Questions and Answers

2010 Champions of Health Professions Diversity Award Honorees

Sandra P. Daley

Q: Who inspired you to do the work you do?

A: There are so many people. I think that my inspiration began with my mother who always said: “If you know what you want, you will get it, because you will make the choices you need to make to get it.” To help me learn what I wanted, my mother showed me how to make a treasure map. We cut out from magazines pictures of the things that I wanted in my life. We pasted these images onto the poster paper and then we put it in my closet. She said: “You don't have to share it with anyone.” I think she used this as a way to get me to close my closet door.

When I went away to the University of Albuquerque, I met Dr. Sun, a Chinese geneticist, who also inspired me. I worked as her lab assistant for four years. Over the summers, she would bring me to work with her at Caltech. She was a mentor to me. She took a personal interest in me and shared her work with me. That’s when I realized how valuable a good mentor can be and what students need in order to choose what they want so that they can achieve it.

Q: How do you know if your pipeline program is working?

A: I realized very early on that we needed to have a strong pipeline for students to get the skills they need to become health professionals. At UC San Diego, we had a lot of people who shared that goal, but not many resources to help our students achieve. My job as assistant dean of diversity and community partnerships at the school of medicine was to champion, advocate for and expand that initiative.

Our Health Careers Opportunity Program (HCOP) begins at National City Middle School and continues into Sweetwater Union High School, which is located in the border community of Chula Vista in San Diego County – one of the largest school districts in the nation. We then track the students, which is challenging because the outcome horizon for the seventh graders is another 10 years.

We have expanded the tracking into the community colleges. We now have 80 students in our community college’s one-month summer residential program. Over 90 percent of these students have transferred to the university level and most of them graduate. Of those who graduate, over 30 percent go into higher education to get advanced degrees.

Q: What is your message to policymakers about higher education?

A: Higher education is incredibly important to our society from so many vantage points, but most importantly, it makes sense economically. We need a taxpayer base. The more educated our citizens are, the higher the taxpaying base. The data show that for each and every student who attends and graduates from college with a bachelor’s degree, our state gets a return on its investment 10 years after the student graduates. Not only does the student pay back the state by the 10th year, they start contributing money above and beyond that because they’re paying taxes. Supporting higher education makes economic sense. If you want someone to pay for your social security when you are 62 years old, invest in higher education.

Ronald D. Garcia

Q: What led you to work toward increasing diversity in the health professions?

A: It was not a clear path. There were a lot of starts and stops. I was very close to my father and he set quite an example for everyone. He was a business agent for the Longshoremen’s Union in Southern California, and he was involved in the Longshoremen’s Union International Office in San Francisco. Harry Bridges, the long-time leader of the union, was a friend of the family. He would come to the house and, at a very young age, I learned about the challenges of organized labor. Each dinner discussion usually focused on public welfare and workers’ rights.

When I was a teenager, I couldn’t use the phone between 6 and 10 p.m. During the evenings, Longshoremen would call the house and my father would simply say, “Another beef on the docks.” He'd have to go back to Port Hueneme at all hours of the night. If someone was injured, my dad would refer them to a medical doctor. There were legal issues. He was really in touch with his community. I learned by example, by seeing what interested him and by his level of commitment. He never pushed me in any one direction. They say that as you get older you become more like your parents – and that can be a scary thing. Not for me. My father’s passion for his work really inspired me to pursue social justice. This is the path that I have followed throughout my life. I am proud to continue his work in my own way.

Q: What is the biggest challenge in your work?

A: Having heard many presentations over the years about health disparities, I think people get it. We all know there are problems. The challenge is what to do about them. Before we can find solutions, we need to address root issues. Health disparities emanate from inequities at the front end, including education, social class and ethnicity. To have good outcomes, you need to invest in and correct disparities at the front end.

The real issue is that many college and medical students come from underresourced high schools. These students come to my office and say: “I showed up, did my homework and got good grades in high school. Now I’m at Stanford and it’s different. I thought I was flying high and I’m realizing that I’m competing with students who have gone to private schools and had different homework assignments and different summer experiences.” Inequities in our educational system and the lack of resources and role models are the real challenges today. And, given our state’s budget crises, it seems to be getting worse.

Q: How is the “distance traveled” criteria used in your admissions process?

A: The concept of “distance traveled” in our admissions process would take into account the barriers and challenges students faced in their educational path. As an example, let’s compare two applicants. One has attended private schools throughout his life. He has a 3.8 GPA and never had to get a job to pay for his schooling. Both parents had college degrees. I don’t want to take anything away from that student. He’s worked hard. The other applicant has parents who came to this country from war-torn El Salvador. She has no other family here. The kid could be a monolingual Spanish speaker. Her parents are fieldworkers and did not have high school or college education. This second applicant came up through low-income, underresourced schools and worked. This is really quite common. This kid may wind up with a 3.3 GPA while working 10 hours a week and going to school.

The Association of American Medical Colleges is looking for new ways to evaluate medical school applications, and they’ve started to adopt a “holistic review” in order to take into account a person's entire background. We've been doing that at Stanford for the past 20 years, but we use the phrase “distance traveled.” We examine the context of a candidate’s achievement in terms of his or her economic, social, educational, geographical, racial, ethnic and linguistic background.

Jeffrey S. Oxendine

Q: What led you to become a health executive, educator and consultant?

A: My involvement and passion for this work started early on. My father is Native American, a Lumbee Indian from rural North Carolina. When he was growing up, he suffered a tremendous amount of discrimination and segregation. He attended only Indian schools and lived in communities with other Indians. His family was very poor. My father really felt a lot of pain from that. He was the only one of his 13 brothers and sisters who left. He forged his mother’s signature and joined the Air Force in search of better opportunity. My father instilled in me a sense of social justice. My mother was an elementary school teacher and she taught me the importance of education and the opportunity it provides.

I grew up in Fairfield, California, which is a very diverse town with people of many different socioeconomic and ethnic backgrounds. There were some tensions, but we all got along and it felt very natural. Many of the people I grew up with didn’t know what was possible for them. They were very smart, capable and caring, but there were few role models who had gone to college or who inspired them to believe that they could do anything. I was fortunate that my parents urged me to go to college. They were both the first in their families to go to college.

Q: What can be done to increase diversity in the health professions?

A: We need a bigger commitment from higher education and health employers to reach out to the emerging majority populations in our state and to let them know about the very rewarding opportunities in health careers. These institutions need to provide academic and career counseling, mentoring and other kinds of support to ensure that these students are successful.

It’s not rocket science. There are many leaders in the field who have amazing programs with students that have defied the odds and achieved tremendous success. The issue is that the programs are small-scale and there is no institutional commitment. These programs are dependent on the busy champions to sustain them and they’re not being replicated.

Collectively, we need to support the many programs out there working effectively in middle schools, high schools, community colleges and beyond to help students understand their career options, level the playing field and provide services along the way to make students successful.

Q: What are some of the benefits of diversity in the health professions?

A: Increasing diversity in the health professions matters because in order to meet our health and economic goals as a state and as a nation, we need to have a well-trained, diverse health workforce. We already have tremendous shortages in many of the health professions. The research shows that the people who serve our underserved and diverse communities are much more likely to be people who are from those communities or have similar racial and ethnic backgrounds. We must provide opportunities for people in our state to have meaningful careers and make a good living. We also need professionals who have the knowledge, skill and commitment to work in our underserved communities. California should be serving these communities because improving their health will impact the state’s long-term health and economic goals.