Medical Students Open Free Health Care Clinic

April 07, 2009

In a time of economic stress, University of Rochester School of Medicine and Dentistry students have opened a weekly free clinic for the homeless, working people without insurance as well as those with insurance whose financial problems limit access to health care.

The clinic for people with acute or chronic conditions is held on Thursdays from 6 to 8 p.m. at Asbury First United Methodist Church, 1050 East Ave.

The project is a part of UR Well Student Outreach, through which medical students work in the community. A convergence of goals enabled the launch of the clinic earlier this year. Asbury First United Church wanted to expand its already significant community outreach programs.

“Medical students are looking for more opportunities for clinical experience and more opportunities to serve the uninsured and under-insured in the community,” said Robert Fulton, a School of Medicine and Dentistry student in the Class of 2011 who helped organize the clinic.

A 43-year-old man who complained of a cough and fever that had lasted for two weeks was a recent patient at the Asbury clinic. The patient was homeless and had no health insurance. His last visit to a doctor was more than eight years ago. The medical student health team, along with an attending physician, made the diagnosis of community acquired pneumonia. The team was able to offer the patient free antibiotics. More important, the team discovered he had elevated blood pressure and a high blood sugar level. Using the clinic’s partnerships with primary care providers, the patient was able to be seen at a UR Well program at St. Joseph’s Neighborhood Center, where his chronic issues could be managed.

The mission of the UR Well clinic at Asbury First United Methodist Church is to address acute concerns and exacerbations of chronic conditions, including congestive heart failure, chronic obstructive pulmonary disease, asthma, diabetes mellitus, hypertension, gastroesophageal reflux disease. Acute conditions include respiratory infections, rashes, injuries, and musculoskeletal complaints.

Fulton and C. McCollister Evarts, M.D., Distinguished University Professor, conceived and developed the project with assistance from Nancy Shafer Clark, M.D., assistant professor of medicine. Evarts, an Asbury trustee, worked with church officials to identify space for the clinic. He also obtained equipment and supplies for the clinic.

Volunteer physicians and Nurse Practitioners from the Department of Emergency Medicine and Department of Orthopaedics, as well as physicians who are members of Asbury First United Methodist Church, supervise the clinic. More than 50 medical students have volunteered to work at the clinic. Along with Fulton, medical students Jamie Mullaly, Gregory Ouellet, Michael Bender and Richard Gaines manage the clinic.

“This project will bring health care to the truly needy. It is part of the church’s community mission and also an exceptional educational experience for the medical students,” said Evarts.

The clinic’s services, which continue to expand, include electrocardiograms, urinalysis, fecal occult tests and testing for blood glucose levels and strep. The clinic plans to add tests soon for tuberculosis, sexually transmitted diseases and pregnancy. The clinic also prescribes and supplies medications.

For almost five years, School of Medicine and Students also have provided health care at St. Joseph’s Neighborhood Center one evening a week to many who have no insurance.

Community service and outreach are longstanding traditions at the School of Medicine and Dentistry. About 80 percent of first-year and second-year School of Medicine and Dentistry students volunteer for an ongoing community outreach project. These voluntary projects enhance each student’s effectiveness in caring for patients from diverse backgrounds.

The Community Health Improvement Clerkship (CHIC) is a requirement for graduation from the School of Medicine and Dentistry. The only required fourth-year clerkship of its kind in the country, CHIC provides medical students with a community-based educational experience, while increasing access to health care by underserved populations. Students are encouraged to build on projects begun by past or current CHIC students, which helps sustain efforts that are beneficial to the community. Since its inception in 2002, CHIC has resulted in more than 190 unique community health improvement projects, involving almost 400 medical students. In a survey, 94 percent of a recent graduating class reported that their clerkship project affected their future career favorably. In 2003, community health formally was established as the fourth mission of the Medical Center, along with education, research and patient care.

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