A Call for Residents to Get More Involved With Student-Run Free Clinics

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Student-run free clinics (SRFCs) are currently present at more than 75% of U.S. medical schools1 and ultimately share two common goals: (1) They provide essential services to underserved populations, and (2) they provide co-curricular service–learning experiences for medical students. During the preclinical years of medical school, SRFCs offer early clinical exposures that oftentimes parallel and supplement the diagnoses and treatments students are exposed to in their curricula.2 Nonetheless, from our experiences at Equal Access Birmingham, our SRFC, and likely similarly at other institutions, the number of patients we can serve is limited by attending oversight. In a typical five-hour clinic-day, only eight patients can be seen effectively. The attending acts as the main educator, but with the pressures of maintaining clinic flow, important educational points are often overlooked.
How could we possibly begin to reconcile the balance between clinic flow, patient care, and medical education? Our solution: Get residents involved with SRFCs as well. Residents have always played a critical role in medical student education with students often directly reporting to residents throughout their clinical rotations. Unfortunately, residents are often busy with the many outpatient experiences provided through their residency programs. With this in mind, we would like to make a case for residency programs to offer SRFCs as an alternative continuity clinic experience in an effort to comply with Accreditation Council for Graduate Medical Education duty hours standards. Some clinic models have shown that levels of satisfaction were higher among residents who worked at free clinics compared with residents working in the traditional model.3 The free clinic setting offers residents more patient education opportunities, less interference from specialties, and a chance to instruct medical students. In addition, the free clinic is a venue where residents can practice autonomously in a lower-stress environment with the support of an attending physician, if needed, ensuring adherence with Centers for Medicare and Medicaid Services supervision regulations. This model offers residents a sense of fulfillment through their service and interaction with the community. By including residents in SRFCs, first- and second-year medical students can receive more one-on-one time with a physician, gaining real-time feedback during and immediately following the patient interaction. In addition, having more physicians on hand can mitigate some of the attending physicians’ administrative responsibilities, ensuring the highest quality of care for patients. We believe this suggestion offers an unprecedented solution that benefits medical students, residents, and, most important, the patients we serve.
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