Q: What exactly are the goals of PRIME-US?

A: The goals of PRIME-US are to:

• attract medical students who intend to serve the urban underserved,
• give these students the skills and support they need to succeed in their future medical practice,
• create leaders in the field of urban underserved health care, and
• increase the number of graduates devoted to the health of the urban underserved.

Within these overarching goals, the program has several specific operational objectives to:

• organize and teach a coherent curriculum that provides the conceptual framework, knowledge base, and tools to effectively work to improve the health care and health of vulnerable populations and communities.
• establish partnerships with community clinics and community-based service organizations in underserved neighborhoods that recognize and support these community agencies as key educational resources and models of the cross-disciplinary collaboration needed to serve vulnerable populations.
• provide each student in the program a coherent longitudinal immersion in a neighborhood clinic in an underserved community that spans the full duration of medical school training.
• provide systematic and sustained mentoring (faculty, GME trainees, community leaders) and peer support for a career in an underserved practice setting.

Q: Who is in PRIME-US?

A: Staring in the fall of 2008, there will be three classes of PRIME-US students (15 in the first year, 12 in the second year, and 10 in the first year). Participating students are based at the UCSF San Francisco Campus, as well as the Joint Medical Program (JMP) in Berkeley. Although students come to the program with diverse interests and backgrounds, they share a strong commitment to working with urban underserved populations. We encourage students who are interested in all aspects of health and health care (clinical care, health policy, public health, research, education, etc) and all fields (primary and specialty care).

Q: What is the application process?

A: Application forms for students interested in the UCSF program can be found on the UCSF admissions website.

Applicants to the PRIME-US program must meet all of the requirements of the UCSF School of Medicine.

Applicants interested in the UCSF PRIME-US should check the UCSF campus PRIME-US box on your secondary application forms. A separate PRIME-US essay should then be submitted with your secondary application materials to the UCSF School of Medicine Admissions Office.

Applicants interested in the JMP PRIME-US should check the JMP campus PRIME-US box on your secondary application forms. A separate PRIME-US essay should then be submitted with your secondary application materials to the UCSF School of Medicine Admissions Office.

The JMP has a separate admissions process.

Q: What are the components of PRIME-US?

A: Orientation: PRIME-US students gather in late August for an orientation that lasts 2 weeks for SF students and 1 week for JMP students. The orientation is a combination of seminars and field trips with the goal of introducing students to urban underserved care, Bay Area resources, and each other. Students receive a stipend for their participation in orientation.

Seminars: during the first two years, interactive seminars on the health and healthcare of the urban underserved will be held approximately twice a month. These seminars are in addition to the regular medical school curriculum. Seminars cover public health and policy issues, as well as specific populations and communities. Seminar topics have included:

• Introduction to the Community Health Center Model
• Health of Incarcerated Persons
• San Quentin Field Trip
• Substance Use
• Fresno Road Trip
• Race, Poverty, Gender and Psychosocial Distress
• Health Policy
• Immigrant Health/Language Barriers
• Ethics
• Violence and Health

The seminars are facilitated by UCSF and UC Berkeley faculty as well as community members working with urban underserved populations. Some seminars will be dedicated to the community project curriculum (see below) and others will include field trips. About 2/3 of the seminars will be held in SF, and 1/3 at the JMP in Berkeley.

Community Engagement: during the course of their medical education, SF students will participate in a formal community engagement curriculum and work on longitudinal community projects or service learning activities. These projects and activities can be applied to the masters degree that all students will receive as part of PRIME-US.

Clinical Experience: all UCSF medical students participate in preceptorships during their first two years and clerkships during their clinical years. PRIME-US will take advantage of this aspect of the curriculum by placing participating students in community health centers in the first two years and public hospitals in the clinical years. PRIME-US students will be encouraged to participate in Model SFGH or Model Fresno, third year clerkships that include 3 consecutive rotations in urban underserved settings.

Mentoring: all PRIME-US students will be connected to faculty and peer mentors who share an interest in and commitment to the urban underserved.

Q: How will the curriculum work in relation to the regular medical school curriculum?

A: The orientation will be full-time (excluding weekends) for 2 weeks before school starts. Once school begins, the PRIME-US seminars are scheduled on average every 2 weeks. They are three hours long and are in addition to your regular course work. Community engagement activities will likely require a little extra time, but will be integrated into other activities (seminar series, masters degree, Areas of Concentration). The clinical placements are a part of the regular medical school curriculum, so do not add any additional time. We encourage PRIME-US students to participate in student organizations and activities, as well as noon electives.

The top priority for all PRIME-US students is medical school. If students are struggling academically, they will receive the support they need to succeed and will be excused from PRIME-US activities until improvement is demonstrated.

Q: Will PRIME-US separate me from my classmates?

A: Involvement in the PRIME-US program may distinguish you from your classmates on some occasions, but we are committed to finding the right balance between creating a special group of students interested in working with the urban underserved while at the same time ensuring that you are integrated into your medical school class (and that your peers have a chance to participate in some of our activities as well).

We have purposely scheduled some of our seminars in the evening so that all interested students can participate. We will work to create other opportunities for all UCSF and JMP students committed to working with urban underserved populations.

Q: What exactly does “urban” mean and why is PRIME-US focused only on the urban underserved?

A: Our definition of urban underserved is not limited to big cities like San Francisco or Los Angeles. PRIME-US students will get to know Fresno, a city in the Central Valley, and learn about the intersection between rural and urban communities and their health care needs. We are primarily focused on the urban underserved in the United States, but recognize that international interest and experience is of great value. UCSF has chosen to focus our PRIME program on the urban underserved because it is an area in which we have great expertise and resources.

Q: Can you recommend some resources or books to learn more about urban underserved populations?

A: Readings for our seminar series will include excerpts from several books (two are listed below) and various journal articles.

Medical Management of Vulnerable & Underserved Patients Principles, Practice, Population, King TE, Wheeler M, Fernandez A, Schillinger D, Bindman A, Grumbach G, Villela T, McGraw-Hill Medical McGraw-Hill Medical, 2006

Understanding Health Policy: A Clinical Approach. Third edition. By Thomas S. Bodenheimer and Kevin Grumbach, Lange Medical, McGraw-Hill, 2002.

Q: Are there scholarships for PRIME-US students?

A: We have raised scholarship money for PRIME-US at UCSF. This funding is reserved for students with financial need and will be distributed by the Office of Financial Aid. We also provide stipends for the summer orientation and small grants for community-based projects.

Q: What is the masters degree requirement and when do I have to complete it?

A: All PRIME programs (across the state) require a masters degree. At UCSF, the JMP students work on their masters degree during their first three years, while the SF based students will complete their degree between the third and fourth years (over 50% of UCSF students take time off to do masters degrees or other activities). UCSF students are not required to enroll in any specific degree program. There are local MPH and MPP programs at UC Berkeley and SF State, as well as other opportunities across the country. We are working on developing formal relationships with many of these programs and will help guide your decision-making process. If students choose to stay in the Bay Area, we will continue to have PRIME-US gatherings during the year.

Q: What if I don’t get into PRIME-US?

A: There are many students at UCSF and the JMP who are committed to improving the health and health care of underserved populations. PRIME-US is just one program that takes advantage of the many available resources and opportunities.