Several landmark studies have shown that representative care (when the racial/ethnic background of the physician workforce mirrors the racial/ethnic background of the population served) contributes to better health outcomes for patients from underrepresented communities. However, California’s medical student education pipeline is not supplying enough physicians, especially Latino/x or Black physicians, to support representative care in the state. This shortage contributes to communities of color continuing to bear the brunt of medical systems not designed to truly support patient-centered care.

This report provides an in-depth analysis of the disparities in the state’s recruitment and retention of Latino/x and Black medical students. Key findings include these:

• Although the Latino/x population is the largest in the state at 39%, only 8% of the state’s medical school graduates identify as Latino/x.
• Only 6% of medical school graduates identify as Black. While this figure suggests that, given the percentage of the state’s population, there is representative care for Black populations, the report’s findings show that half of California’s Black medical students leave the state for residency.
• California has neither the number of medical schools nor the number of residency positions needed to produce a physician workforce that reflects its Latino/x population.

Actionable recommendations to help California move toward representative care include these:

• Planning for medical school enrollment relative to population needs and demographics
• Exploring more locations for growth, including more medical schools and more residency slots
• Expanding community college programs that support students of color in the medical school training pipeline

In the wake of the COVID-19 pandemic and gaping health care disparities, medical schools, residency programs, medical training institutions, and state agencies like the Department of Health Care Access and Information face an urgent social imperative to meet the health care needs of Black and Latino/x communities by taking action to achieve representative patient-centered care.

About the Authors

Ephy Love, PhD, MS, head of data science, Thalamus; and Jason I. Reminick MD, MBA, MS, CEO and founder, Thalamus. Thalamus is a commercially available cloud-based graduate medical education interview management platform and scheduling software used by residency and fellowship programs.