Dr. Asma Jafri, family physician and chair of the Department of Family Medicine at UC Riverside: “My underlying mission was to take care of patients who otherwise wouldn’t be cared for." Credit: UCR Health

When the UC Riverside School of Medicine opened its doors 10 years ago, its mission was two-fold: to give more opportunities to students in the Inland Empire, and to increase the region’s healthcare workforce. The school’s residency program started soon after, affiliating with local hospitals including Desert Regional Medical Center and Eisenhower Medical Center.

The programs have seen success, pulling some locals into the field and convincing some residents to stay beyond their programs—but this isn’t enough to meaningfully address the area’s physician shortage.

It can take a decade or longer to train a new physician, and despite increased enrollment in medical schools, there’s a serious supply-and-demand issue, especially in our region.

“It’s kind of the perfect storm, where we have this big bubble population (baby boomers) that is reaching retirement age,” said Dr. Alan Williamson, chief medical officer at Eisenhower Health.

With the aging population, he said, comes more specialized care needs. One other problem: A lot of physicians who are baby boomers are retiring. The COVID-19 pandemic also led many doctors to retire earlier than they’d initially planned.

Nearly 45% of residents in the Coachella Valley are in their 60s or older, according to a report released Feb. 28 by Health Assessment and Research for Communities (HARC), a nonprofit based in Palm Desert.

So, as Williamson put it: The numbers don’t match.

“We have more patients, and we have fewer providers,” he said.

In its latest report, HARC found that the No. 1 barrier to care in the Coachella Valley is the length of time it takes to get an appointment. Some residents wait months to be seen for annual exams and screenings, as well as for specialty care—if they can get an appointment at all.

I’ve had this experience. I moved from the Bay Area to the desert in June 2020, but it took me until December 2022 to find a primary care physician who met my minimal requirements: 1) take my insurance; 2) be accepting new patients; and 3) be somewhat responsive.

Before making the initial appointment, I was warned that I wouldn’t ever see the physician who was technically my doctor; instead, I’d be seeing residents he was overseeing. Desperate for an appointment, I took what they had—and I’m glad I did. I went in with a list of things to go over, and the resident took his time making sure my questions were answered. I didn’t feel rushed, judged or shamed. When we went over my lab results a few weeks later, he answered all my questions. (I’m a journalist, so I tend to ask a lot of questions.)

Eisenhower currently has 120 residents training in internal medicine, family medicine and emergency medicine. The hope is that many of these residents will stay on to work at Eisenhower, or at least stay in the Coachella Valley.

It wasn’t until I started this piece that I realized he is part of the Desert Regional Family Medicine Residency Program. I scrolled through the list of current residents, and most are from California, if not the Coachella Valley, although Bermuda Dunes, Palm Desert and La Quinta are represented. The residents are mostly women and/or people of color. All this is promising.

Eisenhower currently has 120 residents training in internal medicine, family medicine and emergency medicine. The hope is that many of these residents will stay on to work at Eisenhower, or at least stay in the Coachella Valley.

“Over 25% of our residents do stay here at Eisenhower,” Williamson said. That doesn’t count residents who find work elsewhere in the valley or those who return later in their careers.

Residents often end up staying in the area where their training was completed, because they’ve already spent years building a life in the area, said Dr. Asma Jafri, family physician and chair of the Department of Family Medicine at UC Riverside.

Alternatively, they may end up close to where they went to high school or move to be with a partner, Jafri said. Women are more likely to stay closer to home than men, and people with minority backgrounds are more likely to work with underserved communities. This is why Jafri, who oversees the residency program, went into medicine in the first place—to work with underserved populations.

“My underlying mission was to take care of patients who otherwise wouldn’t be cared for,” Jafri said.

In order to meet its goals, the UC Riverside Medical School considers applicants’ ties to the region and diversity, Jafri said. During the 2021-2022 academic year, the school had 328 medical students, and 46% of them had ties to the Inland Empire; 37% were underrepresented in medicine; and 31% were the first in their families to finish college.

The school had 104 students completing their residencies last year: 24 in family medicine, 50 in internal medicine, and 30 in psychiatry, according to UC Riverside data. Another 27 completed fellowships in internal medicine, psychiatry and Ob/Gyn care.

Nearly 40% of this past year’s graduates are staying in the area for their residencies, with 80% remaining in Southern California.

California as a whole has fewer physicians than it should for its population size, and the Inland Empire has had some of the worst shortages in the state. Getting local young people interested in going into healthcare is a great long-term solution, and the Future Physician Leaders program at UC Riverside offers mentorship for young people who may be interested in entering the field. Additionally, career pathways at local high schools, such as topic-specific academies, help introduce students to the idea of healthcare as a career.

But more could be done to attract new and experienced physicians to the area.

Jafri said there are loan-forgiveness and grant programs for those who practice in certain fields (including primary care) or in rural areas. These incentives are necessary, because young doctors are more inclined to go where the majority of the population is—and where the money is—along the coast and in major metropolitan areas.

However, lifestyle is also an important factor when residents are considering where to practice. Less traffic and the lower cost of housing are two pros to living outside of a city like Los Angeles. Practicing outside of a large city may have other benefits, too. A pilot study out of South Dakota indicated that burnout may be less likely for family physicians practicing in rural areas than those practicing in larger metro areas.

Williamson credits Eisenhower’s higher-than-average resident retention rate, in part, to this.

“I think they enjoy working here. They appreciate it’s a quality institution; they’ve got a lot of great support from their faculty who are going to become, now, their colleagues,” Williamson said.

“And they’ve gotten used to the Coachella Valley lifestyle, which for many of us is very appealing—as long as we’re not talking about August and September.”

Maria Sestito is an award-winning journalist and writer living in the Coachella Valley. Her work has appeared in publications across the country, including USA Today, and she previously covered health...

2 replies on “Civic Solutions: Medical Residency Programs Are Bringing Doctors to the Coachella Valley—but More Needs to Be Done”

  1. I too have been using the Eisenhower Cathedral City Residency Program since suffering a stroke in late 2019. I rate my visits and the care I’ve been receiving at 5 stars, a 10 out of 10, and the absolute best and most attentive. Residents provide extremely through exams, spend more time and answer all my questions. I’ve noticed my resident taking her/his notes for review and approval by the supervising physician. My resident then returns and finishes up with me. In a few instances the supervising physician may also enter the room and perform a confirming diagnosis. Since residents are not limited in the time they spend with their patient, I believe that to be a significant factor that allows them to perform their exemplary service. I am assigned a resident who becomes my primary until they graduate from the program. Afterwards I’ll be assigned to a newer resident. My experiences with successive residents have all been unquestionably excellent.

  2. It’s important to recognize that many of the Eisenhower residents are graduates of off-shore medical schools. Students from the US often go to Caribbean schools (Ross, St. Georges, etc.) because they do not have the grades or test scores to enter mainstream schools. The bottom-of-the-class doctors can put patients at risk, as I found through painful experience. It is worth checking to see where your doctor was trained. While some Caribbean grads are good doctors, medicine is one field where academic ranking truly makes a difference.

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