Preparing for change: the plan, the promise, and the parachute

The University of California's (UC's) medical education programs are on the brink of change. In January 2007, the UC system completed a multiyear health sciences planning effort that is the most comprehensive undertaken in decades. For medical student education, the plan calls for an approximately one-third increase in enrollment across the system -- from approximately 650 current medical school graduates per year to a projected 920 graduates annually by the year 2020. During the same period, California's population is expected to increase in size and diversity in ways unmatched by any other state in the nation. The plan calls for development of new programs that will increase enrollment in unique and unprecedented ways. The first phase of this growth is under way and is planned to continue through a series of programs that seek to address the needs of California's medically underserved communities. Areas of focus include rural health and telemedicine (Davis); the Spanish-speaking Latino community (Irvine); diverse, disadvantaged communities (Los Angeles); health disparities and health equity (San Diego); and the urban underserved (San Francisco and Berkeley). In November 2006, UC medical schools received $200 million in bond funding to support this growth and to create new telemedicine programs to increase access to services provided by faculty physicians. In the coming years, UC medical schools will face demographic and budgetary challenges that will require perseverance, creativity, and certain leaps of faith. Public expectations are high.