It seems that everywhere I go these days, doctors and students alike are constantly asking me about the proposed medical school at University of California, Riverside. "When will it be open? How big will the class size be? Will there be a new university hospital?" These and other questions are on the minds of many members of the health care community, both within the Inland Empire and throughout California.

I met with Phyllis Guze, MD, executive director for the UCR School of Medicine Planning and UCLA professor of medicine, to hopefully answer some of these questions. First, it should be known that the school is not an absolute certainty at this point. The curriculum has been proposed, and a great deal of work has been done on the planning side of things, but the budget has yet to be approved by Governor Arnold Schwarzenegger and the state legislature. In order for this to occur, the medical school needs support from the local community, as well as from individuals involved with healthcare. With a $14 billion state budget deficit projected for 2008, UCR will need all the support it can get for this new medical school.

There are currently seven committees working out the final details of the project, each of which is composed of administration, faculty, physicians, and one medical student. The committees each focus on a particular aspect of development. In addition to an executive and leadership council, there are six committees on: academics; administration, finance and student affairs; capital planning and facilities; clinical and clerkship development; graduate medical education; and research enterprise.

Since research is still underway, many of the details concerning the medical school are not available, but the details that have been disclosed promise some exciting opportunities for students, physicians and the community. First of all, the initial class size is proposed to be 50 students in 2012, with the intent to expand to about 100 students as instructional buildings are constructed.
The admissions plan is to keep 24 medical school seats reserved for UCR graduates, with the remaining seats open to all applicants. No changes are proposed for the first two years' curriculum. Students will spend those two years in classrooms and laboratories, with brief excursions to the clinical environment for preceptor visits, where they will learn what is necessary for successful clinical rotations. In addition to lectures, doctoring and case-based learning will continue into the third year.

There are no plans for a university hospital at this time. Clinical rotations in years three and four will take place in local community hospitals. Students will have the opportunity to experience one-on-one rotations with community physicians. At the beginning of the third year, students will be assigned to a primary care provider with whom they will spend their first two weeks. During this time, they will develop a panel of patients whose care they will follow closely for the entire year.

After these first two weeks, students will spend half a day every week with their patient panel, and throughout the entire year they will be there when any patient on the panel is seen by the physician. When the physician is paged concerning these patients, the student will be paged as well, be it day or night--the needs of these patients will take precedence over all other school obligations. This exposes students to longitudinal patient care, allowing them to track the course of diseases, to see how effective treatment is over a longer period of time, and to build more meaningful relationships with the patients.

Students will also be assigned a community service project for the third and fourth years, with the fourth-year project focusing on a clinical question or problem. A rotation in emergency medicine will also be required, in order to expose students to diverse clinical situations requiring quick decisions.

Also during the fourth year, students will be grouped with similarly inclined peers into one of four focused academies: primary care; anatomy-based care; behavioral health; and research. There are also plans to develop residency programs and to integrate research endeavors with the university.

What does this mean for Riverside? The community-based curriculum, as well as local residency programs, will increase the number of physicians remaining in the area after graduation. The expansion of current medical facilities to develop a teaching environment, coupled with increased physician retention in the Inland Empire, will lead to greater access and quality of care for all members of this currently underserved community.

Author Tod A. Aust is a second-year UCR medical student, the UCR delegate to the California Medical Association and vice chair of legislative affairs for the CMA Medical Student Section.