Posted on Tuesday - 09/06/2022 to Up Close
By Barbara Anderson
UCSF and UCSF Fresno welcome the fourth cohort of the UCSF San Joaquin Valley Program in Medical Education (SJV PRIME). The 12 SJV PRIME students are beginning their medical education at a time when increasing the physician workforce is crucial to meeting the health care needs of the medically under resourced and fast-growing San Joaquin Valley – the region stretching roughly from Bakersfield to Stockton.
The Valley’s geographically dispersed and ethnically diverse population greatly outpaces the number of new physicians entering the workforce. With just 47 primary care physicians per 100,000 population, the region falls far short of the 60 to 80 primary care physicians recommended by the Council of Graduate Medical Education. The Valley is further shy of physicians who represent the communities and who are prepared to address the unique health needs of the region’s underserved populations. And this overall lack of access to medical care has never been more glaringly evident than in the past three years, during the pandemic.
Addressing the physician workforce shortage and diversifying the physician ranks are goals of SJV PRIME, a medical school track that is tailored for students from the Valley and who are committed to providing culturally appropriate care, particularly for under resourced communities.
“UCSF Fresno was created in 1975 to improve health access in the San Joaquin Valley. It is clear, however, that improving health requires more than just training physicians in medicine; it requires recruiting students from the region into careers in medicine and giving them the tools to provide care for the diverse population of the Valley. The San Joaquin Valley PRIME is the next step in achieving this goal. The program specifically recruits students with connections to the Valley and from the diverse communities in the Valley. As they complete their medical school, and hopefully specialty training, in the Valley, they will be well-prepared to stay and address the health care needs of our communities,” said Michael W. Peterson, MD, MACP, the Y. Frank and Roxie Moradian Chair in Medicine, UCSF Professor of Medicine and UCSF Fresno Associate Dean for Undergraduate Medical Education and Research.
The 2022 SJV PRIME cohort has strong connections to the Valley and these exceptional students are passionate about being a part of the mission to ensure high-quality, well-distributed medical care is available to every patient.
“We are so pleased to be welcoming our fourth and incoming class of SJV PRIME students, future physician leaders for the San Joaquin Valley. They come from across the Valley and have close ties to the SJV, most having grown up here. Many of them have firsthand experience of the difficulties that our community members have in accessing health care and they are dedicated to being a force to improve that access for our most underserved,” said Loren I. Alving, MD, director of SJV PRIME, health sciences clinical professor in Neurology, and the Mr. and Mrs. David George Row and Stephen W. Rowe Endowed Chair for Teaching in Neurology and director of the UCSF Fresno Alzheimer & Memory Center.
Among the SJV PRIME students in the Class of 2022:
Hector Acosta Parra grew up in the agricultural community of Kerman, California. A Kerman High School graduate, he received a bachelor’s degree in biology in 2021 from UCLA. The son of Mexican immigrants from Ixtlan Del Rio, Nayarit, his parents “instilled core values, such as hard work, selflessness and kindness in me,” Hector says. Like most of his family, his father works as a field worker to help make the Central valley the most agriculturally rich region in the nation, and at age 15, Hector says, “I also began to work in the fields.”
“I witnessed firsthand the health disparities farm workers in the San Joaquin Valley face. Their struggles to receive equitable health care inspired me to pursue a career in medicine and become an advocate for them. Furthermore, the lack of diversity within medicine has motivated me to pursue a role as a mentor to help other underrepresented minorities become physicians. The goal is to have a more diverse physician workforce that better represents our demographics.”
In the future, Hector hopes to return to the Central Valley to be a physician leader, advocate and mentor for the historically underserved community.
Viangkaeo Lee was born in the Wat Thamkrabok Hmong refugee camp in Thailand. At age seven, she immigrated with her family to Merced, California. Her family was part of the last wave of Hmong refugees to resettle in the United States. For Viangkaeo and her family as Hmong refugees, farm work was the only way to make ends meet. Growing up, she spent weekends at various fields – from Merced to Turlock to Los Banos and Fresno – picking strawberries, tomatoes and figs alongside her parents and siblings.
Growing up in a medically underserved and under resourced area, Viangkaeo witnessed health and health care disparities and inequities at play when she took on the role of caretaker and interpreter for her ailing father, who had end-stage renal disease. The experiences motivated her to pursue medicine to positively impact underserved communities and those often left behind by the health care system. While attending Merced High School, she founded the first pre-medical club on campus to support and encourage students interested in medical fields. Following high school, she attended UC Merced, where she majored in Biological Sciences and in her free time mentored high school students. She also volunteered at the hospital, researching kidney diseases and helped the local Hmong community.
Viangkaeo is excited to be part of SJV PRIME, where she is committed to giving back to and advancing the health of the community that raised her.
Myrka Macedo, a native of Sanger, California, attended schools in Fresno, California, graduating from Edison High School and graduated from Fresno State with a double major in Chemistry and Biology.
Growing up, she helped care for her maternal grandmother and grandfather. Her grandfather had congestive heart failure and later developed cancer and dementia. A native Spanish speaker, Myrka attended doctors’ appointments with her grandparents and provided translation as needed. She also witnessed Katherine Flores, MD, a Latina primary care physician and director of the UCSF Fresno Latino Center for Medical Education and Research (laCMER), provide holistic care to her grandparents in their native language, making her grandparents feel confident and in control of her grandfather’s afflictions.
Those experiences helped convince Myrka she wanted to be a physician. While preparing to apply to medical school after college graduation, she volunteered at free clinics and then became an emergency support technician at Valley Children’s Hospital. She joined the Central Valley Health Policy Institute in 2021 as a research assistant, working closely with community-based organizations (CBOs) that provide community health workers to the UCSF Fresno Mobile HeaL COVID-19 Equity Project (CEP). She served for a while as Outreach Director at CEP, providing public health education training in Spanish for the community health workers and helping to create a public health infographic in Spanish that could be distributed to people coming to CEP for COVID-19 vaccines.
The pandemic exposed the need for collaboration to solve health needs in the Valley, Myrka says. She can envision a future in medicine that includes a public health component. “I learned the importance of working with CBOs and I can see myself working with them in the future as a physician.”
The SJV PRIME matriculating Class of 2022:
Hector Acosta Parra, Kerman, California
Jagot Dosanjh, Fresno, California
Kenneth “Ken” Fox, Fresno
Neytali Kanwar, Fresno
Viangkaeo Lee, Merced, California
Myrka Macedo, Sanger, California
Austin O’Callaghan Langhoff, Redding, California
Alan Pham, Fresno
Seshaan Ratnam, Fresno
Mina Sarofim, Tracy, California
Maria “Denalene” Tiu, Fresno
Lilian Vang, Fresno
SJV PRIME BACKGROUND:
SJV PRIME started in 2011 as a collaboration among UC Merced, UCSF Fresno, UCSF, and the UC Davis School of Medicine, which was the degree-granting institution. In July 2018, the UCSF School of Medicine became the degree-granting institution.
Students admitted to SJV PRIME spend the first 18 months of medical school in San Francisco then transition to the Fresno regional campus for the remainder of their education. SJV PRIME’s curriculum is tailored to address health issues prevalent in the Valley and encompasses community engagement programs, core seminars, clinical immersion experiences and robust mentorship and support. SJV PRIME incorporates the unique expertise of UCSF, UC Merced and UCSF faculty at UCSF Fresno, as researchers, educators and leaders in the field of health care in the Valley.
Forty-two students are currently enrolled in the UCSF SJV PRIME and three UC Davis students are completing training in SJV PRIME. To date, more than 50 medical school graduates have completed the program, many of whom are now working in the Central Valley and California as residents or fully licensed physicians.
All six of the SJV PRIME students who graduated in 2022 stayed in California for residency training and to provide much needed care. Four stayed in the Central Valley with one staying on at UCSF Fresno.
“The goal is for SJV PRIME students to be able stay in the Valley after graduation by offering them residency training in the Valley with the hope they will stay here to practice,” said Kenny Banh, MD, assistant dean for Undergraduate Medical Education at UCSF Fresno.