A new Teach for America-style program takes on health workforce shortages

MedServe fellow Misty Cox. Courtesy of UNC
MedServe fellow Misty Cox served as a medical assistant in a North Carolina clinic. (UNC)

What started as a pilot program for solving medical workforce shortages in underserved areas has grown into AmeriCorps' latest direct service option.

MedServe, a nonprofit originally launched as a pilot partnership through Duke and the University of North Carolina, was created to allow premedical students to work in healthcare clinics in order to offer them more meaningful early-career experience while offering underserved clinics much-needed extra help.

In two years, the program helped fill 45 positions in 25 underserved communities. 

"People for the last 30 years have been trying to do something about addressing workforce shortages in healthcare by stressing training pipelines, and people have been throwing a lot of money at it," Anne Steptoe, M.D., one of MedServe's founders, said in an interview with FierceHealthcare.

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Steptoe was the beneficiary of an early-career experience in a clinic, which made a big impact on her decision to become a primary care physician. The idea of MedServe, she said, is to capture other students at an influential time in their career decision-making.

That resonated with AmeriCorps, which began connecting its VISTA volunteers to the program last year. This year, AmeriCorps decided to fund MedServe as one of its direct-service programs.

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AmeriCorps is providing $500,000 in funding toward giving 25 MedServe volunteers a living stipend of approximately $20,000. AmeriCorps typically keeps volunteer stipends low, both to make funding stretch further and to give volunteers an idea of what it's like to live near the poverty line.

Steptoe said she believes the program has a return for the future doctors because of the early work experience it offers them. "Often the people we want to invest scholarship money in—because of where they grew up or their personal connection to underserved communities—either have too much difficulty getting into places like medical school or they have not had the same exposure either to be competitive or to be ready for the scholarship opportunities," Steptoe said. "And so, our fellows who come and do two years in the program have made a pretty big demonstration of their commitment that we have found to be really attractive to our medical schools and other partners."

Of the first graduating class of MedServe volunteers, 25% have already been offered scholarships in a medical school program. That is before large scholarship decisions that will come later this fall. In the general applicant pool, around 10% of accepted students are offered some sort of scholarship, Steptoe said.

Serving rural communities

Clinics, in turn, receive an almost immediate source of additional support as well as a pipeline for future talent. Volunteers spend about half of their time working directly in a clinic and the other half doing community health outreach such as health coaching.

Although volunteers lack the certification to fill some of the worst gaps in these rural health systems, clinics still require a range of entry-level roles that don't require such certification. Medical assistants, medical scribes, language interpreters all require few qualifications but still allow volunteers to make a meaningful contribution. Clinics, particularly rural ones, see lots of turnover in their clinical support staff, which can leave them shorthanded and overworked.

RELATED: Rural health crisis escalates: Sometimes there’s only 1 doctor in town (if you’re lucky)

Volunteers' responsibilities often aren't limited by the law. Instead, licensing and certifications requirements are more frequently instituted by the organizations where volunteers are placed. "There are relatively few barriers from a legal licensing perspective. There are plenty of barriers and standards that organizations enact about whether there are certain certifications required for certain positions. But those are organizational barriers, not necessarily legal barriers," Steptoe said.

The one main exception to that, Steptoe said, was clinics in advanced stages of meaningful use, where volunteers were not legally allowed to do certain types of paperwork.

The upshot of all this, however, is that MedServe volunteers can expect to experience a wide variety of healthcare roles, depending on where they are stationed—a fairly common situation for AmeriCorps programs.

This post has been updated to clarify the distinct, nonprofit status of MedServe.

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