Student Volunteer Retention and Operational Stability in U.S. Student-Run Free Clinics.

Abstract

Student-run free clinics (SRFCs) provide essential safety net care for under- or uninsured patients in the United States and are predominantly staffed by student volunteers. Variable volunteer availability and turnover may threaten staffing consistency, clinic operations, and downstream continuity of care. An anonymous, web-based cross-sectional survey was provided to attendees at the 2025 Society of Student-Run Free Clinics annual conference (Chicago, Illinois) using convenience sampling and QR-code recruitment. Two ordinal outcomes, staffing difficulty and operational disruptions, were collapsed into ordered categories. Predictors included clinic characteristics and operational factors. Multivariable ordinal logistic regression models were fit separately for each outcome. Estimates were pooled using Rubin's rules and reported as odds ratios (ORs) with 95% confidence intervals (CIs). Among 513 conference attendees, 154 responses were obtained (30%), and 152 respondents were identified as having completed the survey. Most clinics used an electronic medical record (83%) and reported high student participation (64% with ≥ 10 volunteers/shift). Staffing difficulty was most often reported as occasional (48%) or rare (32%). Operational disruptions were uncommon (57% never, 34% rare). Higher student volunteer retention beyond 1 year was associated with lower odds of greater staffing difficulty (OR 0.43, 95% CI 0.20-0.94) and lower odds of greater operational disruptions (OR 0.42, 95% CI 0.19-0.93). In SRFCs, student volunteer retention appears to be a central correlate of staffing stability and reduced operational disruption. Operational models that promote longitudinal student engagement may improve clinic reliability and support sustainable delivery of safety net care.