1. With a predicted nation-wide shortage of primary-care physicians in the U.S. due to both increased patient demand and declining student interest in the field 1, innovative means to recruit medical students into these fields is increasingly essential. Student-run free clinics are gaining recognition as valuable opportunities to expose medical students to primary care settings 2. Methods Discussion Does Leadership in a Student-Run Free Clinic Correlate with Residency Selection? Kate Currie, Stephanie Garbern, Pablo Joo, M.D. DEPARTMENT OF FAMILY MEDICINE, ALBERT EINSTEIN COLLEGE OF MEDICINE OF YESHIVA UNIVERSITY References Publicly available residency match results from 2007, 2008, and 2009 were analyzed using Pearson’s chi-square test to compare the proportion of students with leadership positions at ECHO (board members or session coordinators) matching into primary care specialties to the rest of the Einstein class. Comparison was also made to the national proportion of U.S. seniors (subtracting all Einstein students) matching into primary care specialties using National Residency Match Program (NRMP) data. Primary care specialties were defined as: Family Medicine Internal Medicine Medicine-Family Medicine Medicine-Pediatrics Medicine-Primary Pediatrics Pediatrics-Primary 1.Hauer KE, Durning SJ, Kernan WN et al. Factors associated with medical students’ career choices regarding internal medicine. JAMA. 2008 Sep;300(10):1154-64. 2.Simpson SA, Long JA. Medical student-run health clinics: important contributors to patient care and medical education. J Gen Intern Med. 2007 Mar;22(3);352-6. 3.Campos-Outcalt DE. Specialties chosen by medical students who participated in a student-run, community-based free clinic. Am J Prev Med. 1985 Jul-Aug;1(4);50-1. 4.Einstein Community Health Outreach (ECHO) Free Clinic. Website available at http://www.einstein.yu.edu/echo/features.aspx. Accessed Nov 30, 2009. Our analysis showed that Einstein students holding leadership positions at ECHO were significantly more likely to match into primary care residencies compared to their classmates (χ 2 = 11.108, df=1, p<0.001) and all U.S. seniors (χ 2 = 13.370, df=1, p<0.001). Our analysis shows that a high degree of involvement in a student-run free clinic correlated with a greater likelihood of matching into a primary care specialty. One challenge we faced was in the definition of “primary care.” While family medicine and pediatrics are fairly universally considered primary care, we found internal medicine varied in whether it was considered a primary care specialty or not. Our analysis showed results similar to studies performed at other student-run free clinics 4. However, from these studies alone, it is impossible to establish whether students who are predisposed to primary care careers become involved in ECHO, or whether involvement in ECHO influences their residency selection. Our results do prompt future studies to deduce the nature of the relationship, such as questionnaires to gather student input on the influence involvement in community-based free clinics has on residency selection. Introduction Results Acknowledgements Many thanks to Dr. Amarilys Cortijo, the ECHO board, Dr. Albert Kuperman, and the Department of Family and Social Medicine for their encouragement and advice. Figure 2. Students at ECHO Clinic. ECHO Non- ECHOTotal Primary Care38188226 Non-Primary Care21265286 total59453512 ECHO U.S. SeniorsTotal Primary Care381746217500 Non-Primary Care212515225173 Total594261442673 All Einstein U.S. SeniorsTotal Primary Care2261746217688 Non-Primary Care2862515225438 Total5124261443126 Table 3. Primary Care selection among all Einstein students vs. U.S. seniors Table 2. Primary Care selection among students with ECHO leadership roles vs. U.S. seniors. Table 1. Primary Care selection among students with ECHO leadership roles vs. non-ECHO Einstein students. Since 1999, preclinical- and clinical-level students at Albert Einstein College of Medicine of Yeshiva University have operated Einstein Community Health Outreach (ECHO), a free primary care clinic in the South Bronx, a low-income urban setting, for adult patients without insurance 3. We hypothesize that students with leadership roles (either board members or session coordinators) will have a greater likelihood of matching into primary care specialties than students who do not participate or who serve in non-leadership positions. Figure 1. Student preparing a laboratory sample. Of the 59 Einstein students with leadership positions at ECHO, 38 (64.4%) matched into primary care residencies as compared to 188 of their classmates (41.5%). Einstein students as a whole matched into primary care residencies at about the same proportion (44.1%) as compared to all U.S. seniors (41.0%) (χ 2 = 2.093, df=1, p=0.148) Figure 3. Registering patients at the front desk.