Relationship of Volunteer Student-Run Clinic Experience with Future Primary Care and Underserved Practice

Ruby P Shah; Tonya L Fancher; Anthony Jerant; Anthony Bhe; Mark C Henderson

doi:10.59586/jsrc.v4i1.69

Ruby P Shah, MD, MPH University of California, Davis
Tonya L Fancher, MD, MPH University of California, Davis
Anthony Jerant, MD University of California, Davis
Anthony Bhe, MD University of California, Davis
Mark C Henderson, MD University of California, Davis

DOI: https://doi.org/10.59586/jsrc.v4i1.69

Keywords: career, medical education, primary care, student-run clinic, career choice, specialty choice

Abstract

Background: Student-run clinics (SRCs) are increasingly common at or in partnership with medical schools, providing service-based learning to students and increasing access to care for underserved populations. Early, small studies suggest that student participation may be associated with eventual practice in primary care and in medically underserved areas, but current career outcomes are largely unknown. The purpose of this study is to determine the relationship between participation in SRCs, primary care (PC) career choice, and future practice setting.
Method: For all graduates of the University of California, Davis from 2004 to 2008 (N=454), the authors determined practice specialty (family medicine, general internal medicine or pediatrics, or not) and practice setting (health professional shortage area [HPSA] or not) two to five years after residency. Multivariate analysis adjusted for level of SRC participation, age, gender, race, more than one language spoken, total dollar debt at graduation, research experience during medical school, Medical College Admission Test, and United States Medical Licensing Examination Step 1 and 2 performance.
Results: Of 454 total graduates, 68% participated in a SRC. In adjusted analyses, committed SRC participation was associated with PC practice after residency (adjusted odds ratio [AOR] 2.15, 95% confidence interval [CI] 1.18-3.75) and intermittent SRC participation was not (AOR 1.13, 95% CI 0.65-1.99). The sole predictor of post-residency practice in a HPSA was more than one language spoken (AOR 1.97, 95% CI 1.20-3.25). Race was not significantly associated with practice in HPSAs.
Conclusions: This study indicates that students who were committed SRC volunteers were more likely to practice in PC after residency. These findings suggest that participation in SRCs may increase graduates practicing in PC, but further studies are required to address the strength of the relationship between SRC participation and future PC practice.