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Preparing Physicians to Care for Underserved Patients: A Look at California's Teaching Health Centers

Janet M. Coffman, Margaret Fix, and Kristine Himmerick of the Healthforce Center at UCSF
California's six teaching health centers offer important physician training in medically underserved areas. Despite recent growth, they face numerous challenges.
Doctor listening to a child's chest with a stethoscope.

The Teaching Health Center Graduate Medical Education program was established as part of the Affordable Care Act (ACA) to increase the number of primary care physicians serving people in medically underserved areas of the US. The Health Resources and Services Administration (HRSA) has awarded grants to 60 teaching health centers across the country. Six are in California.

This issue brief describes California's teaching health centers and discusses their progress toward increasing the number of primary care physicians practicing in underserved areas. It also identifies facilitators and barriers to sustaining California's existing teaching health centers and establishing new ones.

Key findings:

  • All of California's teaching health centers are in underserved regions of the state, including the Central Valley, the Inland Empire, and Shasta County.
  • All have attracted substantially more applicants than they can admit.
  • Most graduates of teaching health center residency programs continue to practice in underserved areas in California following their residency. Many, however, have moved to different locations within the state.
  • Key facilitators to the success of teaching health centers include support from boards and CEOs, passionate faculty, ability to leverage hospital partnerships, and effective resident selection criteria.
  • Challenges to the long-term sustainability of teaching health centers include lack of stable funding, tension between education and service missions, and accreditation requirements for inpatient settings.

The full issue brief is available as a Document Download.

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