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

The impact of health volunteering of radiology students on improving their self-skills and practical capabilities in the Kingdom of Saudi Arabia

Background

Volunteering is a beneficial activity with a wide range of positive outcomes, from the individual to the communal level. In many ways, volunteering has a positive impact on the development of a volunteer's personality and experience. This study aimed to evaluate the impact of health volunteering on improving the self-skills and practical capacities of students in the western region of the Kingdom of Saudi Arabia.

Materials and methods

The study was a descriptive cross-sectional electronic web-based survey that was submitted on a web-based questionnaire; 183 students answered the survey, and then, the data were analyzed using SPSS.

Results

This study shows that 95.6% of participants agree and strongly agree that the health volunteering experience was useful, 2.7% of the participants neither agree nor disagree, and 1.6% disagree and strongly disagree. Regarding the distribution of the participants on skills learned from volunteering experience, the largest proportion of student (36.1%) volunteers in the health sector acquired communication skills and the smallest proportion of student (14.8%) volunteers in the acquired time management skills. Regarding the disadvantages, 81.4% of the participants do not think there were any disadvantages to their previous health volunteering experience, while only 18.6% of them think there were any disadvantages to their previous health volunteering experience. Additionally, the study found that the type of the sector affects the skills acquired from health volunteering.

Conclusion

Research revealed that the majority considered volunteering a great experience. Volunteering increased the self-skills and practical capacities of radiology students, which proved the hypothesis.

Psychological Predictors of Medical Students' Involvement in Pro Bono

THEORY

Medical pro bono, in which medical professionals provide no (or low) cost services, is one approach to addressing unmet healthcare needs. Prior efforts to understand who chooses to take part in pro bono and why they might do so have been primarily atheoretical in their approach. The current investigation focuses on students in medical school and draws on relevant theory and research in psychology to identify predictors of their intentions to engage in medical pro bono service during and after medical school.Hypotheses:Four major approaches to identifying predictors of medical pro bono are examined: the role of demographic variables as predictors of medical pro bono, conceptualizing medical pro bono as a form of volunteerism, viewing medical pro bono as an expression of personality, and medical pro bono as a reflection of role identities and expectations. Each of these approaches can be characterized as being about medical students' individual attributes or aspects of the situation they are in.

METHODS

A total of 278 medical students from 15 different medical schools in the United States of America completed a web-based survey (8/4/2020-9/22/2020). The students completed measures of pro bono identity and expectations, intentions to engage in medical pro bono activities, prosocial personality, volunteer motivation, exposure to volunteering, general traits of personality, and demographic variables (in this order). We used linear regression analyses to separately predict three measures of intentions (general medical school intentions, intentions toward medical pro bono trips during medical school, and general post medical school intentions).

RESULTS

The strongest predictors of intentions to engage in medical pro bono were one's identity and expectations related to pro bono. Medical students who had incorporated medical pro bono into aspects of their identity and/or considered medical pro bono to be an expectation indicated higher intentions to engage in medical pro bono work. Conversely, volunteer motivation/exposure, personality, and demographic variables were much weaker predictors of medical pro bono.

CONCLUSIONS

The findings of the present study have implications for ways that medically oriented volunteering may be increased by individual-level interventions and/or changes in medical education. Individual-level interventions could leverage the importance of identity and expectations to craft persuasive messaging to appeal to identity and expectations as drivers of engagement in medical pro bono. Program level interventions could work toward the institutionalization of medical pro bono by the inclusion/promotion of medical pro bono into the program's co-curricular and/or extracurricular activities.

Learning Outcomes from Participation in Student-Run Health Clinics: A Systematic Review

Student-run clinics (SRCs) offer unique opportunities for students to engage in healthcare delivery, but the student learning outcomes of such clinics have not yet been systematically examined in a comprehensive manner. The purpose of this review was to appraise and synthesize existing literature pertaining to student learning outcomes associated with participation in SRCs. A systematic review was undertaken using PubMed, CINAHL, and Web of Science databases. The quality of articles that met inclusion criteria articles was appraised using the Mixed Methods Appraisal Tool (MMAT). Study details, such as learning outcomes, were also extracted. Ninety-two studies met inclusion criteria. Most studies were conducted in North America (n = 73, 79.3%), and related to clinics involving solely medical students (n = 35, 38.0%) or multi-professional clinics (n = 34, 37.0%). Demonstrated learning outcomes of SRC participation include clinical skills, interprofessional skills, empathy/compassion for underserved patients, and leadership. SRC participation had little apparent impact on students' future career directions. Quality appraisal via the MMAT found mixed levels of research quality amongst reviewed studies. In summary, while SRC participation appears to offer benefits for student learning, improved study design and research outside of North American contexts would further advance knowledge.

The impact of volunteering with a student-run free clinic on medical student specialty selection

BACKGROUND

The shortage of primary care physicians in the United States is expected to grow to 17,800-48,000 physicians by 2034. Student Run Free Clinics are an increasingly popular component of medical schools and may provide an avenue for increasing medical student interest in primary care specialties. However, there is limited research on the impact of Student Run Free Clinics on medical student specialty choice. This investigation sought to determine whether volunteering with the Interprofessional Community Clinic (ICC), the Student Run Free Clinic associated with Chicago Medical School, was associated with an increased likelihood of matching into primary care specialties. Secondarily, the authors investigated associations between volunteering and matching into family practice. Finally, the authors explored associations between volunteering and the competitiveness of specialty choice.

METHODS

This retrospective review utilized data on medical school graduates from 2015 - 2021 including their matched specialties, the number of ICC shifts they volunteered for, and whether they held an ICC leadership position (executive officers). Primary care specialties were defined as internal medicine, family practice, pediatrics, or combined internal medicine/pediatrics. Residency fill rate was used as a proxy for competitiveness.

RESULTS

This analysis included 506 medical students (254 ICC volunteers and 252 non-volunteers). Among ICC volunteers, 47.2% matched into a primary care specialty compared to 36.5% of non-volunteers (RR 1.29, 95% CI 1.05-1.59). Each additional shift worked at the ICC was correlated with increased odds of matching into family practice by a factor of 1.042 (95% CI 1.005-1.079).

CONCLUSIONS

Medical students who volunteered with the ICC were more likely to match into primary care residencies. Students who volunteered more frequently were more likely to match into family practice. Further investigation is warranted to determine whether these associations are causative and could thus be leveraged to encourage medical students to pursue primary care careers.

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

Student-run clinics (SRCs) are becoming increasingly popular at medical schools in the United States. These clinics have provided a variety of benefits, including serving disadvantaged populations and providing early clinical exposure for students. There has been no consensus on the impact of SRCs on medical education, specialty selection, and patient care. This review provides a thorough overview of student and patient outcomes as a function of medical students volunteering at SRCs. We queried PubMed for original literature published in English between the years 2000 and 2020. Inclusion criteria included primary research articles evaluating the impact of medical student participation in SRCs on education, specialty selection, and patient care. All articles included in the final review were agreed upon by three reviewers, and the pertinent data were extracted. Of 10,200 initial search results, seven papers were included in this review. These included two studies evaluating medical education, five studies evaluating residency selection, and three studies analyzing patient care. Three studies were included in multiple evaluations. The relationship between volunteering at SRCs and academic performance is unclear. Clinic volunteers had increased retention of empathy compared to non-volunteers. Additionally, clinic volunteers provided satisfactory care as determined by patient-reported outcomes, and were not more likely to pursue primary care specialties. As SRCs are increasing in number, research into the impact on medical students and patients is necessary to understand how these clinics may affect the field of health care. It is important to further evaluate how medical student involvement in SRCs can further improve patient care and outcomes.

Student-Run Free Clinics Stand at a Critical Junction Between Undergraduate Medical Education, Clinical Care, and Advocacy

Student-run free clinics (SRFCs) act as primary care providers that bring health care to populations in need and are an important source of undergraduate medical education (UME), guiding trainees through the art of history taking and physical examination. However, they are also social justice and advocacy initiatives-addressing disparity in access to care and educating medical trainees with firsthand exposure to socioeconomic determinants of health as well as language and medical illiteracy barriers. Here, the authors review academic literature examining the impact of SRFCs in their 3 roles: as medical care providers, as components of medical education, and as advocacy organizations. Based on the evidence of that literature and decades of direct SRFC leadership experience, the authors make the case that SRFCs are an undersupported means by which UME institutions contribute to correcting health care disparities and to serving social justice reform.

Impact of COVID-19 on residency choice: A survey of New York City medical students

Objectives

The Coronavirus disease 2019 (COVID-19) pandemic disrupted medical student education, particularly in New York City (NYC). We aimed to assess the impact of the COVID-19 pandemic on medical students’ residency choices.

Methods

The authors conducted a cross-sectional survey of medical students in all years of study at four NYC medical schools (Columbia, Cornell, NYU, and SUNY Downstate). The survey was fielded from 19 Aug 2020 to 21 Sep 2020. Survey questions included items assessing COVID-19 impact on residency choices, personal impact of COVID-19, residency/specialty choices, and factors influencing these choices.

Results

A total of 2310 students received the survey, with 547 (23.7%) providing partial responses and 212 (9.2%) providing valid responses for our primary analysis. 59.0% of participants thought that COVID-19 influenced their choice of residency/specialty, with 0.9% saying the influence was to a great extent, 22.2% to some extent, and 35.8% very little. On multivariable analysis, factors that were independently associated with COVID-19 impacting residency choice included low debt ($1 to $99,999: _adjOR 2.23, 95%CI 1.02–5.03) compared with no debt and Other race/ethnicity (_adjOR 0.26, 95%CI 0.10–0.63) compared with White race/ethnicity. On secondary analysis of all participants answering survey items for logistic regression regardless of survey completion, direct personal impact of COVID-19 was significantly associated with COVID-19 impacting specialty choice (_adjOR 1.90, 95%CI 1.04–3.52). Moreover, 24 students (11.6%) reported a change in their top residency choice from before to during/after COVID-19, citing concerns about frontline work, work-life balance, and risk of harm.

Conclusions

Our study found that 3 in 5 (59.0%) participants felt that COVID-19 impacted their residency choice, with 11.6% of respondents explicitly changing their top specialty choice. Investigating the impact of the pandemic on medical student residency considerations is crucial to understand how medical career outlooks may change in the future.

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

Purpose

As the need for effective physician leaders caring for underserved populations grows, it is important to initiate interventions for medical professionals early in their education. Board experience on a student-run free clinic serving vulnerable populations within the community has the potential to educate medical students in a hands-on environment. This paper aims to determine if serving as a leader of a student-run free clinic impacts leadership skills and future leadership goals of medical students.

Design/methodology/approach

Medical students leading a student-run free clinic completed an anonymous electronic survey to determine how this experience affected their teamwork skills, interprofessional leadership skills and future leadership career goals. The survey consisted of 12 items to which students responded with how closely they agreed via a five-point Likert scale with 1 = strongly disagree and 5 = strongly agree. Descriptive statistics are reported.

Findings

From the 46 students (42.2% response rate) responding to the survey, 95.45% had a previous leadership experience and 89.2% expressed previous interest in a leadership position. Students scored on average 4.36 (out of 5) for improvement in teamwork skills, 4.34 (out of 5) for improvement in interprofessional skills and 3.88 (out of 5) for impact on future leadership career goals.

Originality/value

This study suggests that service on a student-run free clinic improves teamwork and interprofessional leadership skills as well as future leadership plans of medical students in an underserved vulnerable population environment. Other institutions could use student-run free clinics for early development of effective leaders in medical health care for the vulnerable population.

Pro Bono Services in 4 Health Care Professions: A Discussion of Exemplars

OBJECTIVE

The purpose of this article is to discuss exemplars of pro bono and charity activities in health care professions.

METHODS

We searched PubMed and Google Scholar from inception to August 2019 using search terms "pro bono healthcare," "medical volunteerism," "pro bono clinics OR free clinics OR organizations," "pro bono curriculum OR education," "underserved OR uninsured OR underinsured OR disadvantaged OR poor populations." Inclusion criteria were that practitioners, students, or volunteers be involved in pro bono care or education and in any discipline, including medicine, physical therapy, chiropractic, or dentistry.

RESULTS

We selected 5 exemplars to review, and determined that students can benefit from participation in pro bono or charity health care such as through a student administered clinic model. Academic curricula can play a role in building confidence and create positive attitudes and behaviors regarding pro bono and charity activities, and nonprofit organizations can help build sustainable models.

CONCLUSION

We conclude that the implementation and delivery of health care pro bono or charity services can fill a health care gap and can be applied successfully in the health professions.

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

BACKGROUND

The choice of medical specialty is related to multiple factors, students' values, and specialty perceptions. Research in this area is needed in low- and middle-income countries, where the alignment of specialty training with national healthcare needs has a complex local interdependency. The study aimed to identify factors that influence specialty choice among medical students.

METHODS

Senior students at the National Autonomous University of Mexico (UNAM) Faculty of Medicine answered a questionnaire covering demographics, personal experiences, vocational features, and other factors related to specialty choice. Chi-square tests and factor analyses were performed.

RESULTS

The questionnaire was applied to 714 fifth-year students, and 697 provided complete responses (response rate 81%). The instrument Cronbach's alpha was 0.8. The mean age was 24 ± 1 years; 65% were women. Eighty percent of the students wanted to specialize, and 60% had participated in congresses related to the specialty of interest. Only 5% wanted to remain as general practitioners. The majority (80%) wanted to enter a core specialty: internal medicine (29%), general surgery (24%), pediatrics (11%), gynecology and obstetrics (11%) and family medicine (4%). The relevant variables for specialty choice were grouped in three dimensions: personal values that develop and change during undergraduate training, career needs to be satisfied, and perception of specialty characteristics.

CONCLUSIONS

Specialty choice of medical students in a middle-income country public university is influenced by the undergraduate experience, the desire to study a subspecialty and other factors (including having skills related to the specialty and type of patients).

Several Ways Generation Z May Shape the Medical School Landscape

Just as medical colleges have adapted to the Millennial generation of students, a new generation is poised to enter as matriculants. Learner attributes of this generation, Generation Z, are in stark contrast to previous ones, but more than that, they provide new challenges that undergraduate universities are already facing. This article aims to highlight some of these challenges, including those relating to student counseling services, volunteering activities, learning environments, and learner perspectives. These challenges are framed and discussed within the context of medical education.

Specialty Choice Stability: Are There Implications for Early Entry Into Residency?

Introduction

The medical education community is piloting early entry to residency as a potential outcome to competency-based education and as a way to more quickly train future physicians in specialties of need. However, there is limited knowledge of which specialties may be best suited to this streamlined training. Student career desires may change over the course of their undergraduate training. We aimed to understand which specialties have stable student interest from matriculation to residency match in an effort to highlight which fields may be reasonable to consider for such accelerated programs.

Methods

Medical students at one school of medicine who matriculated in the years 2009-2013 were surveyed upon entry regarding the medical specialty they were most interested in pursuing. Six hundred fifty-four students were eligible for inclusion and 535 of the records met all requirements. On completion of medical school, final specialty choice for students obtaining a residency position was recorded. The data were analyzed to assess specialties with the highest versus the lowest rates of retention.

Results

Of 535 included students, the top specialties with retention of interest (no change in specialty choice for that student) from matriculation to match were physical medicine and rehabilitation, (100%, n=3 retention/3 initial), psychiatry (57.1%, 4/7), internal medicine (48.5%, 47/97), and family medicine (47.7%, 41/86). The specialties with the lowest retention were pathology (0%, 0/2), preventive medicine (0%, 0/4), dermatology (12%, 1/8), neurology (16.7%, 3/18) and radiation oncology (16.7%, 1/6).

Discussion

Some specialties that attract student interest before matriculation may be more likely to maintain interest compared to others. This suggests a need for further research to determine if residency entry can begin earlier than traditionally thought, with certain fields better suited for accelerated training.