously served as members of the Advisory Board include Drs. Richard Zapanta, Fernando Antelo, Jose Avalos, Alberto Manetta, and Mario San Bartolome.

Unidos Podemos Más: Collaborations

While the students who join LMSA West tend to be Hispanic/Latino in ethnic origin, the organization is open to all students who share the vision of the organization. Students of LMSA West often have formed alliances with other student organizations. These collaborations have been particularly lasting when made with student organizations from backgrounds considered Underrepresented in Medicine, such as the Student National Medical Association (SNMA) and the Association of Native American Medical Students (ANAMS). Seeing similar problems in their communities, the lack of representation in medicine, and interests in bringing about social justice and change, common programming was sought.

One example was the Pre-Health Conference co-hosted by LMSA and SNMA at UC Irvine. The conference offers undergraduate students a wide variety of workshops to expose them to various health career pathways. The 18th annual conference was held in November 2019. At chapters including Arizona, Utah, Oregon, and Washington, the students of the various racial and/or ethnic minoritized groups like ANAMS, SNMA, LMSA, and the Asian Pacific American Medical Student Association (APAMSA) have routinely held social events and supported each others’ lectures, fundraisers, and conference events.

At Stanford, a coalition formed of medical student representatives from APAMSA, LMSA, SNMA, Stanford American Indigenous Medical Association (SAIMA), LGBTQ-Meds, and Stanford Muslim Medical Association (SMMA). Named the Stanford University Minority Medical Alliance (SUMMA), its annual pre-medical student conference aims to increase diversity in the health professions in order to better care for underserved communities. The annual SUMMA pre-medical conference is one of the oldest on the U.S. West Coast and draws hundreds of students from throughout the Bay Area. The SUMMA is supported by the Center of Excellence for Diversity in Medical Education (COEDME). Established in 1993 with the assistance of a grant sponsored by the U.S. federal Health Resources and Services Administration, the goal of the COEDME is to prepare the next generation of medical leaders to address the health issues of a diverse society.

Recently, LMSA West has also worked closely with the Alliance in Mentorship (Mi Mentor). This 501(c)(3) non-profit network was formed in 2012 by LMSA alumni, who envisioned peer-to-peer mentoring in addition to medical students to pre-medical mentorship. The Mi Mentor partnership led to the “Get on the Bus” Campaign, whereby students are able to attend the annual LMSA Regional Conference with travel (chartered bus), lodging, and conference registration provided at a very low cost ($30 USD, in 2019).

We also collaborate with MiMentor because we get to see these pre-med students and it’s amazing to give back to people who have gone through the same things that you have and you are able to inspire them to become a physician.

—Maria Zepeda, Medical Student, UC Davis LMSA Chapter Co-Chair

Additional LMSA West Programming

The LMSA West region continues to engage actively in health policy affecting the Latino and other vulnerable and/or underserved communities. The VP of Policy position was expanded to have one leader in each of the Northern and Southern regions of LMSA West. Some of the issues that the organization has delved into in the last decade include advocacy in support of people who are undocumented but brought to the U.S. as minors, commonly termed DREAMer or DACA-students after the acronyms for legislation (Development, Relief, and Education for Alien Minors Act or Deferred Action on Childhood Arrivals). More recently, students have also delved into advocacy regarding the treatment of asylum-seekers.

Lastly, the LMSA West Scholarship program continues to offer several of the original scholarships, including the Amanda Perez, MD scholarship; Janine Gonzalez, MD MCAT scholarship; and the Sí Se Puede Scholarship. More recently, the organization established the High School Pipeline Program Scholarship for pre-medical students, the Cinthya Felix Scholarship for pre-health students, and the DREAMers of Tomorrow Scholarships to support undocumented medical and pre-medical students attending school in the states served by LMSA West. Additionally, the Latino Health Research Scholarship was developed in 2017 to support, encourage, and facilitate scholarly research and academic engagement by LMSA-West medical students. In recent years, the scholarship program of LMSA West has received significant support from AltaMed Health Services Corporation.

El futuro: LMSA West 2022 and Beyond

LMSA West has demonstrated tremendous growth in its first decade of existence following unification. Its success is rooted in the long history of student activism present in the region since the 1960s. This activism has driven generation after generation of LMSA students to advocate for their communities. Moreover, activism represents such an important aspect of the organization’s values that not one but two members of the regional board are to focus on policy. Individual LMSA chapters each continue to develop mentorship programs with local premedical organizations and individuals, many funded through the mini-grants that the regional organization provides. Regional conferences and the LMSA National Conference continue to provide opportunities for mentorship and networking along the pipeline of medical education.

Minerva Romero Arenas, MD, MPH, FACS (former VP of Scholarships) recounts:

I was a member and student leader in LMSA (West) at the University of Arizona—Tucson. The connections I made and the valuable leadership skills I developed while in LMSA placed me in a position to confidently become one of the four founding members of the Latino Surgical Society (LSS) after residency. Two of the other three founding members of LSS, Joseph López, MD and Gezzer Ortega, MD, were student leaders of LMSA a their respective institutions, during their medical school tenure. The fourth founding member, Joseph Fernández-Moure, MD, was an ally and supporter of LMSA. The benefits of LMSA are not for medical school days alone.

Through the innovative use of digital platforms such as Mighty Networks and Zoho, LMSA West strives to connect pre-medical and medical students to physician mentors for career advice, allows members to engage with each other virtually, and build community throughout the year. Collectively, these efforts will continue to improve the landscape of healthcare for LHS+ trainees, physicians, and patients in the West and beyond.

LMSA gives a lot of motivation to the pre-medical students. My cousin and I were the first ones to pursue any education, much less higher education in my family. My mom was undocumented immigrant and had not even primary education and my dad did not go to elementary school. My tío, my cousin’s dad, was a bracero. What my cousin and I did was a huge leap for my family. LMSA kept me motivated. It was really important for me to see someone who looked like me graduate.

—Margarita Loeza, MD, UCSD alumna and LMSA Inc. leader [MSR, Treasurer, Conference Coordinator, Southern Co-Chair]