Health Equity & Disparities Track | Kaiser Permanente Undergraduate & Graduate Medical Education Northern California

Do you have a unique passion in the care of diverse populations and want to be part of our mission of eliminating disparities in health outcomes and achieving health equity? Read on!

Oakland serves incredibly diverse populations, whether defined by socioeconomic status, social determinants of health, race, or ethnicity. You can be part of the tradition of the first Kaiser medical center that offered dedicated clinics in HIV care (in the 1980s) and in the care of LGBTQ individuals. You could say ensuring the best possible health outcomes for individuals of all backgrounds is in our DNA.

Nationally, such diversity is usually matched by similar discrepancies in healthcare outcomes. Kaiser Northern California has been shown to be a significant exception to this rule, thereby providing you a unique window to train in a model of healthcare delivery that can reduce or even eliminate disparities in healthcare outcomes within a diverse population. During your training, you will have the opportunity to spend time at both our Oakland and Richmond Kaiser Permanente Medical centers with extremely diverse communities at both sites. Our Richmond center is the only hospital in West Contra Costa County, providing a unique experience of serving both Kaiser Permanente members and others who may not receive routine care.

The Health Equity and Disparities track will allow you opportunities to examine the Kaiser model alongside a community health model and will position you to be leaders in eliminating healthcare disparities. As a Health Equities and Disparities resident, you will have continuity clinics both within the Kaiser Permanente system and in the community at a safety-net clinic.

National Resident Matching Program (NRMP) Code: 1042140M0

Residents interested in both the Health Equity and Disparities and Categorical IM tracks at KP Oakland should know that these programs have unique NRMP code numbers and are separately matched programs.

Clinical Experience: You will have the unique opportunity to manage patients longitudinally in a Kaiser Oakland adult medicine clinic and in a community partner clinic along with satisfying the core requirements of an internal medicine residency
Scholarly Activity: You will engage in scholarly projects mentored by Kaiser Division of Research investigators who specialize in Health Care Delivery and Policy.
Community Advocacy & Health Policy: By being embedded in community sites, you will help build meaningful and collaborative partnerships to support our surrounding community organizations in Oakland and the greater East Bay. You may also take part in a fully funded, special 2-week Health Policy elective, led by Kaiser in partnership with policy experts from local county and state departments of public health.
Health Equity Training: In addition to our Academic Half Day Curriculum and other noon conferences and Grand Rounds, our Disparities track residents have dedicated time for exploring topics focused on eliminating health disparities by focusing on the barriers our communities are facing and the many things outside of the walls of our healthcare systems affecting the health of our communities.

I chose the Disparities & Health Equity Track because I wanted to continue my work in caring and advocating for diverse populations in various community settings. I wanted to be intentional during my residency to explore and better understand patients’ perspectives on how they receive care within and outside of the Kaiser system in order to identify ways to eliminate health disparities at an individual and organizational level. I learned so much from my patients and colleagues having maintained my own primary care panel at a FQHC as well as at Kaiser, and I hope to use these experiences to continue to advocate for patients as a geriatrician to promote health equity in my daily practice.

Angelin Cheng, MD, Geriatric Fellowship, University of California San Francisco

The Health Equities and Disparities Track provided me an extremely unique experience to deepen my passion for eliminating health disparities through an array of contrasting clinical experiences. From partnering in the care of patients at San Quentin State Prison, to maintaining a secondary primary care panel at a safety net clinic in East Oakland, to cultivating my interest in immigrant health at the Asian Health Services clinic, the Disparities Track has provided me a lens through which I can focus my clinical and research goals as an Endocrine Fellow and beyond.

Kristine Gu, MD, MPH; Endocrinology Fellow, Massachusetts General Hospital

I was very intentional about what I was looking for in my residency training. This included working in a diverse patient population where I could also utilize my Spanish and being able to engage and partner with the community I serve throughout my three years of training. I also wanted excellent inpatient and outpatient training within a healthcare system that I could support. Kaiser Permanente Oakland was the only program that allowed me to work in such a great system but still have the duality of being in the community through my outpatient community health continuity clinic and my Kaiser Permanente continuity clinic. It was exactly what I was looking for and I’m thrilled to be part of this great opportunity!

Jessica Himmelstein, MD, MPH; General Medicine and Primary Care Fellow, Cambridge Hospital, Harvard Medical School

When it came to choosing a residency program, the health disparities track at Kaiser Oakland was exactly the place I wanted to train! Throughout my undergraduate experiences and most recently in medical school, I gravitated towards efforts in working and bridging the gap for our underserved urban neighborhoods. I learned early on that in order to make purposeful change, gaining trust and engaging local members in the decision-making process is key to successfully help communities overcome barriers in healthcare access. This program allows me to grow, learn, and be able to practice culture humility beyond the hospital walls. With Kaiser Oakland’s incredibly diverse patient population, I am excited that this track will provide me with the skill set needed to reach marginalized groups unable to receive care in this great time of need.

Karina Chavez, MD; Primary Care Physician, Kaiser Permanente Pinole

Elective Opportunities for Residents in the Health Equity and Disparities Track

Our flexible program encourages you to bring your unique background, perspective, and passion to create an individualized schedule of experiences to meet your goals. A partial list of electives includes:

African American Health

Rotation in our Specialty Blood Pressure Clinic (founded by Dr. Nailah Thompson), focused on hypertension in African American Patients.
Teaching African American patients during classes during our group visits for hypertension and Diabetes.

Latino Health

Rotation in La Salud en Español (on-campus clinic at Kaiser Oakland)
Rotations at a federally qualified Latino health center

Caring for patients with HIV

Work in a multi-disciplinary team in the HIV clinic at Kaiser Oakland and in community HIV clinics

LGBTQ Health

Work in a multi-disciplinary team in the LGBTQ clinic at Kaiser Oakland

Caring for Native American communities

Rotations at our community partner, Native American Health Center

Social Medicine

Develop longitudinal projects under the guidance from Kaiser Permanente Community Health team members who lead this work in our communities and with our partner community organizations. Projects can be undertaken in one of these four areas:

Social Care: the public health impact of policy decisions related to social determinants of health
Housing and Health: the public health impact at the intersection of homelessness, health and equity.
Economic Opportunity and Health: the public health intersectionality of poverty, racial equity, and health.
Climate Change, Health, and Equity: the impact of climate change on public health and health equity.

Health Policy Elective

The Resident Elective in Health Policy Course is led by experts from the California State and County Departments of Public Health alongside Kaiser Permanente public health experts. This elective provides an immersive exposure to the “macro” structure of Public Health ad also allows the opportunity to apply policy analysis to real-world challenges by completing a mentored project in health policy. Past residents on this elective have had opportunities to witness policymaking first-hand, through trips to state and local health policy sites (including participation in advocacy at the State Capitol).

See comments below from residents who have experienced this elective.

Residents visiting the State Capitol during the Health Policy Elective

This elective is a wonderful opportunity for residents with an interest in health policy. Through a variety of seminars and site visits, I learned so much about current health policy issues that are particularly important for residents.

Stephanie Kim, MD

The Health policy elective was an amazing collaboration through GW and Kaiser Permanente California. It reminded me why I wanted to be a doctor in the first place. The 3 weeks brought together the experience and connections from the GW health policy faculty and the on the ground examples from physicians working in California as well as across the country. It was inspiring to see the variety of careers physicians had in health policy, from speaking with the founders of primary care progress to visiting shelters and safe spaces for foster children in south LA.

Somalee Banerjee, MD, 4th Year Combined Master of Public Health/Internal Medicine Resident

The Resident Elective in Health Policy (REHP) was a career changing experience for me. During the two weeks, we had the incredible opportunity to hear presentations from the leaders of health policy; to visit sites around the city where there were actively working on improving health conditions for a variety of communities including the LGBTQ, the homeless, the recently incarcerated, the gang members, the undocumented and to learn from recent graduates in different specialties about how they are involved in public health, health policy, and health disparity work. Prior to attending the REHP, I had been interested in health policy; for example, I was a member of the Physicians for a National Health Program (PNHP) in New York. Health disparity and injustice are subjects that I wanted to incorporate into my career as a physician and the REHP provided a foundation to do so, by enlightening me about the current landscape, by providing mentors and networking opportunities, and by changing my paradigm. Fighting against disparity and injustice is an ongoing struggle and my paradigm has shifted from only focusing on activism on the ground to incorporating activism into projects and presentations which may lead to change in policies and, hopefully, equity. There exists a passionate group within the medical community who is dedicated to health equity, and the REHP was the map that helped me navigate towards that group.

Yalda Shahram, MD

Global Health Disparities

You can learn key aspects about the unique challenges in eliminating disparities globally. A variety of international experiences are available through Kaiser Permanente Global Health Programs

Recent Publications focusing on health equity and disparities by KP Oakland Residents

The scholarly publications within the Health Equity and Disparities Track results in cross-collaboration across all IM program tracks and informs our endeavors to focus on equity and eliminate disparities.

Wick JM, Pelliccione A, Lee-Rodriguez C, Tran N, McCleskey PE, Nichol A. Skarbinski J. An atypical presentation of mpox transmitted between transgender males through oral sex. Sexually Transmitted Diseases ():10.1097/OLQ.0000000000001831, May 12, 2023. | DOI: 10.1097/OLQ.0000000000001831

Nwosu UA, Darbinian JA, Chen KK, Zeng B, Arzumanyan H, Lo JC, Zheng S. Prevalence of albuminuria among adults with diabetes and preserved estimated glomerular filtration rate by race and ethnicity. Diabetes Care. 2023 Feb 6;dc221871. PMID: 36740980.

Oh DHW, Conell C, Lyon L, Ramalingam ND, Virk L, Gonzalez R. The Association of Chinese Ethnicity and Language Preference with Advance Directive Completion Among Older Patients in an Integrated Health System. J Gen Intern Med. 2022 Nov 10. doi: 10.1007/s11606-022-07911-9. Epub ahead of print. PMID: 36357725

Vicks W, Lo J, Guo L, Rana JS, Zhang S, Ramalingam N, Gordon N. Prevalence of prediabetes and diabetes vary by ethnicity among U.S. Asian adults at healthy weight, overweight, and obesity ranges: an electronic health record study. BMC Public Health. 2022 Oct 22;22(1):1954. PMID: 36273116

Himmelstein J, Lyon L, Gong C, Conell C, Ramalingam N, Chavez K, Virk L, Gonzalez R. Advance Directive completion among Black adults within a community-based integrated health care system. Perm J. 2022 Aug 11;1-5

Gu KD, Ettinger B, Grimsrud CD, Lo JC. Progression of atypical femur stress fracture after discontinuation of bisphosphonate therapy. Osteoporos Int. 2021 Oct;32(10):2119-2123.

Gong C, Dyer W, Yassin M, Neugebauer R, Karter AJ, Schmittdiel JA. The effect of mail order pharmacy outreach on older patients with diabetes. J Am Geriatr Soc. 2021 Jul;69(7):2028-2030

Gong C, Heins CA. Discovering and Reflecting on Bias: A Discussion about Challenges and Benefits of Culturally Centered Patient Care with Women Physicians of the East Bay. Perm J. 2020 Sep;24:1-5

Lee DR, Chavez K. More Than Words: Reflections to Build Resilience during the COVID-19 Pandemic. Perm J. 2020;24:20.149

Recent Recognition/Awards received by KP Oakland Health Equity and Disparities Track Residents

Jenna Wick served as Guest Editor for a 2023 Special Collection of The Permanente Journal focused on Social Determinants of Health (The Impact of Social Determinants of Health and Interventions to Improve Health Equity) https://www.thepermanentejournal.org/social-determinants-of-health

Tanya Selvam won 1^st Place for the Epidemiology Category at the 2023 American Geriatric Society for her research abstract entitled “Rheumatoid Arthritis Prevalence in an Ethnically Diverse Population of Older U.S. Women.”

Nicholas Tom won 2^nd Place for Research at the 2022 Northern California Chapter of American College of Physicians Meeting Poster Competition.

Angelin Cheng won 1st Placefor Resident Research at the 2022 Annual Meeting of the American Geriatrics Society in Orlando, Florida for her abstract entitled: “Racial/Ethnic Differences in Social Health of Older Adults in a Northern California Healthcare System.”

Chelsea Gong received the Community Advocacy Awardfor her abstract entitled: “Advance Directive Completion Rates Among African American Patients within an Integrated Health Care System “ at the 5th Annual EBY Academy of Medical Educators Research Symposium, May 7, 2021.

Jessica Himmelstein received a 2020 NIDDK/NIH travel award to participate in the NIDDK workshop and 2020 National Hispanic Medical Association (NHMA) Conference (meeting deferred due to the COVID-19 pandemic).

Chelsea Gong’s abstract to the 2020 American Geriatrics Society was selected for the Presidential Poster session and a travel stipend. Her poster was titled: Age matters! Effect of pharmacy outreach in older patients (meeting canceled due to the pandemic).

Where our Graduates are Headed

Angelin Cheng, MD is completing a Geriatric Fellowship at University of California San Francisco.

Karina Chavez, MD, is a primary care provider at Kaiser Permanente Pinole Medical Center.

Jenna Wick, MD, is a fellow in Infectious Diseases at Stanford.

Nicholas Tom, MD, is a fellow in Hospice & Palliative Medicine at UC San Diego

Jessica Himmelstein, MD, MPH, completed a two-year Harvard Medical School Fellowship in General Medicine and Primary Care at Cambridge Hospital (Boston, MA) then returned to her home state of Suth Carolina where she works as a Primary care provider at a FQHC.

Chelsea Gong, MD, completed a Geriatrics Fellowship at the University of California Los Angeles and is now a faculty Geriatrician at UCDSF-Fresno.

Kristine Gu, MD, MPH, is an Endocrinology Fellow at Massachusetts General Hospital.

Tanya Selvam, MD, is a fellow in Rheumatology at Cedras-Sinai.

FAQ

How does the Health Equity & Disparities track differ from the IM/MPH track at Kaiser Oakland ?

If you are interested in in-depth training in social justice and in eliminating disparities in health care you should consider the IM/MPH or the Health Equity & Disparities tracks. Both tracks have separate NRMP codes and it is not uncommon to apply to either (or both) of these tracks in addition to applying to the categorical program. Both tracks are designed to create in-depth experiences for residents interested in careers in Public Health or Community Health. As such the tracks share common aspects, but also differ in some ways:

The IM/MPH track extends training by a year so residents can obtain their MPH degree from UC Berkeley in their fourth year while still being fully supported and funded by Kaiser Permanente. In this track, you will gain epidemiologic research skills in a mentored setting, obtain an MPH degree from UC Berkeley, and use your elective time during residency and the MPH year to tailor your public health experiences to meet your unique career interests, whether it be public or global health, leadership, clinical practice in diverse settings, academic medicine, or fellowship.
The IM Health Equity & Disparities track is a three-year program in which residents spend over a third of their residency in underserved community settings, truly experiencing clinical practices at Kaiser and in several FQHCs in the East Bay. As a Health Equity & Disparities resident, you will learn the intricacies of different systems of care delivery by serving as the primary care physician for longitudinal panels of patients at both Kaiser and at our community partner, Lifelong Medical Care, an FQHC in Oakland. Residents in the Health Equity & Disparities track also have unique access to community rotations such as San Quentin Prison, Native American Health Center, La Clinica de la Raza, Asian Health Services, West Oakland Health Center, and other FQHCs. While Categorical and IM/MPH residents have access to some community rotations, the extent of involvement and the capability of serving as a primary care provider in the community are unique aspects of the Health Equity & Disparities track In this track, if you are interested in scholarly activity you will work with research mentors at the Kaiser Permanente Northern California Division of Research, including those whose research portfolio focuses on addressing health disparities. You will have dedicated mentoring by faculty who are passionate about diversity and eliminating disparities and who are engaged in community advocacy and policy initiatives.

How does the schedule of the Health Equity & Disparities track differ from that of the traditional categorical residents?

As a Health Equity and Disparities track resident, you will be fully integrated into the residency program alongside your peers in the categorical, IM/MPH, and preliminary year tracks. Like the categorical residents, Health Equity & Disparities residents will fulfill all of the ACGME and ABIM requirements, including wards, ICU, and subspecialties. In addition, you will have an increased focus on Community Medicine and will spend over a third of your residency time in community sites. Thus, unlike categorical residents, Health Equity & Disparities Residents:

will follow panels of patients longitudinally at both an FQHC community site and at Kaiser Oakland and will be well-versed in the intricacies of providing medical care in various health care systems
will spend more time in community sites
will be able to select from a variety of unique community-based elective experiences tailored to their interests.

Residents in the Health Equity and Disparities track who are interested in research will be paired with research mentors from the Kaiser Division of Research Health Care Disparities branch.

Typical schedule of a Health Equity and Disparities track resident:

Is there a separate application process for the Health Equity and Disparities track?

The ERAS application is the same for our Categorical and Health Equity and Disparities track. HOWEVER, when you create your Rank List in NRMP, the Health Equity and Disparities track has a separate National Resident Matching (NRMP) code: 1042140M0.

If I am interested in the Health Equity and Disparities track, do I need to apply to both the categorical internal medicine residency and to the Health Equity and Disparities track?

Applicants to the Health Equity & Disparities track are encouraged to apply to both the Health Equity and Disparities track and the Categorical internal medicine track. Be aware that the Health Equity and Disparities track and the Categorical tracks have separate NRMP codes.

Some of the opportunities available in the Health Equity and Disparities track are also available to categorical residents as an elective. However, categorical residents do not follow a longitudinal panel of patients at a community site, do not have access to some community sites, and the overall amount of time that Categoricals may spend in community sites is much less than that of the Health Equity & Disparities track residents (who spend over a third of their training in community settings).

Who are the mentors for residents in the Health Equity & Disparities track?

In addition to mentoring by the faculty and Program Directors in the Internal Medicine Residency program all residents in the Health Equity and Disparities track will also establish additional mentors tailored to their specific research and program interests. All residents will also have as mentors Kaiser Division of Research investigators who specialize in Healthcare Disparities.

Which community sites are Kaiser Oakland partnered with?

The residency program at Kaiser Oakland has established several community partnerships, including affiliations with:
LifeLong Medical Care
La Clinica de la Raza
Native American Health Center
West Oakland Health Center
Asian Health Services
San Quentin prison
The Order of Malta Clinic
Tri-City Health Center

Can I be in the Disparities track if I’m not pursuing Primary Care?

Yes! We strongly believe that training in health equity and disparities and training in a wide range of clinical environments is important regardless of which field of medicine you are in.

Can I pursue Fellowship if I’m in the Disparities track?

Yes! In fact, graduates of the track have gone on to fellowship in Endocrinology (at Mass General- Harvard), Geriatrics (at UCLA), and Rheumatology (at Cedars-Sinai). In the PGY2 and PGY3 years in particular, we work with you to tailor your curriculum to meet your career passions- for example, we arranged for a longitudinal Friday Rheumatology clinic for one of our residents interested in pursuing Rheumatology

Will I get less exposure to certain subspecialties if I’m in the Disparities track?

No. As part of the disparities track, your schedule will include the same subspecialty rotations as the categorical residents. The disparities track fulfills all ACGME requirements for Internal Medicine residency. If there are additional subspecialties you are interested in exploring, or are interested in spending more time in a particular subspecialty, we can arrange for that in your PGY2 and PGY3 years.

Medical Student Rotation – Diversity Scholarships

To promote our Medical Center’s mission to enhance diversity and to help to defray the costs of housing, airfare, and other expenses, Kaiser Oakland is offering scholarships of up to $2000 to senior medical students wishing to pursue fourth year rotations in internal medicine at our medical campus. Recipients will be selected based on their record of promoting diversity and inclusion. More information can be found on our medical student rotation page or applications can contact our Student Programs Coordinator, Rhonda Hall, for more information and for the brief application at: Rhondalyn.R.Hall@kp.org

Internal Medicine Oakland - Health Equity & Disparities Track

Internal Medicine Oakland