UC San Diego Student-Run Free Clinics
They come from diverse places, with different stories and varying circumstances. But all who arrive here — at two churches and two elementary schools — come with the same, shared needs.
Since 1997, the UC San Diego Student-Run Free Clinics have provided health, social and legal assistance to thousands of men, women and children unable to afford or obtain services through more traditional means.
“These are among society’s neediest,” says Ellen Beck, MD, clinical professor of family and preventive medicine at UC San Diego and clinic founder. “This is a clinic for patients who have fallen through the cracks, and who don’t have anywhere else to go.”
Although Beck and a team of School of Medicine faculty members act as advisors, the clinics are largely run by students from the UC San Diego School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, with help from local doctors, dentists, legal advisors, social workers and interpreters — all of whom volunteer their time and expertise.
The clinics have been a marked success since the first clinic opened inside a churchbased homeless shelter in Pacific Beach. Not just for the approximately 2,000 patients seen each year, treated for everything from poor nutrition or an aching tooth to diabetes, asthma and heart disease, but also for the future doctors and pharmacists who choose to serve the underserved.
“Our students come into medicine with passion and compassion,” said Beck. “Programs like this keep those emotions alive.”
They keep patients alive, too.
Jeremy Egnatios, a first-year medical student, recalls working with a woman to help regulate her blood clotting. When a test came back suggesting her medication levels were too high and that she was at risk for excessive bleeding, Egnatios went looking for the patient, who had left no contact information. He found her and lowered her dosage. “It potentially saved her life,” he said.
The clinics are typically open a few nights a week, operating on a $1.6 million annual budget funded by foundations, private donations and the UCSD School of Medicine. Millions more come in the form of in-kind contributions, such as discounted lab testing and brandname drugs from pharmaceutical companies. Eduardo Fricovsky, PharmD, who directs the clinics’ pharmacy operations, says roughly 24,000 free prescriptions are issued each year, with an estimated market value of $2 million.
The clinics bring patients and students together in ways rarely seen in more established venues. “Our method of practice gives us a lot of time to spend on each patient encounter,” said Dylan Mann, a second-year medical student. “This is ideal and quite a bit different from how it will be after we graduate. It’s utopian, really.”
A Collaborative Learning Experience
Medical students work elbow-to-elbow with pharmacy students. They may walk a patient over to a nearby social worker or legal advisor, or to the nearby dental and acupuncture rooms, the latter staffed by students from Pacific College of Oriental Medicine.
“It’s a fantastic collaborative experience,” said Tony Kuleto, a 34-year-old former Secret Service agent turned second-year medical student who chose UC San Diego, in part, for a chance to work in the clinics.
Over the years, others have taken note of the clinics’ good work as well, which has served as a model for similar endeavors at other medical schools. Indeed, more than 107 faculty members from educational institutions in 30 states have visited San Diego as part of a national faculty development program to learn the mechanics of creating and operating a student-run free clinic. At last count, there were more than two dozen similar clinics in operation around the country.
Closer to home, UCSD School of Medicine students have started a free clinic in Tijuana, Mexico, in collaboration with the medical school at the Universidad Autónoma de Baja California. Farther away, Skaggs students are helping start a free clinic in Awka, Nigeria, partnering with Nnamdi Azikiwe University.
For participating medical students, the clinics are a chance to apply classroom teaching to real people and real-world situations. The rewards are psychic as well.
Mann, the second-year medical student, recalls treating two patients with serious health problems linked to excessive weight. He prescribed diet and exercise programs. One day, both patients visited the clinic, leaner and healthier — stories of success. “That was one of my best days ever at the clinic,” Mann said.
Such moments undoubtedly deepen the students’ desires to become the best doctors and pharmacists possible. They spur many to work over the summer and during winter breaks even though they do not receive academic credit. These are moments they’ll remember long after graduation.
The students have already launched a campaign to pledge part of their future earnings to help keep the clinics alive and well. So far, they’ve raised more than $157,000. That’s putting money where their heart is.