Early Exposure to Underserved Patients and Its Impact on Initial Employment Decisions Regarding Physician Assistants.

Purpose: This study explored the impact of early, repetitive, and required participation in a homeless shelter-based, student-run free clinic (SRC) on career choice in primary care, underserved medicine, and future volunteerism in physician assistants (PAs). The investigators hypothesized that students required to participate in the SRC would be more likely to select a career in primary care, be providers to underserved populations, and to volunteer.

Methods: A 30-question online survey, which included open- and closed-ended questions, was administered to alumni of the DeSales University PA program from January 2015 to April 2015. Alumni who had and had not been exposed to the SRC were included in the sample.

Results: Completed surveys were obtained from 43 graduates who attended the university before the opening of the SRC and from 114 graduates who were required to participate in the SRC, for an overall response rate of 31.2%. Graduates who were exposed to the SRC were significantly more likely to have an initial and current career in primary care. Furthermore, alumni who had worked in the SRC were more likely to report that they believed their DeSales University experience influenced their decision to enter primary care as compared to those who did not have exposure to the SRC.

Conclusion: This study provides initial evidence that early, repetitive, and required exposure to a student-run free clinic impacts graduates' decisions on career choice and volunteerism. The structure of this particular clinic and its location in a homeless shelter may have provided an opportunity for students to explore how social determinants affect health in an underserved population.