As medical student Benjamin Vincent learns patient care at the Kaiser Permanente medical offices in north Modesto, he is only three miles from his former high school and his parents’ home.
Vincent has spent his third year of medical school at Kaiser Modesto Medical Center as part of an initiative to bring more doctors to a region that’s notorious for physician shortages and barriers to health care.
The UC Davis program, called REACH, is training medical students in the Central Valley environment where they grew up to motivate them to practice here after completing their medical education and training. REACH is an acronym for Reimagining Education to Advance Central California Health.
The San Joaquin Valley from Stockton to Bakersfield has trouble recruiting physicians because of the strong pull of opportunities and lifestyle in coastal counties of California.
Vincent said he feels at home in Modesto and understands the city’s health care needs.
“I understand the lay of the land,” Vincent said. “I would be very happy working in Modesto. The last year has allowed me to get back to my roots and be me again.”
Vincent and his wife Jacqueline are temporarily living in his parents’ home in Salida. She is due to deliver their first child next month.
Vincent, who is 6-foot 5-inches tall, played basketball at Modesto Christian High School and was valedictorian of his graduating class in 2011. He also played basketball for Pacific Union College in Napa Valley before graduating and leaving for UC Davis medical school.
He said he had a childhood dream of becoming a doctor, and that ambition was sparked again while taking a physiology class in college.
The third year of medical school is for leaving the classroom behind and learning to care for patients in clinics and the hospital. The Kaiser center on Dale Road combines medical clinics and hospital wings in a single complex.
Vincent began the year at Kaiser in Modesto with a family medicine rotation. The students also are learning the skills of inpatient care, obstetrics, pediatrics, psychiatry and surgery. They are assigned to daytime hours or night shifts running from 5 pm to 7 am
Vincent is finishing up with general surgery this month and has been spending time in the operating room as first or second assistant to the surgeon.
The seven students in the REACH program, also from Manteca, Fresno, Bakersfield and other communities, will complete their training at the end of this month. A new cohort will begin May 2.
Dr. Howard Young, a regional director of medical education for Kaiser, said a person raised in the San Joaquin Valley understands the nuances of each community, the people and the culture.
Valley has a physician shortage
The Valley has about 45 physicians per 100,000 residents, a much lower ratio than in Bay Area counties, which have 60 to 65 doctors per 100,000 residents, according to the California Health Care Foundation.
Young said Kaiser Permanente could ultimately hire some of the REACH students as physicians after they complete medical school and residency programs, but some could come back to work for other healthcare groups in the Valley.
The REACH students made their own decisions about how much time to spend on COVID-19 hospital floors last year. All of them were trained in use of personal protective equipment and in treatment of COVID-19 patients, Young said.
“It was an experience wearing double masks and gowning up to see patients,” Vincent said. “At least I learned the protocols so it won’t be totally new if (a pandemic) happens again.”
Vincent said during the past year of medical training he ran into some people that he knew from his younger days in Modesto. “They were surprised to see me,” he said. “It usually puts a smile on their face. It’s good to take a few minutes to catch up.”
Najiba Afzal, another student in the REACH program, said her family came from Afghanistan and settled in Manteca when she was 4 years old. Her parents did not speak English well and she took on the role of child interpreter for her parents during visits to the doctor, which is considered a recipe for bad medical outcomes.
Understanding culture is important
Afzal attended Stanislaus State University in Turlock and was accepted into medical school at UC Davis. She said the health system is hard to understand for ethnic groups in the Valley. Requirements like signing up for health insurance or calling for an appointment may be foreign to them.
“It isn’t done in Afghanistan and I think it’s why a lot of refugee patients end up coming to the emergency room,” Afzal said.
Last week, the medical student was present when a woman from Afghanistan came in for a checkup. Afzal speaks a different Afghan language than the Dari-speaking woman but the interaction was positive, she said.
The patient kept looking at Azfal’s friendly face and nodding during the visit with the doctor. She was fasting for Ramadan and the doctor gave her a medication that could be taken in the morning and night while following rules of the holy month.
Azfal, who speaks Pashto and some Spanish, said she hopes to learn Arabic to be better equipped for patient care in the Central Valley.
The next step for the REACH students is the fourth year of medical school at UC Davis and then a multiyear residency for intensive training in medical practice. With the few residency programs in the San Joaquin Valley, the medical school graduates may travel elsewhere for the training.
Vincent said he’s drawn to family medicine but also is considering a career in anesthesiology. He said he hopes to return to serve patients in the valley somewhere between Modesto and Lodi. Among the admission criteria for REACH is commitment to work in central California, so his fellow students may not be too far away.
“We have gotten to know each other really well,” Vincent said. “I think it will keep us close.”