Home-grown health pros

South Texas prepares professionals to serve its own

He likes to say that he was the first medical resident to graduate from the Regional Academic Health Center in Harlingen.

Three other residents graduated alongside Nolan Perez, M.D., in that first class back in 2004, but he jokingly claims the distinction as the first to cross the stage.

Dr. Perez, who returned to Harlingen to open a gastroenterology practice after completing a fellowship at Wayne State University, might have been the first, but he’s hardly alone. A growing community of doctors in the Rio Grande Valley received training at the Long School of Medicine’s Regional Academic Health Center (RAHC).

One treats patients at Su Clinica Familiar, the largest community health care center in the Valley. Another helped fill a tremendous need for mental health professionals in Brownsville by becoming the city’s second full-time psychiatrist last fall. Of 10 hospitalists at Valley Baptist Medical Center in Harlingen, six came out of the RAHC’s residency program.

Nolan Perez, M.D.

“You know what you’re dealing with when you’re dealing with one of the graduates here,” Dr. Perez said. “You know that they’re at the cutting edge of evidence-based medicine. They’ve been well-trained, and there’s that camaraderie that you share.”

 

The RAHC is just one sign of The University of Texas Health Science Center at San Antonio’s commitment to training doctors and other health professionals who will serve communities along the U.S.-Mexico border. The Laredo Campus Extension is adding to the ranks of health professionals there, while the Med Ed Program encourages middle school, high school and college students in South Texas to pursue careers in the health sciences.

The professionals who come out of Health Science Center programs will be important to addressing disparities in border communities. In Texas, two-thirds of the population within 62 miles of the border lives in a primary care Health Professional Shortage Area (HPSA), according to a 2003 report by the federal Health Resources and Services Administration. That’s compared with a third of the statewide population.

“I have a firm belief that the way we help solve the health care problems in South Texas is by recruiting heavily there – and training there,” said J. Dennis Blessing, Ph.D., PA-C, chair of the Department of Physician Assistant Studies and associate dean for South Texas programs in the School of Health Professions. “And we do.”

 

The Regional Academic Health Center

“That’s a medical school campus right there.”

– Leonel Vela, M.D., M.P.H., RAHC regional dean

 

A native of Port Isabel, Dr. Perez always knew he wanted to return to the Rio Grande Valley, and he also knew that many doctors end up practicing where they train.

But he never thought it would be possible to complete any part of his training in the Valley until Mario Ramirez, M.D., the Health Science Center’s longtime vice president for South Texas and border initiatives, told him about the RAHC opening.

Dr. Perez initially had reservations about taking part in a brand-new residency program. But the more he learned about the RAHC, the better it sounded: “Everyone I talked to said what great support it was receiving from the state and the local community in Harlingen.”

Since it opened in the summer of 2002, the RAHC has housed a residency in internal medicine and educated third- and fourth-year medical students.

Leonel Vela, M.D., M.P.H., regional dean of the RAHC since its inception, said the Harlingen campus uses a community-based model and emphasizes the uniqueness of its academic setting. Students learn about environmental and public health, and about diseases that disproportionately affect the border region, including certain birth defects, diabetes and re-emerging infectious diseases rarely seen elsewhere in the United States.

Dr. Vela hopes seeing the campus will inspire younger students, who may someday practice medicine in the Valley: “You can point to the RAHC and say, ‘That’s a medical school campus right there.’ It motivates students in this medically underserved region to want to study medicine.”

Returning to the Valley appealed to James Castillo, M.D., who had lived there as a child. When it came time to apply for the match, he spotted the RAHC program on the Electronic Residency Application Service and went for it. His wife agreed to the move without ever having seen the Valley, aside from photos Dr. Castillo took during his interview.

By the time he finished his residency, neither wanted to leave. Dr. Castillo now directs the hospitalist program at Valley Baptist Medical Center and is on the RAHC faculty.

While he is part of a thriving medical community in Harlingen, Dr. Castillo sees a need for more doctors in the Valley.

“The thing about the Valley, it’s a lot of people, but it’s very spread out,” Dr. Castillo said. “So to say that there’s plenty of doctors in this one ZIP code is fine, but there’s not so much around. Everything’s close enough that you still have access to some big medical centers, but for primary care you don’t have that so much.”

There’s also a need for specialists, and RAHC alumni can be part of the solution. Dr. Perez, the gastroenterologist, is one example; another is Cesar H. García, M.D., a third-year resident at the RAHC. In July, Dr. García will begin a geriatric fellowship in San Antonio. Afterward, he is seriously considering working in the Valley.

“With the community here, I really feel like I’d be a good fit,” said Dr. García, who grew up in San Antonio. He attended the Health Science Center’s School of Medicine in San Antonio, and he first learned about the RAHC when he rotated there during his third- and fourth-year clerkships.

Dr. García does not see himself in private practice and instead plans to work in indigent care: “I feel like it’s my privilege. I’m looking forward to it.”

 

Laredo Campus Extension

“I’m from here, so I wanted to come back and contribute.”

– Irene Moreno, PA-C, physician assistant program alumna

 

The first building of the Laredo Campus Extension was dedicated in 2002. Since then, the campus has trained students in dentistry and other health professions including respiratory care, clinical laboratory science and physician assistant studies.

Dr. Blessing said the campus is a perfect complement to his P.A. program, whose mission is “to prepare primary health care providers who will contribute to the improvement of the mental, social, and physical well-being of the underserved and vulnerable people of South Texas.”

Those words resonated with Irene Moreno, PA-C, who completed the Health Science Center’s three-year Physician Assistant Studies Program and now works at Gateway Community Health Center in her hometown of Laredo: “When I saw the mission statement, right away I was like, ‘Oh my gosh – I have to get in!’”

She always intended to return to Laredo, so the P.A. program’s emphasis on South Texas made it a good fit for her. “I’m from here,” she says, “so I wanted to come back and contribute.”

But Moreno went through the program before it was offered at the Laredo campus. She did as many rotations as possible in Laredo, but her classes were in San Antonio.

Now six students from each class of 30 can complete the first and third years of the program in Laredo, coming to San Antonio for only two semesters. Moreno believes that will bring more Laredo natives into health professions.

Said Moreno: “I’ve heard more and more people wanting to go into the P.A. program now.”

 

Med Ed Program

“It opens possibilities, and it opens your mind.”

– Andrea García, School of Medicine second-year student

 

When the Med Ed Program was just starting out, Andrea García became one of its earliest members.

She had known that she wanted to be a doctor long before she moved from Puebla, Mexico, to Laredo for her last two years of high school. But the Med Ed Program showed her how to reach her goal. “I think that really helped me,” García said, “because right when I went into undergrad in Corpus Christi, I already had an idea of what I needed to do.”

Through the program, she volunteered at Doctors Hospital of Laredo and visited the Health Science Center in San Antonio. “It opens possibilities,” she said, “and it opens your mind.”

García finished her undergraduate studies in three years and is now a second-year medical student at the Health Science Center at San Antonio. She’s thinking about becoming a pediatric endocrinologist, and she sees opportunities for herself in Laredo.

The Med Ed Program serves about 1,400 students in Laredo and the Valley. It recruits South Texas students with an interest in the health sciences and provides advice and encouragement as they make their way toward graduate or professional programs.

“Itmaynot be that all of those kids end up at the Health Science Center,” said David Jones, Ph.D., associate dean for admissions in the Long School of Medicine, which sponsors the Med Ed Program. “But what is important is that they’re mentored and they’re encouraged in their interests.”

Med Ed works closely with teachers and parents to create a supportive environment for the students. The primary goal is student success, but Dr. Jones also hopes that these students will someday be the ones providing health care in their hometowns.

“I think it demonstrates the commitment of the Health Science Center to the success of students from South Texas,” Dr. Jones said. “This is a substantial financial commitment to student success in the Valley and Laredo. It’s a great credit to the institution to continue to support it in this fashion.”