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Immigrant Docs Help Ease California’s Primary Care Shortage

RIVERSIDE, Calif. 鈥 When Jose Chavez Gonzalez moved to the United States from El Salvador, he took any job he could get聽鈥 stocking warehouses, construction, cleaning houses and working in a meat processing plant.

But unlike most of the other immigrants he worked alongside, Chavez, 38, was a doctor with eight years of medical training. He came to the U.S. in the mid-1990鈥檚 to be with his family, but like all doctors from other countries, he still had to pass the U.S. medical boards and go through at least three years of residency in order to practice here. The process can be both expensive and time consuming, so during the day he worked various menial jobs and at night he studied for the boards.

鈥淚 had to do it. And I wouldn鈥檛 complain,鈥 says Chavez. 鈥淚t was OK to me. I mean, of course medicine is my passion, but since I didn鈥檛 have a license here, I couldn鈥檛 practice it.鈥

Immigrant Docs Help Ease California's Primary Care Shortage

Dr. Jose Chavez Gonzalez examines Graciela Jauregui at Riverside County Regional Medical Center (Photo by Jenny Gold/KHN).

A quarter of U.S. doctors are foreign-born, mostly from countries like India that focus on training 颅颅medical students to work in the U.S. 聽Many other immigrant physicians never become American doctors, particularly those who come from Latin American countries like Chavez. 聽

But a program at the University of California is seeking to change that, while at the same time helping to address in the state. The UCLA offers Latino doctors a stipend along with board preparation classes, mentorship and references to help them find a good residency slot in primary care. In return, the doctors pledge to work in an underserved area of California for two or three years.

The program at UCLA was founded by Dr. Patrick Dowling and Dr. Michelle Bholat to help address the shortage of primary care doctors in the state, and a particular shortage of doctors of Latin American heritage. Though about 40 percent of the state鈥檚 population is Hispanic, only 5 percent of its doctors are.

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Nearly half of the estimated expected to be newly eligible for health insurance under the Affordable Care Act are Latino, and Dowling says it鈥檚 key that patients see a doctor who understands their language and culture.

鈥淵ou can either do total body cat scans on everybody or you can sit down and try to understand what the patient is saying and why and what鈥檚 going on in their life,鈥 says Dowling.

The program is small. But slowly, it鈥檚 making a dent.聽 Chavez was able to pass his medical exams in two years. Today, he鈥檚 hard at work as a first-year resident at the Riverside County Regional Medical Center. Most of his patients are Hispanic, and many are immigrants like him.

Graciela Jauregui came to the clinic with severe pain in her knee. She was born in Mexico but has lived in the U.S. for 17 years, working as a housekeeper. She鈥檚 62 and doesn鈥檛 speak English. She says she always prefers to see a doctor who can actually understand her.

Speaking through an interpreter, Jauregui says, 鈥淎ll doctors are good people, but when they speak Spanish it鈥檚 better.鈥

Chavez鈥檚 fluency in Spanish is prized by his boss, Riverside鈥檚 chief of family medicine Dr. Geoffrey Leung. Leung says the clinic employs translators, but they are often in short supply. And even with a translator, important details can be lost.

Immigrant Docs Help Ease California's Primary Care Shortage

Program founders Dr. Michelle Bholat and Dr. Patrick Dowling (Photo by Jenny Gold/KHN)

鈥淣o matter how good of a translator you have, your concern is that you may lose some part of the integrity of the message,鈥 Leung says.

So far, the UCLA program has placed 54 Hispanic doctors into family medicine training programs 鈥 Dowling says that鈥檚 almost as many as came from all 10 California medical schools put together.

Dowling says hundreds and maybe thousands of immigrant doctors from Latin America could be practicing, but are instead working other 鈥 often menial 鈥 jobs. And that鈥檚 a wasted resource.

鈥淚 was just reviewing an applicant this morning who鈥檚 currently working in McDonalds,鈥 Dowling says. 鈥淎nd I thought of the irony: She鈥檚 serving people Big Macs right now and what she could be doing is explaining to people that isn鈥檛 what you want you want to be eating.鈥

Chavez, for his part, is happy to be treating patients again: 鈥淸It] gave me the opportunity to stop working and focus full-time on studying. Without the program, I would still be working on construction.鈥

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