The Effect of Medical Student Volunteering in a Student-Run Clinic on Specialty Choice for Residency

Abstract

Introduction: Student-run free clinics (SRFCs) are a recent popular addition to medical school education, and a subset of studies has looked at the influence of SRFC volunteering on the medical student’s career development. The majority of the research done in this area has focused on understanding if these SRFCs produce physicians who are more likely to practice medicine in underserved communities, caring for the uninsured. The remainder of the research has investigated if volunteering in an SRFC influences the specialty choice of medical school students. The results of these specialty choice studies give no definitive answer as to whether medical students chose primary or specialty care residencies as a result of their SRFC experience.Keeping Neighbors in Good Health through Service (KNIGHTS) is the SRFC of the University of Central Florida College of Medicine (UCF COM). Both primary and specialty care is offered at the clinic. It is the goal of this study to determine if volunteering in the KNIGHTS SRFC influences UCF COM medical students to choose primary care, thereby helping to meet the rising need for primary care physicians in the United States.Methods: A survey was distributed to first, second, and third-year medical students at the UCF COM to collect data on demographics, prior volunteering experience, and specialty choice for residency. Responses were then combined with records of volunteer hours from the KNIGHTS Clinic and analyzed for correlations. We analyzed the frequency and Pearson’s chi-squared values. A p value of less than 0.05 was considered statistically significant.Results: Our survey had a total response rate of 39.8%. We found that neither the act of becoming a KNIGHTS Clinic volunteer nor the hours volunteered at the KNIGHTS Clinic influenced the UCF COM student’s choice to enter a primary care specialty (p = NS). Additionally, prior volunteering/clinical experience or the gender of the medical school student did not influence a student’s choice to volunteer at the KNIGHTS Clinic.Discussion: Volunteering at KNIGHTS Clinic did not increase student choice to enter primary care, with students choosing other specialties at equal rates, probably due to the variety of specialties present at the KNIGHTS Clinic. This suggests that the volunteer attending physicians present at an SRFC may influence the choice of residency for students. It also suggests that SFRCs are not a viable tool to increase the number of primary care doctors in the United States.

Specialty choice determinants among Mexican medical students: a cross-sectional study

“…As previously reported, the coverage of positions for primary care specialties has diminished as a result of a reduction in the number of students that select these specialties. Exposing students to academic experiences related to primary care seems not to modify choice rates [25].…”

Service on student-run free clinic executive board improves leadership skills of medical students in the underserved medical system

“…Students’ career plans did not change as much, probably because their choice of specialty was not affected by this overall experience. However, the confidence in achieving the career they desire was improved, likely due to the fact that this position is a well-appreciated experience for residency interviews, and because they had the opportunity to publish and present their quality improvement studies (Tran et al , 2017; Lu et al , 2018; Brown et al , 2017; Kovalskiy et al , 2017).…”

Impact of Medical Student Participation in Student-Run Clinics on Education, Residency Selection, and Patient Care: A Review of Selected Articles

“…Another study conducted at the KNIGHTS Clinic in 2017 looked at the effect volunteering had on entering into primary care, as well as the influence gender had on decisions to volunteer at the clinic [ 25 ]. The researchers sent out a survey to first-, second-, and third-year medical students at UCF COM.…”

“…In the literature, there is heterogeneity in the working definition of medical specialties of primary care; however, many consider the primary care specialties to include family medicine, general internal medicine, general pediatrics, and obstetrics and gynecology [ 38 ]. Out of the five studies addressing residency selection outcomes as a function of volunteering at SRCs, four studies found no significant relationship [ 21 , 23 , 25 , 26 ]. Of note, the remaining study demonstrated that 13/52 (25%) of the study participants reported an increased desire to pursue primary care specialties after volunteering at SRCs [ 24 ].…”