A Free Clinic Continuity Experience During Residency Is Associated With Practice in Underserved Areas

BACKGROUND: Exposure to underserved areas during training may increase residents' likelihood of practice in these settings. The Marshall University Family Medicine Residency offers a supplemental continuity experience at a local free clinic to interested residents.

OBJECTIVE: We assessed the association of such an experience with graduate practice choices.

METHODS: We evaluated all residency graduates (N = 138) who completed our family medicine program from 1997 through 2014 and compared participants in the free clinic experience to nonparticipants. Various characteristics and outcome measures were collected retrospectively from resident records maintained for program accreditation.

RESULTS: A total of 43 residents participated in the free clinic experience compared with 95 nonparticipants. Postgraduation practice in an area of need was seen for 56% (24 of 43) of participants compared with 31% (29 of 95) of nonparticipants (P = .005). The 53 graduates practicing in areas of need were nearly twice as likely to have taken part in the free clinic experience (45% [24 of 53] versus 22% [19 of 85], P = .005). Participants were more likely to practice in rural areas (63%, 27 of 43) than residents who did not participate (43% [41 of 95], P = .033). Board certification rates were high for both free clinic participants (98%, 42 of 43) and nonparticipants (95% [90 of 95], P = .43).

CONCLUSIONS: Resident participation in a supplemental continuity experience at a free clinic was associated with practicing in areas of need and rural communities after graduation.