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Implementing Federal Immigration Medical Examinations into a United States Student-Run Free Clinic
Julio Siliezar1, Paola Rodriguez2, Yakelin Arroyo-Velazquez2
1University of California Davis School of Medicine, Sacramento, CA, USA. jarsiliezar@ucdavis.edu.
Abstract:
The Immigration Medical Examination (IME) is a mandatory step in obtaining U.S. permanent residency, yet its high cost and limited accessibility pose significant barriers for low-income immigrants. Addressing these challenges is critical to ensuring equitable healthcare access for underserved populations. To present the benefits and process of integrating IME services into a student-run free clinic serving low-income immigrant populations. A review of IME requirements, cost barriers, and existing student-run clinic models informed the development of an IME program at the Knights Landing One Health Center (KLOHC). The implementation process involved four key steps: assessing community needs, securing qualified personnel, establishing clinic logistics, and implementing a structured training model for student volunteers. A retrospective chart review of patients receiving IME services from May 2022 to May 2024 was conducted to analyze patient demographics, service utilization, and health screening outcomes. KLOHC provided IME services to 204 patients, with 177 adult records analyzed. The majority were Hispanic/Latino (84%) and Spanish-speaking (79%), highlighting the importance of culturally and linguistically competent care. Patient volume steadily increased, with a consistent waitlist of 14-20 individuals per session. Cost reduction was significant, with services provided at no cost for selected cities already served by KLOHC. These cities include Knights Landing, Davis, Winters, Woodland (Yolo County), Yuba City (Sutter County), and Sacramento (Sacramento County). A $250 was charged to non-target community patients, compared to the private sector's $400-$900 range. IME health screenings identified cases of tuberculosis and sexually transmitted infections, enabling timely treatment. The structured student leadership model ensured continuity, training, and sustainability. Integrating IME services into student-run clinics is a feasible and effective strategy to expand access to essential health evaluations for immigrant populations. Funds collected from non-target communities were used to pay for vaccines, x-rays, and transportation for target community members which eased the financial burden of the already expensive immigration process. KLOHC's model demonstrates a cost-effective service for patients, improves healthcare accessibility, and provides hands-on training for future healthcare professionals. This initiative serves as a replicable framework for other student-run clinics nationwide, addressing a critical gap in immigrant healthcare and promoting a more equitable healthcare system.
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