As healthcare providers scramble to find desperately needed skilled workers, from technicians to nurses and doctors, a new report focuses on how a program in California designed to streamline the process for community college students to transfer to four-year institutions could help develop a stronger workforce pipeline for the healthcare industry.
While the state’s Associate Degree for Transfer (ADT) program has helped many students in different majors earn associate and bachelor’s degrees, one area that hasn’t seen as strong results is in healthcare, according to a Campaign for College Opportunity report. The group says various factors could be preventing students interested in the field from taking advantage of ADT, including ADT’s credit-earning process and curriculum alignment among participating higher education institutions. Shoring up some of the process issues and clearing related confusion could result in more students using ADT to earn a baccalaureate in the healthcare field, the report says.
Aside from helping to replenish the employee pipeline, ADT can also help to diversify the healthcare workforce, it adds. More than 60% of California’s population is Latinx, Black, Asian American, Native Hawaiian/Pacific Islander and American Indian/Alaska Native, representing the majority of the state’s workforce, the report says. But it notes that the state’s healthcare workforce does not reflect that diversity. For example, Latinx Californians account for 39% of the state’s population, but Latinx individuals comprise only 6% of medical doctors, 5% of pharmacy school graduates and 10% of registered nurses in the state. Black healthcare workers in the state are also underrepresented. Black individuals comprise 6% of California’s population, but only 3% of medical doctors, 3% of pharmacy school graduates and 5% of registered nurses are Black.
Community colleges are crucial to increasing those numbers. About 57% of college students in California enroll in a community college, and most of those students come from underrepresented backgrounds, the report says. As such, community colleges can play a critical role in both the growth and diversification of California’s workforce of health professionals.
Community colleges are also a critical starting point for students who will eventually seek advanced degrees beyond a bachelor’s degree in their field, the report continues. A study of 43,382 medical school graduates between 2010-2012, for example, found that 25% had attended a community college, and medical students who started their education at a community college were more likely to choose family medicine as their specialty, “indicating the unique promise of community colleges in diversifying the composition of primary care medicine,” it says.
Some of the challenges
ADT is a degree from California’s community colleges that streamlines the transfer process while also guaranteeing students admission to California State University (CSU) campuses in a similar major after fulfilling 60 lower-division semester units, the report explains. All courses taken as part of the ADT program transfer into the university and fulfill general education requirements. Students then must complete another 60-semester units to earn a bachelor’s degree.
“The ADT simplifies students’ educational plans, saving them both time and college costs,” the report says.
More than 40 ADTs are offered at California’s community colleges, and each community college offers its students a different range of ADTs. But a lack of ADT health-related programs and the complexity of implementing health programs into ADT can be a barrier, the report says. Researchers spoke with various college leaders to learn about those challenges and some innovative solutions.
For example, they heard that many community colleges resist implementing ADT because it challenges pre-existing articulation agreements for “local” degrees that can more easily accommodate strict course requirements for health and STEM majors. However, the report observes that such agreements do not guarantee admission to CSUs and may also require additional units above the 60-unit lower-division cap. Also, some degree programs at CSU require students to take lower-division laboratory courses that are not in the ADT pathway, and the same is true for the University of California (UC), which is the other public four-year system in the state.
In addition, required lab sections taken in conjunction with science courses lead to an accumulation of units that exceed the ADT unit cap. “In effect, the cap poses a barrier to implementation of the ADT,” the report says.
The challenges of aligning curricula in health and STEM majors among different colleges with varying infrastructure, size and resources can lead to confusion, extra coursework and extra costs for students, the report continues.
“Students are sometimes advised to take time-consuming laboratory courses while at the community college as to not overload them after they transfer to the CSU or UC for their upper-division coursework, it says. “However, science-intensive ADT degrees cluster general education coursework at the front-end of the student baccalaureate journey while attending community college, leaving no room for additional coursework. This leaves those ADT students to take most or all of their laboratory courses at the upper-division level at CSU or UC. The result is that a student trying for that pathway cannot take advantage of the ADT because of the course sequencing requirements by CSU and/or UC for lower-division coursework.”
Ideas for overcoming challenges
The Campaign for College Opportunity has several recommendations to guide toward easing the transfer process in health-related studies:
- Ensure public four-year universities work with community colleges to align general education curricula, accept ADTs in the health fields and match those to the largest possible baccalaureate offerings. Fresno City College faculty, for example, developed strong ties with Fresno State University, Fresno County Public Health Department and community partners. And California State University, Monterey Bay and Cabrillo College’s health sciences department faculty are collaborating on articulation agreements related to a new ADT in public health at Cabrillo.
- Enhance institutional capacity to develop and implement additional ADT pathways in health fields. Despite the benefits of ADT, some community colleges have been slow to implement the program. For example, small community colleges with less capacity to develop and support new courses may find it easier to adhere to old articulation agreements rather than allocating limited resources to develop new ADT pathways, the report says. It notes that several rural colleges expressed interest in expanding nursing programs toward a baccalaureate, but a lack of institutional capacity and the small number of students make it prohibitive.
- Build and maintain robust programs that reach transfer students early in their college trajectory to keep them on a clear pathway toward a health career. Some college leaders noted their institutions even reach out to high schools via dual- and concurrent-enrollment efforts to raise the visibility of health-career pathways.