Student-Run Free Clinic Project is Transforming Lives Through Holistic Care and Cooperative Learning

Story by:

• Joyce Pritchett- [email protected]

Media contact:

• Stephanie Healey- [email protected]

Topics covered:

• School of Medicine
• Free clinic
• Community health
• Holistic care

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Finding a place to belong is a universal desire. We all want to fit in and find connections with people who inspire and encourage us. For nearly 30 years, the University of California San Diego School of Medicine Student-Run Free Clinic Project has provided that comforting and familiar space for thousands of patients, medical students, physicians and volunteers.

Founded in 1997 in the basement of a Pacific Beach church, the Student-Run Free Clinic Project has grown to four locations across the county - Downtown, Normal Heights, Pacific Beach and Lemon Grove. From its simple beginning of providing basic primary medical care to those in need, the clinic now offers primary and specialty care, restorative dental care, pharmacy, vaccines, food, acupuncture, social work, support groups and mental health services.

The collective impact of the clinic reaches far beyond the patients who receive care. The volunteer medical and pharmacy students who serve at the clinic are being transformed and inspired as well.

Second-year medical student, Roberto Mora, general manager of the Pacific Beach clinic location, knows first-hand the benefits of free community clinics.

"Growing up, the only times me or my family members received care, outside of emergency care, was through free clinics," said Mora. "I often felt like an outsider when I just wanted to feel like I belonged somewhere. Being able to now provide care at the free clinic is something I always dreamed of. Now I get to be an advocate for those in need."

For those living without health insurance, the free clinic provides vital care designed to improve their well-being and empower the community. They are often living with chronic conditions, including diabetes, high blood pressure, depression, asthma and more.

"Patients come to us for care because without insurance they cannot afford to pay for visits, labs, medications or dental services," said Michelle Johnson, M.D., clinical professor of family medicine at UC San Diego School of Medicine and director of the Student-Run Free Clinic Project. "They come because they trust us and know that we will listen, care and do everything we can to help."

For patient Zulma Medina, the free clinic has cared for her family for two generations. Medina recalls that years ago, she had just given birth to a healthy baby and was not feeling well herself. She brought her mom in for an appointment and mentioned her discomfort to the doctors caring for her mother.

"They did an exam and blood work to check on me," Medina said through an interpreter. "They found out I had a thyroid problem and began treating me right away."

For the last 23 years, Medina has trusted her medical care to the Student-Run Free Clinic Project, including follow-up care after having two strokes. She explained that the reason she comes back to the clinic is because of the doctors and students that she has met over the years.

"If I don't feel well, I know I can call them, and they will take good care of me," said Medina, who has utilized many of the clinic's services including specialty care, dental care, cooking classes and even weekly acupuncture.

Esmeralda Martinez, social worker at the free clinic, says it's patients like Medina who make her job so rewarding.

"Once I started volunteering at the clinic, I loved it right away," said Martinez who has been at the clinic for 20 years serving in a variety of roles, including volunteer, interpreter and currently social worker. "I thought what I was doing (as an interpreter) was a very small contribution. But it turns out what I was doing is a big deal. I was making a real difference for the patients."

Esmeralda Martinez works closely with the patients, students and physicians at the free clinic, including clinic director, Michelle Johnson, M.D.

Collaboration and learning

The volunteers who run the clinic locations come from throughout San Diego county and include pre-medical and pre-dental students, medical and pharmacy students, physicians, dentists, pharmacists, interpreters and other allied health professionals.

The skills that each person brings to the clinic are invaluable to assuring the best possible outcomes for all through an unparalleled learning environment. First-year medical students are paired with fourth-year medical students for initial patient interactions. After meeting with patients, the students present to resident and attending physicians to collectively determine treatment plans.

"The clinics are student-run, but they are closely supervised by physicians from UC San Diego Health and other area hospitals and clinics," said Johnson. "This assures the cycle of learning continues through the medical students' journey. Those first-year students grow and learn and then when they are fourth-year students, they take on a mentorship role."

No matter the type or level of experience they bring with them, each person who is part of the Student-Run Free Clinic Project is vital to its success and equally respected.

"The free clinic is a magical place," said Sussi Yamaguchi, D.D.S., dental clinical director for the Student-Run Free Clinic Project, who also serves as an advisor for the pre-dental society at UC San Diego. "Everyone is teaching and learning from one another - the doctors, the students and the patients."

A legacy of caring

In neighborhoods where residents may not always feel comfortable seeking medical, dental or mental health care, the clinic's reputation for providing compassionate and equitable care is so important.

The clinic's very first paid staff member, Isabel Dominguez joined the clinic in 1998. She was a parent volunteer at Baker Elementary School in the Mountain View community, where her children were attending. She heard from other parents that a new free clinic had opened at the school to offer primary care for those without insurance. Not initially seeking care for herself, she took a neighbor in need to the clinic.

"When I took my neighbor who was sick to the clinic, I saw the services and the care they gave," said Dominguez. "After that, I started telling everyone about the clinic."

With so many patient referrals coming from Dominguez, Ellen Beck, M.D., Professor Emeritus of Family Medicine at UC San Diego School of Medicine, and founder of the Student-Run Free Clinic Project, invited Dominguez to initially become a clinic volunteer and then the first paid staff member. As a promotora, or health promoter, Dominguez is often the first person that patients encounter at the clinic.

At left, Alex Luli, Pharm.D., assistant clinical professor of pharmacy at Skaggs School of Pharmacy and Pharmaceutical Sciences and associate pharmacy director at the Student-Run Free Clinic Project, explains medication dosage with Emily Phung, pre-pharmacy student volunteer. At right: Jessica Bernal, fourth-year pharmacy student at Skaggs School of Pharmacy and Pharmaceutical Sciences, prepares a prescription for a patient.

In addition to supporting patients through their medical care, Dominguez has been a part of the myriad of other services that the clinic provides. She assists with the weekly empowerment group and nutrition/cooking classes.

From humble beginnings to whole person care

The needs of the patients at the Student-Run Free Clinic Project have shifted over the years. In response to those shifting needs, the students have adapted and created new programs to support those needs.

When students and volunteers determined that more that 75% of the clinic's patients experience food insecurity, they worked to create the "Food Prescription Project." Through a partnership with Feeding San Diego, those patients in need receive fresh and shelf-stable food at each of their clinic visits. In 2023, the clinic distributed 63,000 pounds of food to its patients.

The Nutrition Kitchen Project is another initiative created by a medical student volunteer. The student was passionate about cooking, food, health education and patient empowerment so they designed a program where patients, medical students and health promoters cook together and talk about nutrition. In place for more than a decade now, the program is still thriving today.

In response to growing mental health concerns during the COVID-19 pandemic, the student volunteers approached the project's mental health director, Celia Falicov, M.D., about creating a safe space for students and interpreters to meet with mental health professionals from the free clinic to talk about mental health topics relevant to their patients and learn skills to address those topics in a culturally appropriate way. The Fireside Chats became not only a safe space, but also a learning environment and way of connecting. The monthly meetings are still taking place in response to the needs of the students, volunteer interpreters and community as a whole.

Attending physicians supervise the medical students throughout the patients' clinic visit, including during blood draws.

Dedication to care

Natalie Rodriguez, M.D., clinical professor of family medicine at School of Medicine, is the Student-Run Free Clinic Project's associate director. She noted that the patients' trust in the clinic volunteers and staff is one of the things that brings them back each visit. For the student volunteers, it's the collaborative, whole-person approach to care, learning and teaching that inspires them to return to the clinic.

"The students can earn elective course credit, but it is their choice to come to the clinic each week," said Rodriguez, who began her journey at the Student-Run Free Clinic Project as a School of Medicine student more than 20 years ago. "We are an intergenerational place. We have all learned so much about life being here together."

"The feeling of community that I have found here usurps all," said Alena Pauley, second-year medical student and a general manager of the downtown clinic location. "The community is really special. Being able to work with people in so many different ways, with so many levels of experience makes coming here the highlight of my week."

Everyone involved in the Student-Run Free Clinic Project embodies the project's stated mission: "In partnership with the community, our mission is to provide respectful, empowering, high quality health care for the underserved while inspiring the next generation of health professionals."

Johnson, who also began her journey at the clinic as a medical student more than 20 years ago, perhaps summed it up best, "The patients are incredible. They are resilient, wise and have taught me so much. The students and volunteers are inspiring. They give me hope for the future with their dedication, passion, commitment to equity and humanism. I absolutely love working with the clinic. It's my dream job because it's meaningful, dynamic, inspiring and challenging."

Much of the work being done by the Student-Run Free Clinic Project depends on the generosity of individuals, foundations, businesses and organizations. To learn more about how you can support the project, please visit the UC San Diego Student-Run Free Clinic Project website.

The clinic fosters community and family-like bonds between the patients, medical students and physicians. They all work together to assure patient-centered, holistic care for their patients.