University of Pennsylvania | School of Medicine  
Understanding Medical Student-Run Health Clinics

Overview

What is a medical student-run clinic?
For our research, a student-run clinic is defined as "a healthcare delivery program in which medical students take primary responsibility for logistics and operational management during clinic hours; and which is capable of prescribing disease-specific treatment to patients." This definition does NOT include community service projects limited to handing out health supplies, merely checking blood pressure, or student volunteer programs hosted by professionally operated medical groups.

Typically, student-run clinics – sometimes called "homeless health projects" or "neighborhood health projects" – are medical student programs in which students manage a patient care clinic. Clinics tend to serve under- and un-insured patients in underserved areas. With the growth of these programs in the last 10-15 years, they now constitute significant healthcare delivery programs for many patients.

How many student-run clinics are there?
In a national survey of medical schools in the 50 states (76% response rate), we identified 111 student-run clinics in 25 states.

How many patients do these clinics serve, and what can they offer patients?
We collected detailed patient data from 57 clinics, which reported about 36,000 annual patient visits. The average clinics encounters 19 patients a week, of whom 15 see a physician. The most common services offered:

Blood pressure checks (98%)
Acute care (97%)
Blood glucose readings (86%)
Standardized patient education (66%)
Condom distribution (64%)
Health form completion (64%)
Multivitamin distribution (55%)

Most clinics (79%) dispense some or all medications on site, including antibiotics (86%), hypertension drugs (84%), non-prescription analgesics (84%), and neurological drugs (45%). Most clinics have arrangements for laboratory services on- or off-site (81%). Most clinics do not charge patients (88%), and those that do frequently have fungible fees for patients who cannot afford them.

What do you know about patients of student-run clinics?
The most common reasons for visiting a student-run clinic is for an acute complaint (36%), to monitor a chronic health problem (33%), for a check-up or physical (18%), or to pick up a medication they regularly receive at the clinic (10%).

Nationally, student-run clinics serve predominantly minority patients:

31% Hispanic
31% African-American/Black
25% White
11% Asian

Because many clinics do not ask for insurance status or other financial information from patients, it is difficult to specify patients’ economic background other than anecdotally. However, most clinics report serving uninsured patients (88%).

How many students volunteer at student-run clinics?

The average clinic has 16 medical student volunteers a week. Almost all clinics host preclinical medical students (95%), but many also have clinical medical students (77%), health-related graduate students (37%), and undergraduates (35%). In our survey, clinics leaders described an average volunteerism rate of 25% among first and second year medical students, and about 20% among third and fourth year students. A local survey at our institution found that more than one-half of a class of students volunteered at a student-run clinic in the preceding year, often learning new clinical skills in the process.