Implementation of a Specialty-Focused Musculoskeletal Service in a Medical Student-Run Free Clinic in Puerto Rico

Musculoskeletal (MSK) conditions are a leading cause of pain, disability, and functional limitation worldwide and disproportionately affect underserved populations. Student-run free clinics frequently provide essential primary care services but often lack the specialty capacity needed to address MSK-related complaints. This study describes the implementation of a specialty-focused MSK clinic within a community-based student-run free clinic in Puerto Rico. A specialty-focused MSK clinic was implemented within an existing student-run free clinic in Puerto Rico from April 2025 through March 2026 using an interdisciplinary model that integrated volunteer orthopedic surgeons and physical medicine and rehabilitation specialists into the clinic's care structure. During this period, a total of 54 patients attended the clinic. The clinic emphasized functional assessment, patient education, and management planning within a trusted community-based setting. Evaluation relied on descriptive clinic metrics, patient-reported presenting complaints, reflective practice through post-clinic debriefings, and informal feedback from patients and volunteers to guide iterative refinement. During the study period, MSK pain, prior injuries, and mobility-related concerns were among the most common patient-reported complaints. Implementation of the MSK clinic expanded the clinic's capacity to evaluate and manage chronic and acute MSK conditions that had previously been under-addressed because of limited specialty access. Early observations included improved identification of MSK conditions, greater emphasis on pain management and functional restoration, increased patient understanding of care plans, and strong interdisciplinary collaboration among specialty and primary care volunteers. Integrating specialty MSK services into a student-run free clinic is a feasible approach to addressing an important service gap in underserved populations. This model highlights the value of interdisciplinary collaboration and may be adaptable to similar resource-limited clinical settings seeking to strengthen community-based specialty care and address MSK health needs.