School of Medicine grad returns to the region that inspired her to become a doctor

(SACRAMENTO)

GREENFIELD, CA - Alejandra Beristain-Barajas grew up in Santa Cruz County, left for Harvard University and eventually found her way to the UC Davis School of Medicine.

Before graduating, she interviewed for residency training programs throughout California. But when it came time to rank her choices, she knew where she needed to be.

Close to home. At Natividad Medical Center in Salinas.

She wanted to serve patients whose lives and experiences felt deeply familiar to her.

Today, Beristain-Barajas is a primary care doctor at a busy community health clinic in Greenfield, a small Monterey County community about an hour south of where she was raised. Many of her patients are farmworkers or members of farmworker families.

Dr. Beristain-Barajas and Dr. Rangel are completing and expanding the circle by giving back to their communities and mentoring the next generation of doctors. It's good for the medical students, good for our clinic and good for our community." -Noah Hawthorne, chief medical officer at Mee Memorial Healthcare System

"I really love the patient population here," she said in an exam room at Albert and Donna Oliveira Clinic, where most patients speak Spanish or indigenous languages from Southern Mexico.

Beristain-Barajas is the kind of physician the UC Davis School of Medicine was designed to develop: one committed to rural and medically underserved communities that often face the greatest barriers to health care.

She is also a product of the School of Medicine's Rural-PRIME medical education program, which trains students how to care for patients in rural regions.

"Oftentimes, once people will go to college or medical school, they'll leave and won't go back to those rural areas," Beristain-Barajas said. "I felt like a mission or a pull to come back to this area."

From student to mentor

Alejandra Beristain-Barajas, third from right, with Rural-PRIME classmates at the School of Medicine's Induction Ceremony in 2016.

Now she's helping build that same pathway for others.

Beristain-Barajas and clinic colleague Francis Rangel-Ventura, also a UC Davis School of Medicine graduate, are leading the effort to reestablish their Greenfield clinic as a training site for medical students.

They hope the experience will expose future physicians to the rewards of practicing rural medicine more than 200 miles from Sacramento. At the same time, they want to inspire students to build careers in communities that face deep health disparities and vast shortages of primary care doctors.

"Dr. Beristain-Barajas and Dr. Rangel are completing and expanding the circle by giving back to their communities and mentoring the next generation of doctors," said Noah Hawthorne, chief medical officer at Mee Memorial Healthcare System.

"It's good for the medical students, good for our clinic and good for our community,"

UC Davis medical school graduates Francis Rangel-Ventura, left, and Alejandra Beristain-Barajas are leading efforts to train and mentor the next generation of physicians to serve rural populations at a community clinic in Greenfield.

A dream without a roadmap

Beristain-Barajas was born in Santa Cruz County, a coastline where foggy, cool air blankets the strawberry fields teeming across the region.

She spent her early years in a trailer, then moved to low-income apartments. Although she was self-motivated and dreamed of becoming a pediatrician, she didn't know the path to medical school.

Her parents, immigrants from Mexico, didn't know the path either: Her father toiled in construction, while her mother worked as a housekeeper.

But her mom encouraged her to apply to Harvard - and she got in.

It turned out to be an unexpected challenge that Beristain-Barajas was largely unprepared for.

"My mom had only a very limited formal education and my dad did not graduate from high school, so I didn't really have a roadmap for navigating higher education, networking, or the unwritten rules of a place like Harvard," Beristain-Barajas said.

She juggled school with campus jobs and extracurricular activities, such as directing the school's Ballet Folklorico troupe and assisting in a Boston Children's Hospital clinic.

Beristain-Barajas graduated with a degree in neurobiology.

Alejandra Beristain-Barajas and her mother Clara Barajas at medical school commencement, which was held online due to the COVID pandemic.

Taking her own advice

Despite earning a diploma from an elite university, she wasn't sure what she could, or should, do next.

So Beristain-Barajas went back home to Freedom, the tiny, unincorporated community bordering Watsonville and became a math tutor, then a charter school algebra teacher. She led parent meetings. She guided students with college applications. She thrived on pushing the sons and daughters of farmworkers to think big.

Then it hit her.

"Eventually," Beristain-Barajas said, "I realized I needed to take my own advice."

The thought of becoming a doctor finally moved to the forefront. "I had always been interested in medicine," she reflected, "but wasn't sure I could actually do it."

She completed post-baccalaureate science coursework offered by UC San Francisco and pursued her dream.

Oftentimes, once people will go to college or medical school, they'll leave and won't go back to those rural areas. I felt like a mission or a pull to come back to this area." - Alejandra Beristain-Barajas

Returning to the Central Coast

Four years after Harvard, she joined the UC Davis School of Medicine and its Rural-PRIME pathway, which placed her with patients near home. The experience eventually led her to the family medicine residency in Salinas.

"I saw the hospital, I saw the community, and I knew I wanted to be back here," she said.

Beristain-Barajas didn't think twice about her next move: joining the Greenfield clinic, which is part of the Monterey County-based Mee Memorial Healthcare system, where most patients are covered by Medi-Cal government insurance.

She's been there two years.

"I've found a lot of meaning in returning to the Central Coast and caring for families in a community where I feel the work is genuinely needed," Beristain-Barajas said.

"I like being here in Greenfield because I feel that I'm uniquely prepared to be working with this population because of my background," explained Beristain-Barajas, who grew up speaking Spanish.

A region with limited access to care

Monterey County may be well-known for its coastal scenery, tourist attractions and lettuce shipped around the globe. But it also has another distinction: a region where physicians are in short supply.

Alejandra Beristain-Barajas returned to southern Monterey County, about an hour from the rural community where she grew up, to practice family medicine, drawn in part by the area's large farmworker population and need for accessible health care.

In 2023, the county had 51 primary care physicians for every 100,000 residents, according to the California Health Care Foundation. Sacramento County, by comparison, had 69 per 100,000. San Francisco had 123 per 100,000.

In sheer numbers, Monterey County had just 221 primary care doctors, which is about 15% less than the level recommended by a federal advisory committee.

UC Davis notices those kinds of statistics.

"Primary care is the front door to our health system - primary care physicians provide the preventive care that helps people live longer, healthier lives," said Melody Tran-Reina, the UC Davis associate dean for workforce, pathways and collaboratives.

"When a community doesn't have enough of them, chronic conditions go untreated until they become emergencies, and patients end up in the nearest emergency room for care that could have been prevented," added Tran-Reina, an internal medicine physician who oversees Rural PRIME and other pathways.

As a land-grant university established to serve the public good, UC Davis is committed to making a difference in Monterey County and communities throughout Central and Northern California.

"The Central Coast grows much of the food that feeds California and the world," Tran-Reina said. "The people who do that work deserve the same access to care as anyone else, and we should do our part to keep their communities healthy."

UC Davis alumni help shape the next generation of doctors

A new medical school partnership to draw students from UC Santa Cruz - PRIME Central Coast - will soon establish training sites in medically underserved communities in and around Monterey, San Benito and Santa Cruz counties.

Evelin González, a Rural-PRIME classmate of Alejandra Beristain-Barajas and Frances Rangel-Ventura, trains UC Davis medical students during clinical rotations at Salud Para La Gente in Watsonville.

Among the family medicine locations is Salud Para La Gente in Watsonville, led by UC Davis alum Evelin González, a Rural-PRIME classmate of Beristain-Barajas and Rangel-Ventura.

"As a daughter of farmworkers and an immigrant myself, I have always felt a strong need to serve communities like this one - particularly monolingual Spanish-speaking patients, immigrants and farmworkers. I see many of my own family members in the patients I care for," González said.

"Having grown up in Mexico," she added, "I feel that I can better understand some of the challenges they face, and being able to communicate with them in their native language while also understanding some of their traditional healing practices is paramount to developing trust and a strong therapeutic partnership.

The chief medical officer at Salud Para La Gente is excited about the health center's new role with UC Davis and UC Santa Cruz.

"It's a challenge to recruit people to come here," said Devon Francis, who sometimes travels out of state in search of doctors to serve the Watsonville area. Francis is hopeful that the health center's new role with UC Davis and UC Santa Cruz may help address the workforce shortage.

"We've found we've been most successful when people have some connection to living or working in the area," she noted.

A full circle return

Back in Greenfield, Beristain-Barajas and Rangel-Ventura are preparing for the next students who will spend several weeks of their clinical rotations in rural healthcare.

It's a promising development for the health center and for the UC Davis School of Medicine.

The opportunity is personally rewarding for Beristain-Barajas.

" It feels very meaningful and full circle to be here," Beristain-Barajas said.

"I also take the responsibility of mentoring and training the next generation very seriously and hope that by rotating here they can see themselves in the role."