Student-Run Free Clinics Stand at a Critical Junction Between Undergraduate Medical Education, Clinical Care, and Advocacy

Abstract

Student-run free clinics (SRFCs) act as primary care providers that bring health care to populations in need and are an important source of undergraduate medical education (UME), guiding trainees through the art of history taking and physical examination. However, they are also social justice and advocacy initiatives-addressing disparity in access to care and educating medical trainees with firsthand exposure to socioeconomic determinants of health as well as language and medical illiteracy barriers. Here, the authors review academic literature examining the impact of SRFCs in their 3 roles: as medical care providers, as components of medical education, and as advocacy organizations. Based on the evidence of that literature and decades of direct SRFC leadership experience, the authors make the case that SRFCs are an undersupported means by which UME institutions contribute to correcting health care disparities and to serving social justice reform. SRFCs as Medical Care ProvidersSRFCs primarily serve patients of low socioeconomic status, targeting communities where up to 45% of the

Experience and Attitudes Toward Telehealth in Student-Run Free Clinics (SRFC)

“…It is commonplace in SRFCs for students to practice history-taking and physical exam skills, present to attending physicians, collaborate across disciplines (eg, nursing, pharmacy, social work), develop leadership skills, and engage with patient populations they may not otherwise encounter in their clinical rotations. 14 Several of these opportunities may be unavailable or suboptimal in a virtual setting. These include managing volunteers or medical inventory, performing physical exams, and coordinating with interdisciplinary personnel to address psychosocial needs.…”

“…SRFCs primarily serve racial minorities, individuals with incomes below the federal poverty line, and immigrant communities who speak English as a second language. 14 Fewer non-English speaking patients have been seen via telehealth than in-person clinic visits, and lower proportions of minority patients were seen via telehealth across all adult specialties. 5 Those of high Social Vulnerability Index, as characterized by the Centers for Disease Control and Prevention, have faced more patient-related barriers, including lack of reliable Internet or appropriate devices, patient discomfort with technology, and language barriers.…”

Systems-Based Practice in Graduate Medical Education: Evolving Toward an Ideal Future State

“…There are several possible avenues for learners to engage in peer-led activities. At the institutional level, there is a long history of student-led campaigns, clinics, and other initiatives that focus on areas within SBP, often through an advocacy lens 45,46 . The Choosing Wisely STARS (Students and Trainees Advocating for Resource Stewardship) program equips student leaders from multiple medical schools to lead grassroots efforts at their local schools to raise awareness and advocate for changes related to resource stewardship 47 .…”

“…At the institutional level, there is a long history of student-led campaigns, clinics, and other initiatives that focus on areas within SBP, often through an advocacy lens. 45,46 The Choosing Wisely STARS (Students and Trainees Advocating for Resource Stewardship) program equips student leaders from multiple medical schools to lead grassroots efforts at their local schools to raise awareness and advocate for changes related to resource stewardship. 47 This program, initiated first in Canada and subsequently spread to a number of other countries (Brazil, Italy, Japan, the Netherlands, New Zealand, Norway, and the United States), has prepared thousands of students to teach up and act as local change agents by integrating resource stewardship into case-based learning, creating student interest groups and electives, launching social media campaigns, and organizing student-led conferences and special presentations.…”

Learner-Centered Teaching

“…One way to incorporate IPE in the LCT learning environment is to have student-run free clinics (SRFCs). In SRFCs, faculty and preceptors work with students from different healthcare disciplines to help underserved populations (Drexler et al, 2019;Rupert et al, 2021). SRFCs can act as alternative to healthcare programs in medical schools that do not have rotation locations for their learners and have a population that requires care.…”