Practice Intention: Addressing the Needs of Diverse Underserved Communities in Medical Education.

Background and objectives: The US physician workforce is at a critical juncture, with a projected shortage and misdistribution of primary care physicians. Culturally and linguistically diverse states, such as California, are challenged to search for innovative approaches in medical education to address the physician needs of diverse underserved communities. The University of California recognizes this imperative and supports Programs in Medical Education (PRIME), including PRIME Leadership and Advocacy (PRIME-LA) at University of California Los Angeles (UCLA). This study examines medical education outcomes for PRIME-LA graduates versus a comparator group.

Methods: We conducted a secondary data analysis of the graduation questionnaire responses from UCLA graduates between 2018 and 2023. Our study included 97 PRIME-LA graduates and 811 comparator graduates. Primary outcomes included intentions to practice in underserved areas and intentions to care for underserved populations. Secondary outcomes included participation in experiences related to health disparities, health education, providing mentorship, and specialty of interest.

Results: A higher proportion of PRIME-LA graduates reported an intention to practice in underserved areas than the comparator group (89% vs 32%, P<.001). Intentions to care for underserved populations were higher among PRIME-LA graduates than those in the comparator group (93% vs 44%, P<.001). Family medicine is the most common specialty among PRIME-LA graduates in contrast to graduates of the comparator group (26.4% vs 6.3%, P<.001).

Conclusions: Mission-based medical education programs play a critical role in addressing the physician workforce gap in underserved communities. The PRIME-LA program may equip students with additional skills and training to address California's physician workforce needs.