This story originally appeared in UCLA Today, a discontinued publication.

Future doctors are primed to serve those in greatest need

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lined up for foot wash
Homeless clients of the Union Rescue Mission lined up at the Happy Feet clinic to receive foot care from UCLA medical students and faculty.
How to help L.A.’s homeless? One foot at a time, determined a group of UCLA medical students who created a podiatry clinic for a population that walks an average of 13 miles a day, often in broken or poorly fitted shoes or slippers.
 
Now in its second year, “Happy Feet” has helped hundreds of homeless at Union Rescue Mission in downtown L.A. and the Path of Life Homeless Shelter in Riverside. Visitors to the daylong clinic find themselves treated to the kind of hands-on pampering most of them might only dream of: an unhurried, soothing foot wash in a tub of warm, soapy water. Next comes a foot exam, with students working alongside their faculty mentors to check for everything from fungal infections to diabetes, which often shows up first as a loss of sensitivity in the feet. If a foot ailment is found that can be remedied, it’s taken care of on the spot. Patients then stop by a medical “education station” and receive fresh socks and foot care products.
 
foot wash
Treatment started with a warm, sudsy foot bath, and was followed with a foot exam.
Happy Feet is the creation of a team of 17 medical students committed to taking their doctoring skills to California’s neediest populations. So committed, in fact, that they’ve signed on for a five-year, dual-degree program — UCLA’s Program in Medical Education (PRIME) — that combines a medical degree with a master’s degree in a related field, along with hands-on community service from the get-go.
 
UCLA PRIME, which currently enrolls 53 students, is part of a broader UC initiative with 250 students spanning seven UC campuses. PRIME is one way that UC — which trains two-thirds of all medical students in California — hopes to help the state cope with an anticipated shortage of up to 17,000 physicians by 2015. Feeling the pain most will be economically disadvantaged communities, which already suffer a dearth of doctors, said UCLA PRIME director Lawrence Doyle, adjunct assistant professor of general internal medicine and health services research at David Geffen School of Medicine.
 
“Some 5 million to 7 million Californians live in areas that have been identified by the federal government as having a shortage of physicians,” Doyle said.
 
Worse yet, Doyle added, is a scarcity of culturally sensitive doctors in a state with a mushrooming multicultural population. PRIME is helping to fill the gap in a unique way — with students who not only meet the medical school’s tough admissions requirements but have a track record of serving disadvantaged communities. Some PRIME students come from such communities themselves.
 
Carlos Sandoval
UCLA PRIME student Carlos Sandoval said a childhood without health insurance fueled a desire to become a doctor in underserved communities.
“I grew up without health insurance, and it definitely had an impact on my life,” said third-year medical student Carlos Sandoval, speaking in a video that he and fellow students made about the Happy Feet program they created. “My father suffered from diabetes throughout my childhood. … People were just so grateful for something as basic as health care. This is why I want to be a doctor, to give back to the community.”
 
Katrina Fischer, also on the Happy Feet team, said that her middle-class family’s move from the Bay Area to the San Joaquin Valley when she was in high school was an eye-opener (her mother, UC Merced Dean of Natural Sciences Maria Pallavicini, transferred from a faculty position at UC San Francisco).
 
“I was shocked to see how differently people lived just a few hours away,” Fischer recalled. “Bay Area suburbia isn't how the majority of Californians live.”
 
Fischer volunteered at a women’s health clinic, where she saw the effects of poor health, poverty and limited access to healthcare. As a UCLA undergraduate, she spent a year studying in South Africa. “When I came back,” she recalled, “I realized that the Central Valley has many of the same problems as developing countries. I’d never thought about it that way before.”
 
UCLA PRIME, Fischer said, is “the perfect mix of everything I was looking for” — training in medicine as well as in issues of public health, the field in which she’ll obtain her master’s degree.
 
While UC-wide PRIME programs share a common core, each campus tailors its program as it sees fit. Most incorporate collaborations with local institutions: UCLA, for example, collaborates with UC Riverside and the Charles R. Drew University of Medicine and Science. UCLA PRIME also puts special emphasis on cultivating teamwork and leadership skills. 
 
“We expect our graduates to go on to serve leadership positions in medicine,” Doyle said.
 
Jumpstarting this process, he said, is a three-week project that each year’s cohort of incoming students completes as a group before classes even begin. In fact, the Happy Feet podiatry clinic grew out of such a project in 2008.
 
“We watched these students who didn’t even know each other come together and become a team, implementing a project that makes a difference,” Doyle said.
 
Sandoval, Fischer and their peers found a venue for the clinic after proposing it to Dr. Mary Marfisee, medical director of the Union Rescue Mission’s UCLA School of Nursing Clinic for the Homeless. That collaboration would be the first of many the students would forge throughout their years in PRIME, preparation for the partnerships they will find indispensable throughout their careers. 
 
"A lot of the lessons I've learned through Happy Feet are things that I never would have been exposed to in a regular medical school class,” said Fischer. “There’s a vicious cycle of poverty in a lot of communities in California. Only through becoming leaders can we go in and break that cycle.
 
“PRIME,” she said, “is teaching us to be leaders.”
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View a video about Happy Feet:
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A Happy Feet clinic is scheduled next for Oct. 30 at the Ocean Pacific Community Center, a homeless facility in Santa Monica, and volunteers from the campus community are invited to take part. E-mail uclaprime.cohort2@gmail.com.
 
Visit the UCLA PRIME website for more information and to view videos about two additional community projects at the Renacimiento Community Center in Pomona and the Stanford Avalon Jardin de la Salud (Garden of Health) in L.A.’s Watts neighborhood.
 
And read a story about PRIME programs across UC.
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