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Stanford Report, January 12, 2000

Educational pipeline aims to increase diversity of health care providers


It may not be a yellow brick road, but an innovative new outreach program to local schools may pave the way for disadvantaged and underrepresented minorities to pursue health care careers at Stanford and other universities. The Santa Clara County Educational Pipeline aims to provide a kaleidoscope of activities highlighting professional opportunities in health care to young people from middle school to junior college throughout the Peninsula. If successful, the pipeline hopes to counteract a dismaying downtrend in diversity among medical professionals.

"We are planning lots of hands-on, age-specific activities to make a difference in the types of horizons that appear for these students," said Ronald Garcia, PhD, assistant dean for minority affairs and director of the new program. Both Garcia and Fernando Mendoza, MD/MPH, associate dean of student affairs, believe that when it comes to selecting a career, familiarity breeds comfort rather than contempt. By targeting their outreach efforts to low-income and ethnically diverse San Jose neighborhoods, Garcia and Mendoza aim to stimulate interest in health care careers in students who may not otherwise be exposed to such opportunities.

"If you've never had personal contact with a health care provider, that career option may not be in your conceptual framework," said Mendoza, principal investigator for the program. Students wishing to pursue careers in health care will be tracked as they transit from grade school to high school and junior college. Along the way they will be given information about application deadlines and financial aid at Stanford and other universities.

The new Comprehensive Health Careers Opportunity Program (C-HCOP), supported by a federal $1.3 million grant from the Health Resources and Services Administration's Division of Disadvantaged Assistance, is housed in the Stanford School of Medicine's Center of Excellence for Minority Health and Education (COE). The pipeline is an ambitious and far-reaching extension of Stanford's previous HCOP but remains consistent with a COE goal to increase the diversity of health care providers. Since its inception last fall, the pipeline has formed alliances with Alum Rock School District and Andrew Hill High School in San Jose, Foothill College in Los Altos Hills, De Anza College in Cupertino and San Jose State in San Jose.

Both C-HCOP and the new pipeline were designed to encourage underrepresented minorities (defined as Mexican Americans, African Americans, Native Americans and mainland Puerto Ricans) to apply for admission to medical schools in this country. According to Garcia, who is also the director of both C-HCOP and of Stanford's Center of Excellence, the percentage of minorities applying to medical schools is dropping, while the percentage of minorities in the general population is increasing dramatically.

"The concept of minority is not even appropriate any more," said Garcia. He emphasizes that by 2020, whites are estimated to make up only 24 percent of people under 19 years old in California. Forty-six percent are expected to be Hispanic, and about 21 percent will be African Americans. Asian Americans, the fastest growing group in the state, will make up about 9 percent of this age group by 2020.

"Sixty percent of all children in California today are children of color," said Fernando Mendoza. "Physicians need to be ready to treat these populations." And yet, according to Gabriel Garcia, MD, associate dean for admissions, the percentage of underrepresented minority students in Stanford's incoming medical student class has been steadily dropping. About 14 percent of the entering medical student class of 1999 is underrepresented minorities, compared with 21 percent in 1998.

Stanford is not the only institution concerned about such trends. Lynelle McElhannon, MPH, health program coordinator at participating Andrew Hill High School in San Jose, sees the pipeline as an ideal way to further Andrew Hill's mission to expose the school's ethnically diverse student population to as many types of medical career opportunities as possible. Around 700 of the approximately 2,200 students are enrolled in Andrew Hill's medical magnet program. Magnet students can come from any school in the Eastside Union High School District and need simply to indicate an interest in becoming a health care professional.

Andrew Hill's new alliance with Stanford will become evident in March with a series of seminars by Stanford and community health care workers and a pilot buddy program that will match five Andrew Hill students with interested medical students at Stanford. Future plans include a virtual reality biology lab, allowing students to view a college class in action, and targeted career nights to inform students and their families of resources available to help them pursue their career goals.

The 25 elementary and middle schools in the Alum Rock School District will also benefit from in the C-HCOP pipeline program. Although a program for younger students is still in the planning stages, Garcia and school officials envision talks by health care workers and discussions about potential career opportunities starting at the grade school level.

And the new pipeline reaches beyond middle and high school levels to
college-age students or older adults interested in switching careers who can participate through Foothill and De Anza Community Colleges and San Jose State.

"Many students who enter Foothill are very capable but have never really been able to visualize themselves as a doctor," said Bill Patterson, PhD, vice president of instruction and institutional research at Foothill. "This connection with Stanford will help them to see that maybe being a doctor is not an impossible dream."

"The key elements of a pipeline are the connections," said Garcia. He hopes that administrators at every level of the participating schools help to identify and continue to communicate with students who express an interest in health care careers.

"What we're really trying to do is have the content and activities be community based," said Garcia. "We want to make health relevant to these students' lives." He envisions health modules focused on diseases prevalent in their community, such as heart disease, smoking and alcoholism. While studying the science behind the disease, students would also be interacting with health professionals in their communities and learning what types of health issues are important within their own ethnic groups.

Garcia and Mendoza hope that repeated exposure to health career options, reinforced with an understanding of the importance of health care to their own ethnic groups, will launch students into new careers as medical professionals. "We want to keep that opportunity in front of them so they can grab hold," said Mendoza. SR