California Initiative: Phase I

Goals and Objectives

The California Pipeline program ran from January 2002 to July 2007 and was an integral component of the national Pipeline initiative.  The California Endowment funded four dental schools (UCLA, USC, Loma Linda, and University of Pacific) and the Robert Wood Johnson Foundation one school (UCSF).  The primary goal of the Phase I Pipeline program was to reduce disparities in access to dental care.

The objectives were:
Have senior students and residents spend an average of 60 days in patient-centered community clinics providing care to underserved patients.  In this setting they are three to four times more productive than in dental school run clinics.  As a result, they treat many more underserved patients and gain more clinical experience;

Provide students and residents didactic courses and clinical experiences in cultural competency to prepare them to treat diverse patient populations.  The demographics of the U.S. population are changing rapidly and dentists need to effectively care for patients from other cultures;

Increase the number of underrepresented minority and low-income (URM/LI) students recruited into dental school.  A more diverse dental workforce is a critical component of any effort to reduce access disparities; and

Try to influence the establishment of state and federal health policies in order to sustain the Pipeline program.

A detailed description on how the California Pipeline program got started is presented in a Journal of Dental Education article 69(2): 232-238 2005.

Accomplishments

The major accomplishments of the Phase I California Pipeline project include:
All five California dental schools collaborated in the recruitment of URM/LI students and health policy initiatives and shared information and resources for the community-based dental education and cultural competency training components of the program.

Senior students and General and Pediatric Dentistry residents rotated to over 70 community health centers in the state, including many in rural areas.  The average number of days in community rotations was close to 60.  As a result, thousands of low-income, rural, and medically compromised patients received dental care.

The schools established a set of didactic courses in cultural competency that extended throughout all four years of the curriculum.  In addition, most schools provided cultural competency training to their faculties and staff.

At the start of the Phase 1 Pipeline program, California had the most diverse population in the nation but the lowest number of URM dental students.  Working collaboratively, the percentage of freshman URM students enrolled in California dental schools increased from five percent to 12 percent.

Several important investigations were undertaken of dental health policy issues in California: a) Stakeholder views on dental access disparities and the roles of schools, organized dentistry and state government in addressing these problems.  The results indicated that all stakeholders recognized the problems, but there was little consensus on what to do about them. b) A survey of the California dental safety net reported that many clinics were having difficulty recruiting dentists.  Most clinics were interested in developing partnerships with dental schools for senior student and resident rotations.