INTRODUCTION:Student-run free clinics (SRFCs) have become increasingly popular in US medical schools since the late twentieth century. The University of Cape Town, South Africa developed the Students’ Health and Welfare Centres Organization (SHAWCO) in response to the growth of informal settlements in the Cape Town area with the goal of improving access to primary care services for the poor and uninsured. These clinics are an alternative option for those unable to visit local day hospitals and clinics. Studies have assessed the impact of involvement in student-run free clinics on medical students’ clinical skills and interest in primary care, however, no studies have been done to determine medical student motivation to volunteer or medical student perception of the care that is provided. The aim of this study is to better understand what makes a student-run free clinic worthwhile for medical student volunteers and determine if volunteering influences the career goals of participating medical students.
METHODS: The project was a mixed methods evaluation of patient satisfaction following receipt of care at a SHAWCO Health Clinic. Consenting patients and medical student pairs at select SHAWCO clinic sites are chosen at random and an observation checklist is completed during the visit. After the patient encounter, medical students completed a self-administered survey regarding their perception of patient satisfaction and their motivation to volunteer. Patients completed a separate survey and interview concerning their experience at the clinic with a SHAWCO affiliated community health worker who speaks the patient’s primary language. Data was collected and entered into RedCap for security of participant information. Redcap and Excel were used for data analysis. Patient experience was compared with medical student perception of patient satisfaction, age of the medical student, medical student motivation to volunteer, and desire of the medical student to work in underserved areas in the future.
RESULTS: Data collection was completed with a total of 35 patient surveys, 12 patient interviews, 58 student surveys, 31 patient-student pairs. Results showed that medical student motivation to volunteer varies as the students progress through medical school. Senior students’ main motivation is teaching younger medical students while the junior students’ main motivation is improving their clinical skills. Medical student desire to work in underserved areas was high both before and after volunteering with SHAWCO, but begins to decline after the 5thyear in medical school. There was little evidence showing that volunteering with SHAWCO increased desire to go into primary care.
DISCUSSION:While data collection is planned to continue, it seems that medical student volunteering at SHAWCO is motivated by improving clinical skills of the students and engaging with younger students. Emphasizing the opportunities to improve clinical skills and teach may be beneficial for SRFCs looking to recruit additional student volunteers. Medical student desire to work in underserved areas remains high for a majority of students volunteering with SHAWCO and may be due to a selection bias. Students who initially desire to work in underserved areas are likely to volunteer in SRFCs and SHAWCO reinforces this desire to work in underserved areas in the future.