California needs more medical residency options

Our health system is broken ! Another situation that defies common sense in a state that is underserved.

Read the story about a medical student who wants to practice primary care and psychiatry, who cannot find a suitable residency in California.

By Trevor Cline

California and its public education system is the only home I’ve ever known. I’m a proud alumnus of UC Berkeley and soon-to-be alumnus of the UC Davis School of Medicine.

I understand my state’s needs and want more than anything to serve urban California communities as a dually trained internist and psychiatrist. In order to realize my dream, I need to match into a residency program, otherwise known as a graduate medical education program.

There is currently only one dual-training residency program in our entire state. Because of that, there is a very real possibility I will have to leave California, the only place I want to live and work, to continue my medical training.

This lack of graduate medical education training positions, especially in primary-care specialties like the one I wish to match into, is problematic in many ways.

First, it deprives our state of its physician workforce, as doctors are more likely to permanently live and work within 80 miles of where they receive GME training. It also perpetuates an existing health care access crisis and physician shortage that exists throughout our state.

California ranks 32nd in access to doctors compared to our neighboring states. Nearly 40 percent of our state’s counties fall below what is considered a minimum physician-to-population ratio to allow those seeking medical care to be able to do so in a timely manner.

To compound this issue, most GME programs are funded by federal Medicare dollars, which haven’t increased in nearly 20 years to keep pace with an increasing population and demand for doctors.

The lack of coordination of health care at the state level and federal level defies understanding when Obamacare increased the patient load abruptly.  Why was an increase in graduate medical funding included ?

Additionally, it’s projected that California needs 8,423 new primary-care doctors by 2030 to meet our population’s need for care services, and we don’t have nearly enough graduate medical education programs to meet that need.

To help ensure that California patients can see a doctor promptly when they need one, our Legislature passed a budget in 2016 that committed to investing $100 million over three years ($33 million each year) to fund the Song-Brown Program, an existing grant program housed within the Office of Statewide Health Planning and Development that supports primary-care residency programs in medically underserved areas.

However, Gov. Jerry Brown’s current budget proposal eliminates $33.4 million in health care workforce funding and redirects $50 million in tobacco tax revenues (Proposition 56) that was intended to go to GME programs.

It’s disappointing that Gov. Brown dropped his commitment to open more GME programs to keep more highly qualified California medical students in our state.

Anyone concerned with the future of our state’s health should contact their state representatives and Brown’s office. Tell them to stop raiding tobacco tax revenues and invest those funds toward the Song-Brown program and other means of expanding GME programs in California. The future of my profession and the health of our state depend on it.

— Trevor Cline is a student at the UC Davis School of Medicine. He is a dedicated health policy advocate and a medical student leader in the California Medical Association Medical Student Section.

California needs more medical residency options