Politicians, lobbyists and legislative staff are common sights when the California State Legislature is in session. Yet, nearly every summer for the past decade, a group you might not expect can also be found in the halls of the Capitol: students from the UC San Diego (UCSD) School of Medicine. Thanks to the “Introduction to the Politics of Medicine” class taught by Assistant Professor of Anesthesiology Robert Hertzka, M.D. – which he started in 1988 – medical students are able to step out of their usual clinical confines and gain firsthand experience working at the intersection of health care and legislation.

Below, Jesse Garcia, a UCSD medical student who recently took Dr. Hertzka’s class, shared his experience and takeaways after participating in the program.

Jesse Garcia (third from left) pictured with Assemblymember James Gallagher (second from left).

Responding to evacuation centers throughout Chico as an EMT in the immediate aftermath of the 2018 Camp Fire left me with an unforgettable memory of raw human suffering. Yet it was in the months and years that followed the fire, as I witnessed thousands of survivors fight through bureaucracy to rebuild their lives, that I began to question the systems in place meant to protect and maintain our citizens’ well-being.

A preexisting housing shortage, material inflation, homebuilder scams, skyrocketing premiums and indefinitely delayed settlements compounded the suffering of an already vulnerable group. After five years of working alongside brilliant physicians and community leaders in Chico, I found myself completely invested in the restoration of Butte County and struck with a need to unravel the bureaucracy that shapes and governs our lives.

In 2022, as a first-year UCSD medical student looking for a soft intro into the world of California politics, I signed up for a Health Policy, Politics and Leadership elective, taught by Dr. Hertzka.

For decades, the UCSD School of Medicine has given medical students like me an up-close look at legislative dynamics that influence the social structures, cultures and institutions that impact our day-to-day lived experience. Under the leadership of Dr. Hertzka, and with support from the California Medical Association, medical students are given a unique opportunity to engage in California politics and learn first-hand from lawmakers.

In addition to a trip to lobby legislators at our State Capitol in the spring, our class was offered the opportunity to intern in the Capitol during the busiest time of the legislative year (following summer recess). Thanks to Dr. Hertzka’s outreach efforts, and a brief run-in with Assemblymember and minority leader James Gallagher (who represents my hometown in Butte County) and some friendly high school football banter, I was able to secure an internship in Assemblymember Gallagher’s office.

I couldn’t have asked for a better experience. The assemblyman and his staff were beyond accommodating and kindly flooded my schedule with thought-provoking tasks and work with the California Assembly Republican Caucus.

I found myself attending session, writing up bill recommendations, sitting in on lobbying efforts, writing research proposals for future bills focused on stratifying psychiatric hospitals, writing letters to the Governor, authoring notices to Alcohol Beverage Control and Cal Fire, drafting op-eds, curating graphics and acting as our office’s front desk attendant. I was also able to participate in a Rice Farmers Cooperative conference, where we discussed the electric vehicle mandate timeline that could have widespread impacts and affect farmers’ business expenses and buyers of all income levels and backgrounds at the grocery store. I found this discussion to be extremely relevant considering access to affordable fresh produce is one of many critical upstream drivers of health.

However, what I cherish most from my internship was the opportunity to visit Gallagher’s district office in Chico, where I met with local hospital administrators and Healthy Rural California representatives. I was able to delve into conversations regarding health care district funding, physician employment, free schedule changes, reimbursement models, federal residency caps, and novel ideas for establishing mental health and family practice residency programs in Chico by 2025. These were all timely and important topics, considering the current push for well-coordinated, value-based health systems and the dire need for physician recruitment and retention in rural and frontier counties.

Macro-level policy interventions are long-term efforts that require significant investment and often do not often yield rapid results. However, based on the mentorship I received, I believe that genuine community engagement and bipartisan relationships inside and outside the political area make for the best outcomes.

This class and internship have immersed me into the worlds of organized medicine and California politics to a degree I never thought possible. This experience has opened my eyes to the vast potential and benefits that can come from focusing part of my career on improving the interchange between policymakers and physicians.

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