Kaiser Permanente Northern California, Oakland,
CA Health Equity and Disparities Track

Background: Kaiser Permanente Oakland serves an incredibly diverse population. Nationally, such diversity is usually matched by discrepancies in healthcare outcomes, but Kaiser Northern California is a significant exception to this rule, thereby providing a unique window to observe a model of healthcare delivery that can reduce or even eliminate disparities in healthcare outcomes in a diverse population. We developed a Health Equity and Disparities track within the Internal Medicine-Oakland residency program to give trainees the opportunity to examine Kaiser’s population-based healthcare delivery system alongside a community health model, positioning graduates of the track to understand varied health outcomes and actively engage in solutions to eliminate health disparities.

Methods: Our program expanded the number of ACGME-accredited internal medicine residency positions by 2 residents each training year over a 3-year period. The 3-year track consisted of 4 components: (1) longitudinal clinical experiences, (2) didactic experiences, (3) scholarly activities, and (4) community advocacy. Residents received in-depth patient care experience in Kaiser and non-Kaiser care models, learning the resources to study strategies for eliminating health disparities. We recruited a track program director and marketed the track externally through recruitment and a website.

Results: We projected 6 new residency positions between 2017–2020 and one new Community Medicine fellow or Health Equity and Disparities fellow to precept residents in the community setting. We had 252 applicants for the disparities track only and 1,155 applicants for the disparities track with one or more additional tracks. The track development increased communication between Kaiser and federally qualified health centers; demonstrated financial commitment by Kaiser leadership; and increased interest internally and externally from medical students, residents, and faculty, leading to discussions of track expansion in other residency programs and locations.

Conclusion: At full development (2020), 6 residents in collaboration with a community partner will provide healthcare to under/uninsured and underrepresented patients in the community. We aim to assess educational outcomes of this track and initiate similar programs in other residencies. We are committed to developing leaders and eliminating health disparities in the communities we serve.