26 counties in Texas have no primary care physicians and 74 counties have two or fewer physicians; and,

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1 COOPERATIVE AGREEMENT BETWEEN The Texas A&M University System Health Science Center College of Medicine and South Texas College for Cooperative Participation in The College of Medicine s Partnership for Primary Care Program Therefore, 26 counties in Texas have no primary care physicians and 74 counties have two or fewer physicians; and, all but approximately 30 of Texas 254 counties are federally designated as partially or wholly medically underserved areas; and, the number of primary care physicians, per 100,000 population, in Texas lags well below the national average; and, Texas is among the fastest growing states in the nation; and, the rapid growth in the population in Texas predicts continued and increasing regional disproportions in the number of primary care physicians per 100,000 population; and, South Texas College (STC) has a good history of service to the people of south Texas and provides a supportive atmosphere for premedical education; and, The Texas A&M University System Health Science Center College of Medicine (TAMUHSC-COM) is dedicated to the production of primary care physicians for rural and underserved areas of Texas; and, South Texas College and The Texas A&M University Biomedical Science Program (BIMS) in the College of Veterinary Medicine and the Biology Program in the College of Science agree to jointly cooperate in a Articulation Agreement; South Texas College and The Texas A&M University System Health Science Center College of Medicine agree to sponsor jointly and cooperate in the Partnership for Primary Care Program (PPCP) Program Partners The Texas A&M Unviersity System HSC College of Medicine Texas A&M University College Station South Texas College Prairie View A&M University Tarleton State University Texas A&M International University Laredo Texas A&M University Commerce Texas A&M University Corpus Christi Texas A&M University Kingsville West Texas A&M University Canyon

2 Purpose: This program is for the purpose of recruiting, enrolling, and graduating significantly greater numbers of physicians to serve the designated health professions shortage areas of south Texas, to correct disproportions in physician distribution, and to meet the health care needs of rural and underserved south Texas. Partners Agree To cooperatively recruit qualified students for simultaneous admissions to STC and to the TAMUSHSC-COM provided students transfer successfully to the Texas A&M University BIMS or Biology programs. Students are expected to complete the associate of science degree at STC, a baccalaureate degree in BIMS or Biology at Texas A&M University, and the M.D. degree at the TAMUSHSC-COM. Albeit students will be exempt from taking the Medical College Admissions Test (MCAT) before entry to the College of Medicine, it is also agreed that students must maintain high levels of academic performance and adhere to other pertinent conditions outline in the document entitled Operational Guidelines and Partner Responsibilities. Number of Positions The TAMUSHSC-COM and STC agree that the number of students admitted to the program during the first year of operation should not exceed 10 students 5 incoming freshmen and 5 current freshmen. It is also agreed that the number of students admitted to the program for subsequent years should not be less than 2 or more than 5 qualified students. However, should the College of Medicine not select students from STC, the unfilled positions may be met with qualified students at any of the other partner institutions. Program Description The TAMUSHSC-COM and STC agree to operate the Partnership for Primary Care Program in accordance with the description in the document entitled Operational Guidelines and Partner Responsibilities for the Texas A&M University System Health Science College of Medicine Partnership for Primary Care Program. Duration The agreement between The TAMUSHSC-COM and STC shall commence on the day the parties execute the agreement. The program may be discontinued only my mutual, written, consent of the parties. Both parties agree that any student enrolled in the program at South Texas College at the time of program termination shall be permitted to complete the program.

3 Nancy W. Dickey, M.D., President The Texas A&M University System Health Science Center Vice Chancellor for Health Affairs, A&M System Date Christopher C. Colenda, M.D., M. P.H., Dean The Texas A&M University System Health Science Center College of Medicine Date Shirley A. Reed, M.B.A., Ed.D., President South Texas College Date

4 Operational Guidelines and Partner Responsibilities for The Texas A&M University System Health Science Center College of Medicine Partnership for Primary Care Program An Early Acceptance Program Designed to Meet the Current and Future Needs of Texas A COOPERATIVE PROGRAM BETWEEN The Texas A&M University System Health Science Center College of Medicine AND South Texas College AND The Texas A&M University Biomedical Science and Biology Programs 2004

5 Program Purpose The program s purpose is to provide primary care physicians for rural communities and areas of south Texas with disproportionately low numbers of primary care physicians. Program Description The Partnership for Primary Care Physicians Program (PPC) is a cooperative program between The Texas A&M University System Health Science Center College of Medicine, South Texas College (STC), and The Texas A&M University (TAMU) Biomedical Science Program (BIMS) in the College of Veterinary Medicine and the Biology Program in the College of Science. Recruitment and Selection The College of Medicine and the partner universities identify high school seniors from rural and medically underserved areas within the catchment area of the individual partner institutions. Strategies used to identify prospective applicants are: Joint recruiting with the admissions office of the partner university. College Nights at area high schools. Workshops for high school counselors on advising students on a career in medicine. COM Website which highlights the Partnership for Primary Care Program. A web-based application Students considered for the program must have high achievement in high school and must express interest in a career in primary care medicine, serving rural or underserved areas of south Texas. To be eligible for consideration, graduating high school students must have the following: A 3.50 GPA (on a 4.00 scale) or equivalent Ranking in the top 10% of graduating class A minimum 1200 SAT or 26 ACT Legal residence in a rural, underserved, or health professions shortage area as defined by the Health Professions Resource Center, Texas Department of Health A U.S. citizen or permanent resident of the U.S. A resident of the state of Texas Acceptance to STC and commitment to attend STC, and Acceptance to the STC Valley Scholars Honors Program To be eligible for consideration as college students, prospective applicants must have the following: Be enrolled as a college freshman at STC A 3.60 cumulative GPA though the end of the freshman year at STC A STC Valley Scholar A 3.50 GPA or equivalent through the end of high school A ranking in the top 10% of high school graduating class A minimum 1200 SAT or 26 ACT Legal residence in a rural, underserved or health professions shortage area A U.S. citizen or permanent resident of the U.S. A resident of the state of Texas The College of Medicine s admissions committee screens and interviews eligible applicants. STC provides appropriate input in the process of screening prospective participants, such as but not limited it information on academic background and potential communication skills, breadth and depth of interest and activities, community service or altruistic activities, and personality. The admissions committee determines the final recommendations for selection through an interview and deliberation process and submits prospective candidates to the Dean of the College of Medicine for official offers of acceptance. Acceptance into the PPC program will guarantee admissions to the College of Medicine M.D. degree program and waive the Medical College Admissions Test (MCAT). Admission into the College of Medicine is contingent upon a number of conditions. (See section below on Conditions of Admission to the College of Medicine for a list of these conditions.)

6 The admissions process time line for consideration into the PPC program consists of the following: MAILING OF INFORMATION The coordination of mailing of information to prospective applicants is conducted in the early fall and no later than December of each academic year. The information included in the mailing consists of the following: A letter from the Dean of the College of Medicine to high school counselors announcing the program Printed booklets and flyers describing the program and the College of Medicine Application Information Forms, Application Instructions, Supplemental Data Form, and Faculty Evaluations/recommendations Form FILING OF APPLICATION Earliest Date December 1 (year preceding expected college enrollment) Deadline Date February 2 (year of expected college enrollment) LETTERS OF RECOMMENDATION Earliest Date December 1 (year preceding expected college enrollment) Deadline Date February 2 (year of expected college enrollment) PERSONAL INTERVIEWS An interview by the College of Medicine s Admissions Committee is required for selection, and the process of admitting applicants to the program is selective. Early April (year of expected college enrollment) Interviews are conducted on a Thursday in early April, beginning in College Station and concluding in Temple. TENDER OF ACCEPTANCE April 15 (notification of acceptance to high school students year of expected college enrollment) June 15 (notification of acceptance to eligible college students after completion of spring term of the freshman year) Program/Curriculum UNDERGRADUATE Students must declare science as their major at STC and complete an associate of science degree with a cumulative GPA of 3.60 to guarantee transfer into the Biomedical Science program or the Biology program of study at Texas A&M University. Their course of study at STC and Texas A&M University must include the 47 credit hours of prerequisite courses for enrollment to the College of Medicine: General Biology with laboratories 8 credit hours Advanced Biological Sciences 6 credit hours General Chemistry with laboratories 8 credit hours Organic Chemistry with laboratories 8 credit hours General Physics with laboratories 8 credit hours English 6 credit hours Calculus or Math-based Statistics* 3 credit hours Total 47 credit hours

7 * The Calculus course can be any calculus taught by a Math or Physics department. Business Calculus or any pre-calculus IS NOT ACCEPTABLE * The statistics course must be math based and preferably taught by a Math or Statistics department. Each of the above courses must be satisfied with at least a grade of C from the partner institutions. However, it is strongly preferred that participating students perform at the A and B grade levels in all the prerequisite courses. The prerequisite courses must be completed before or by the time of matriculation to the medical school. STC provides relevant, health care related enrichment experiences for students in the program. The enrichment experiences can range from the assignment of a physician mentor who practices in a rural or medically underserved area, to special formal courses in health care delivery and ethical issues in medicine. In conjunction, the College of Medicine provides participating students with a summer clinical enrichment experience to allow students to observe the practice of medicine at its clinical facilities. A summer research experience at the College of Medicine is an option for participating students who have strong backgrounds and interest in research or wish to pursue the M.D./Ph.D. dual degree program. For these students, it is highly recommended that they gain research experience in substantive fashion at STC and in particular at Texas A&M University. Upon successful completion of the baccalaureate degree in BIMS or the Biology program at Texas A&M University and satisfaction of the conditions for entry into the College of Medicine, students in the program will enroll in the College of Medicine s M.D. degree program. Available to students upon entry will be the option of participating in the total medicine track of the medical school. PROFESSIONAL The first two years of training in the M.D. program are at the College of Medicine on the campus of Texas A&M Unviersity in College Station. During the first and second years, students have the opportunity to experience medicine in a rural or medically underserved area within ta 50-mile radius of the College of Medicine. Students further these experiences when they participate in the Texas wide preceptorship program and undertake significant clinical time in rural or underserved areas of Texas during the summer between the first and second years of medical school. The third and fourth years of medical school will be conducted primarily at the Temple campus. However, students are provided with the opportunity to complete selected clerkship experiences in primary care or rural medicine at anyone of the 19 Scott & White primary care satellite clinics in Central and East Texas or at any one of the designated rural/primary care clinics in south Texas and coastal bend areas. Graduates are advised on careers in medicine for choice of residency training programs and locations and are given assistance in accessing available financial aid for the residency process. Financial Aid STC will endeavor to secure and provide scholarships or financial aid for each student selected to participate in the Partnership for Primary Care Program. The student will be required by STC to remain in good academic standing in the program as is customary for scholarship recipients. Evaluation The Director of Recruitment and Special Programs and the Assistant Dean for Admissions of the College of Medicine monitor the progress of participating students during their undergraduate years in conjunction with the health professions advisor at STC. The Assistant Dean for Student Affairs and Admissions will monitor particular students during the four-year medical education experience. In addition, the students will be tracked through their residency training to their ultimate type and location of practice. To assure communication between participating students, STC and the College of Medicine, STC must provide continuous monitoring and support of the students enrolled in the program and assist in evaluating that the students are meeting the conditions of the program. STC will report the statuses of participating PPC students to the Director of Recruitment and Special Programs as designated times during an academic year (as determined by the Director). Number of Students Admitted to the Program The goal for the College of Medicine s STC-TAMU PPC program is to enroll a total of 10 students for the first year of the program: 5 incoming freshman students and 5 current freshman students. In subsequent years, five (5) incoming freshman will be enrolled in the

8 program per year. If spaces are available, the COM will consider current freshman or upcoming sophomores for the program provided they meet the eligibility criteria. The maximum numbers of students admitted to the PPC Program through STC and TAMU, or in aggregate, will be the sole responsibility of the College of Medicine. The total class size for the College of Medicine, the number of qualified applicants and other competing programs (i.e., Joint Admissions Medical Program or JAMP) will be relevant factors in this determination. Since the inception of the program, the goal has been to enroll at least two and not more than five qualified applicants for the program from any one of the partner universities. This will prompt the College of Medicine to consider more qualified applicants from any other partner university. Conditions of Admission to the College of Medicine Students accepted for the Partnership for Primary Care Program are guaranteed admission into the College of Medicine provided they maintain high academic performance and other indices of appropriate demeanor during their undergraduate educational experiences. Admissions into the College of Medicine is contingent upon meeting the following conditions 1. Remaining in good standing at all times at South Texas College, Texas A&M Unviersity, and The TAMUSHSC-College of Medicine (as defined in the Student Handbook of each respective institution) 2. Maintaining high levels of performance in all courses taken: a. Achieving a minimum 3.60 cumulative GPA at the end of each academic year at STC (fall through summer) and earning a minimum 69 credit hours of transferrable credit. b. Completing the Associates of Science Degree at STC. c. Transferring to TAMAU with a 3.60 GPA at STC. d. Achieving a minimum 3.50 cumulative GPA at the end of each academic year at TAMU (fall through summer) until matriculation to the College of Medicine 3. Completing all course work and a baccalaureate degree within a standard acceptable time frame (typically within a 4 year period) at Texas A&M University. (After transfer, taking courses at college other than TAMU will require the approval of the Assistant Dean for Admissions of the College of Medicine.) 4. Completing, with no grade below a C, the undergraduate prerequisite courses for enrollment to the College of Medicine. 5. Consulting at least four (4) times a year with the Chief Health Professions Advisor regarding the completion of all requirements. 6. Communicating with the College of Medicine s Director of Recruitment and Special Programs at least four (4) times a year regarding completion of all requirements. 7. In substantive fashion, participating in extracurricular and health related activities, demonstrating leadership, doing community service, and exercising ethical behavior. 8. Holding place at the College of Medicine and no other medical schools. (Student who apply to other medical schools will lose their assured place at the College of Medicine.) 9. Obtaining favorable letters of evaluation from STC and TAMU faculty, major advisor, and/or chief health professions advisor in the Office of Professional School Advising when seeking enrollment to the College of Medicine. 10. Writing a substantive letter to the Assistant Dean for Admissions on or before April 1 of the year preceding enrollment requesting enrollment in the College of Medicine. 11. Submitting a complete application and record of college work to the Texas Medical and Dental Schools Application Service (TMDSAS, Austin, TX) before or by August 1 of the year preceding enrollment in the College of Medicine. 12. Interviewing with members of the College of Medicine s Admissions Committee to determine suitability for enrollment to the College of Medicine. (Before official enrollment to the College of Medicine, the admissions committee must grant a favorable recommendation for enrollment to the Dean of the College of Medicine.) 13. Having official transcripts of all courses complete from all colleges and universities attended, sent directly to The TAMUSHSC-College of Medicine, Office of Student Affairs and Admissions before or upon matriculation to the College of Medicine. Nullification of Admission to the College of Medicine If at anytime a participating PPC student files an application with any other medical school, the guaranteed admission to the College of Medicine is nullified immediately. Students whose guaranteed admission has been rescinded, however, may apply for admission to the College of Medicine through the normal or traditional pathway. Such a pathway necessitates competition with other applicants for admission to the College of Medicine, satisfactory attainment of all prerequisite courses, and taking the MCAT. Nullification of a

9 guaranteed admission through the PPC program shall not adversely affect consideration of the applicant through the normal competitive pathway. However, the applicant must report in the application to other medical schools his acceptance and/or participation in the PPC program because the program by design makes an official offer of acceptance to the College of Medicine s M.D. Degree Program. Nullification of admission may also occur is any or all of the above conditions are not met. Exceptions to the above conditions are at the sole discretion of the admissions committee. Should exceptions be made, the admissions committee will determine the appropriate conditions or terms for continuing in the program and ultimately enrolling in the College of Medicine. Specific Responsibilities South Texas College ADMINISTRATIVE Agree to the articulation agreements with the Texas A&M University Biomedical Science and Biology programs and TAMUSHSC College of Medicine Partnership for Primary Care Program Designate a program coordinator (preferably the chief health professions advisor or faculty designee) to manage the development and operation of the program Nominate students qualified for consideration Offer qualified prospective students admission to STC and provide scholarships Submit appropriate status reports on students to the College of Medicine Submit transcripts or other appropriate official documents verifying students grades and course work from semester to semester Submit appropriate recommendations to the Assistant Dean for Admissions at the College of Medicine the year preceding enrollment to the College ADMISSIONS Advertise the program to high school students in Hidalgo and Starr counties and from rural, underserved or health professions shortage areas in the catchment area of STC Establish linkage to the College of Medicine Web Site for information on PPC Use the Applicant Information Form provided by the College of Medicine (paper and web-based versions) Identify candidates and submit appropriate recommendations to the Assistant Dean for Admissions at the College of Medicine If prospective applicants are currently enrolled as freshman at the university, submit a letter of evaluation on behalf of the applicant in addition to letters of support from two faculty. Provide input in the admission committee deliberation process in selecting students for the program (conducted once a year in early April) FINANCIAL AID Consider admissions application for scholarship competition Develop long-term academic scholarships for students selected to the program CURRICULUM Develop and implement a curriculum track for the program with the TAMU Biomedical Science or Biology programs Require students to declare Biology as a major at STC Require students to take at least 9 credit hours of honors courses with six (6) of 9 hours in Biology, Chemistry, or Physics Provide students with advice regarding curriculum selection and related matters Provide students with access to academic advising and social counseling and other appropriate support mechanisms Provide students with faculty and physician mentors Plan in conjunction with the Director of Recruitment and Special Programs appropriate summer academic enrichment or research experiences.

10 Texas A&M University System Health Science Center College of Medicine ADMINISTRATIVE Provide overall leadership for the Partnership for Primary Care Program. Have the Director of Recruitment and Special Programs function as the PPC program director to assist each partner school coordinate in the implementation of the program. Select a total of 5 students per year. (The number accepted each year into the program would be affected by the total enrollment maximum for the College of Medicine. The number of students accepted should not be less than two or more than five qualified applicants) To develop and continually update a common brochure to inform prospective high school and freshman college students, counselors, and science teachers about the program and to enhance student understanding of medical practice in a rural or medically underserved area To network with high school counselors and science teachers at high schools in the catchment area of STC To distribute and process all applications to the PPC program To coordinate interviews of qualified applicants to the PPC program. To notify all applicants at appropriate times of their status in the application process. ADMISSIONS Collaborate with the Office of Admissions at the partner institutions in disseminating information on the program to prospective students. Provide an informational Web Site for the program and make available linkages to each participating partner university o Assist each partner university in the review of prospective applicants Have the Director of Recruitment and Special Programs at the College of Medicine work closely with the admissions offices of the partner institutions in the development of informational programs for high school guidance counselors and students regarding potential careers in primary or rural care medicine and admission into the PPC program Screen all nominated, eligible applicants Conduct the final selection of candidates Set conditions for enrollment and continuing participation in the program Exempt students selected for the program from taking the Medical College Admissions Test (MCAT) FINANCIAL AID Work with the partner institutions to develop jointly scholarships which will follow the students from admission to STC to graduation from Texas A&M University and the TAMUSHSC-College of Medicine. CURRICULUM Assist each partner institution s program coordinator and designated faculty members with the development and/or implementation of the program s undergraduate curriculum Provide summer enrichment activities as designed by the COM Work with the partner institutions to develop clinical preceptorships for students in their respective communities Develop a medical-mentor program to connect each student with a physician practicing in a rural or medically underserved area to enhance the students understanding of primary care medicine Develop and maintain opportunities for students in the program to receive a good proportion of their clinical training in rural and/or underserved areas (as deemed appropriate by the College of Medicine) EVALUATION Monitor the effectiveness of the Partnership for Primary Care Program in meeting the objectives of the program. Recommend to the partner institutions changes as a result of the College s evaluation and of the objectives to make the program more appropriately meet the needs of Texas.