UCSF Fresno's Katherine Flores (left and above right, with students) started Doctors Academy at Fresno's Sunnyside High School a decade ago.

Raised by her migrant farmworker grandparents, Fresno native Katherine Flores worked in the fields herself as a youth, picking apricots, pears and plums.

The first in her family to attend college, she became a doctor and now her hometown community is reaping the fruits of her labor.

Flores, a UCSF assistant clinical professor and director of UCSF Fresno's Latino Center for Medical Education and Research, started the Doctors Academy in 1999 at Sunnyside High School. The innovative, University of California-sponsored program prepares disadvantaged students for college and for health science careers.

The Doctors Academy now includes three high schools in Fresno County, a Junior Doctors Academy at three middle schools and the Pre Health Scholars program at Fresno State. Their combined annual enrollment is 430 students — a diverse group with 55 percent of the participants Latino, 17 percent Southeast Asian, 12 percent East Indian, 7 percent African American and 7 percent white.

"As a farmworker, you see a lot of social injustice," Flores said. "What stood out to me were the health inequities. My grandfather was diagnosed with diabetes when I was very young. I remember him developing gangrene in his leg, which required an amputation, and I lived through the culturally incompetent health care process with him. I believe that there should have been a better way for my grandfather to have received care."

Tools for success

The Doctors Academy, a partnership with UCSF Fresno, the Fresno Unified School District, Fresno County Office of Education, Fresno State University, Fresno City College, local hospitals and community health centers, lays a foundation for easing those health inequities. It provides an academic and social support network geared to give students the tools to succeed in college and in their future careers. It includes structured summer enrichment programs, tutoring, mentoring, guidance counseling, SAT preparation, financial aid workshops and parent empowerment workshops. Students are required to take AP courses and participate in community service learning activities and cultural competency/health disparity projects.

Changing the dressing on someone shot in the leg "... really gave me a face-to-face personal experience with medicine that I hadn't had before." — Nathan Singh, Doctors Academy alumnus and medical student at UCSF

"We want our kids to believe in themselves," said Flores, a practicing family physician. "If you raise the expectations, they can meet them and exceed them."

Despite Fresno's high dropout rate, all Doctors Academy graduates have attended two- or four-year colleges, with 43 percent going to UC campuses. Some are in medical school and dental school, while others are nurses and many plan to help fill a hometown shortage of health professionals. The academy is part of UC's broader efforts to educate health professionals and provide health care in the San Joaquin Valley, with programs including ones by UCSF Fresno, UC Davis and UC Merced, which is developing plans that could lead to a medical school.

"I'm just really thankful to the Doctors Academy," said alumnus Nathan Singh, a second-year medical student at UCSF. "It's hard to put into words the impact this program is having."

When Singh was 6, his father, a taxi cab driver, was shot and killed on the job. His mother started working to support Singh and his three older siblings. While his oldest brother got involved in gangs and his sister became pregnant as a teen, his closest brother became an elementary school music teacher in Fresno.

"I saw the contrast of the two different roads," Singh said. "I wanted to follow in the footsteps of my closest brother."

Singh developed an interest in medicine after fracturing his arm playing basketball in eighth grade and spending time with his doctor during his recovery. He applied to the Doctors Academy and was accepted into its second class.

The academy pushed Singh to do well in classes, provided support and offered opportunities to volunteer. In a "seminal moment," Singh changed the dressing on someone shot in the leg. "It really gave me a face-to-face personal experience with medicine that I hadn't had before," he said.

Mitigating lack of care

Flores' childhood also shaped her views on medicine. Her mother died just after she was born, so she was raised by her grandparents, migrant farm workers from Mexico. Flores saw a lack of health care providers in the valley, especially among minorities, and wanted to do something about it.

[The Doctors Academy] "made me who I am today. If it weren't for the Doctors Academy, there is no way I would've been a competitive applicant to get into Brown." — Cynthia Vuittonet, medical student, Brown University

A high school teacher encouraged Flores to apply to Stanford — her only application. Flores was accepted a month after her grandfather died. She initially struggled socially and academically at Stanford, but she persevered, went to medical school at UC Davis and vowed to help her hometown increase the size and diversity of its health professional work force.

Doctors Academy is helping to make that happen. The academy expanded last year to two more high schools in rural communities: Caruthers and Selma. Other public schools in California — and around the country — have done site visits and started similar academies.

Doctors Academy has received financial support from UCSF Fresno, the U.S. Health Resources and Services Administration, California Endowment, California Wellness Foundation, Wells Fargo and Kaiser Foundation, Flores said, but raising funds remains a constant challenge.

"It's very fulfilling," Flores said. "It's a long road, but you have to start somewhere. I think UC is on the right road."

So are Doctors Academy alumni, a tight-knit group who maintain a Facebook group. Many, like Cynthia Vuittonet, a member of the initial academy class, intend to serve their hometown community. Vuittonet has wanted to be a physician ever since preschool, when she would accompany her Spanish-speaking grandmother to the doctor's office and translate for her.

"I figured, 'Why doesn't the doctor speak Spanish?' I'm going to become a doctor," said Vuittonet, whose mother teaches migrants at Sunnyside High School. "I'm a Mexican-American. I know Spanish. I know the culture."

The Doctors Academy "made me who I am today," said Vuittonet, a third-year medical student at Brown University. "If it weren't for the Doctors Academy, there is no way I would've been a competitive applicant to get into Brown."

College is hard, she said, "but I just keep remembering why I'm doing it, why I want to be a doctor."

Giving back

Just like Flores. "She's kind of the end goal of what I want to be - a female physician who gives back to her community," Vuittonet said.

Vuittonet wants to do her residency at UCSF Fresno and return home to practice. She is considering emergency medicine, infectious disease and obstetrics. No matter her choice, she wants to start outreach and preventive health programs.

Singh plans to return to the valley to practice orthopedic surgery or family medicine. And help with the Doctors Academy.

"I look at it as a way to give back to a community that has given a lot to me in my 23 years," Singh said.

Alec Rosenberg is health and agriculture communications coordinator in the UC Office of the President's Integrated Communications group.