Development of a four-day service-learning rotation for third-year medical students

Despite the proven benefits of service-learning, its use in medical school curricula has been inconsistent. The effect of service-learning on students' primary care residency choices is largely unknown.

Fifty-three students completed a 4-day service-learning experience, which included homeless clinics, homeless shelter, and street outreach, then completed surveys and wrote reflection essays. The survey responses were tested for significant differences using an overall F test, and the responses of volunteer versus assigned students were compared. The essays were analyzed for thematic content using an inductive approach. Primary care residency rates of the students were compared with the class as a whole.

Of the participating students, 94.3% agreed or strongly agreed that learning objectives were fulfilled, and 81.9% rated the educational experiences as outstanding or good. The best-achieved learning objectives were increased understanding of the role of poverty in disease and development of a sense of professional commitment as a physician. Of the essays, 74% discussed barriers to care, of which substance abuse (28%) and mental illness (19%) were the leading themes. Primary care residency rates of participants were not different from the class as a whole, but there was a nonsignificant trend toward primary care residencies in volunteer versus assigned students.

We present a brief service-learning experience that provides educational value to medical students and service to the community, fulfills Liaison Committee on Medical Education accreditation requirements, and has only a small cost in time taken from the clerkship curriculum.