Objective:

To describe the patient population at FNCHC and its impact on neurology resident education and training.

Background:

Uninsured patients with neurologic diseases suffer worse healthcare outcomes than insured patients. Limited access to care is exacerbated by lack of subspeciality neurology care in free community health clinics. Our neurology residency partnered with the local free clinic, establishing Free Neurology Community Health Clinic (FNCHC) to provide neurology evaluations for uninsured patients.

Design/Methods:

FCHC operates one half day per month with 4-6 patient slots, staffed by 1-2 neurology residents and one attending. Diagnostics and medications prescribed are free for patients. Patient variables are collected from clinic EHR. Six neurology residents who volunteered 2+ clinics were given feedback surveys pertaining to educational value, clinical decision making, personal fulfillment, and career practice graded on a 5-point Likert Scale from “strongly disagree” to “strongly agree”.

Results:

Over the fifteen months since inception, 73 new or return clinic appointments were scheduled, 66 were seen (91.6% show rate). Most common spoken language was Spanish (66.7%), then Polish (18%). The most frequent chief complaint was headache (50%), then parasthesias (9.1%), double vision (6.1%) and stroke (4.5%). Subspecialities fields represented included vascular, headache, neuromuscular, epilepsy, movement disorders, sleep, and cognitive neurology. Most therapeutics initiated were targeted at headache management, followed by antiseizure medications, and myasthenic medications. 6/6 residents completed feedback surveys. All residents strongly agreed that their FNCHC experiences was fulfilling and educational for CDM in low resource settings. Furthermore, all residents agreed their experiences encouraged continued commitment to underprivileged populations during residency and future careers.

Conclusions:

Diversity of patient population and neurologic disorders are well represented in FNCHC. Resident feedback demonstrated overwhelmingly positive impact on fulfillment and clinical education, as well as future career involvement in underserved populations. Future directions for FNCHC include expanding diagnostics, therapeutics, and formal integration into residency education.