Q&A: Rutgers program seeks to address PCP shortage, promote workforce diversity

Rutgers New Jersey Medical School has launched a program to assist economically disadvantaged medical students while addressing the primary care physician shortage.

The Reducing Barriers to Success Scholarship (RBSS) program within the Office of Primary Care and Community Initiatives (OPPCI) provides funding for students from underserved communities to work and volunteer in medically underserved communities in Newark. RBSS collaborates with community organizations to fulfil care deficits in the Newark area. The program was designed and developed prior to the COVID-19 pandemic through funding from a 5-year, $3.25 million grant that the institution received in July 2020.

“The role of a primary care doctor is ... to advocate for those in need and to be the main medical point of contact,” Ana Natale-Pereira, MD, MPH, the assistant dean of primary care and community initiatives, division director of general internal medicine and an associate professor of medicine, said in a press release. “Unfortunately, the shortage of PCPs in urban areas forces many residents to seek health care from the ED or community health fairs, leaving them with no continuity of care. Students are educated and encouraged to engage in the care and advocacy needed in today’s primary care.”

Healio Primary Care spoke with Natale-Pereira to learn more about the program and how it is promoting diversity and closing gaps in care.

Healio Primary Care: Can you briefly describe the program?

Natale-Pereira: The OPPCI was created by the dean of Rutgers New Jersey Medical School (NJMS) to provide research, education and community service-learning opportunities for students, faculty, organizations and community members to create mutual beneficial collaborations grounded in mutual respect. The OPPCI has a bidirectional responsibility to connect community organizations and the medical school and create opportunities in community engagement.

Through the OPPCI office, medical students are provided with experiential opportunities in community service and engagement that complement their social justice and health equity education. The RBSS program, funded by the Health Resources and Services Administration, supports 20 medical students with financial scholarships to become primary care physicians and practice in medically underserved communities. The RBSS program seeks to diversify the health care workforce, increase minority representation in medicine and improve health quality and equity in primary care.

Healio Primary Care: How long will the students work in underserved communities in New Jersey? Is there a set amount of time?

Natale-Pereira: Since its inception, NJMS has provided service to the Newark community and greater area. Our students, faculty and staff are committed to improving the health of our community. Students at NJMS have been working with our most financially challenged patients through our work at University Hospital, but also through the Student Family Health Care Center, a student-run, faculty-supervised primary care practice that was established in 1968. All through their 4 years of medical education, students contribute to the health of the community in many roles. Through OPCCI, they are involved in community engaged service learning and volunteering opportunities.

Healio Primary Care: What criteria do students need to meet to qualify for the program?

Natale-Pereira: The RBSS program is a federal grant scholarship program. Students need to demonstrate financial need and an interest in primary care and working in medically underserved areas. Other criteria include environmental, educational and social disadvantage as defined by the federal government. The program is designed to offer students opportunities to explore all areas of primary care, including general internal medicine, family medicine and pediatrics.

Healio Primary Care: How will this program help promote the primary care specialty and equalize coverage in underserved communities?

Natale-Pereira: We are hopeful that the program will provide students with an opportunity to explore primary care in ways they didn’t know it existed. We expose them to different types of primary care delivery and practice and provide mentoring opportunities. We educate them on the need that exists among under-resourced communities, and the tremendous need for health education. It is important for students to see that primary care is complex, and it requires commitment to health care quality and advocacy for those whose voices are not heard. Our students are the future doctors who will lead on equality.

Healio Primary Care: What benefits come from a diversified physician workforce?

Natale-Pereira: There is both research and documented patient experience demonstrating the benefit of a diverse physician workforce, including improved health outcomes. We know that patients do well when they can relate to their doctor, both culturally and linguistically. Diversity also elevates the quality of the learning environment and leads to more innovation. Students benefit tremendously when they are trained and mentored by physicians that represent the community in which we live and learn. The RBSS program seeks to diversify the health care physician workforce by recruiting and training underrepresented minority and disadvantaged medical students, thereby increasing representation in medicine and improving health care quality and equity for our community.

Healio Primary Care: How will incorporating a more community-focused curriculum shape how future PCPs treat patients?

Natale-Pereira: At NJMS, we believe in the importance of cultural and linguistic competency, health equity and social justice. Our curriculum is rooted in these values, and our students are trained in community service and engagement. When you embed health equity, humanism and social justice as part of medical education, and when you provide students with service-learning opportunities, it shapes the way they see their patients and the world around them. They become more sensitive to the challenges afflicting our communities and begin to explore innovative ways to deliver the care they serve. When they start on clinical rotations, students demonstrate an elevated understanding and respect for their patients.

Healio Primary Care: What are your hopes for the program?

Natale-Pereira: The OPPCI vision is to create and disseminate best practices in community engagement while improving the quality of life for the residents of Newark, through research, service and education. The RBSS program allows us the opportunity to educate and train medical students, expose them to complex primary care, including behavioral health integrated models of care, and mentor them to lead. It is critical to have physicians who can relate to their patients, and who can creatively shape a future without health care inequalities. While this is a grant-funded opportunity, we are hopeful to build a collective future where people will contribute to the sustainability of this important program.

Healio Primary Care: Are there any additional programs/initiatives coming out of the Office of Primary Care and Community Initiatives?

Natale-Pereira: This year, the OPCCI focused on strengthening our academic-community partnerships, enhancing primary care and community collaborations, and engaging the greater Newark community during the COVID-19 pandemic. Our students have volunteered over 2,340 hours to educating the community about COVID-19, supporting the Rutgers vaccination programs, delivering food to house-bound citizens (1,600 seniors and 600 families) through our work with CareSparc, Inc., and supporting the COVID-19 testing center at University Hospital. We support students in developing service projects, such as the Street Medicine program focused on the homeless population, and the new American Preventive Screening and Education Association organization, developed by students in collaboration with University Hospital to provide free health screenings and educational programs focusing on healthy lifestyle throughout Newark. We are continuously evolving and developing new partnerships in primary care and service learning.

Healio Primary Care: Is there anything else you would like to add?

Natale-Pereira: We look forward to a future where students who choose to enter any primary care field will have the financial support necessary to change the future of health care. The debt burden of medical education often prevents students from entering primary care fields. This grant sets the foundational structure to grow the primary care workforce. We welcome everyone committed to its sustainability.

Reference:

Addressing the primary care physician shortage. https://www.rutgers.edu/news/addressing-primary-care-physician-shortage. Published Oct. 18, 2021. Accessed Nov. 5, 2021.