For the past four years, Dartmouth medical students have been doing the usual—going to class, doing lab work, hitting the books. And running a free medical clinic for uninsured residents of New Hampshire towns along the Mascoma River.

Twice a month, in donated space in Canaan, the Mascoma Valley Free Health Clinic provides primary care to those in need. The idea originated as a 2003 Schweitzer Fellowship proposal by Amy Noack '05. Ever since, DMS second-year students and DHMC residents have kept the clinic going. Over 50% of the current second-years helped at the clinic this year, and more than 60% of first-years plan to volunteer next year.

Time: Working at the clinic gives students an early chance to apply classroom knowledge. They learn how to relate to patients as they gather medical histories so the resident in charge can make treatment decisions. "Students do not have the same time constraints as do fullfledged doctors," says fourth-year student Matthew Laquer, "enabling them to have longer interactions with patients."

Care: Kristen Yurkerwich, a second-year, recalls a teenaged patient who came in for a pregnancy test. "The second-year student that evening got to have a very thorough and thoughtful conversation with the girl and her mother," says Yurkerwich. The student "and the teen really bonded that night, and both left with a very positive clinical experience." The teen was then referred to DHMC for further testing and prenatal care.

The clinic, a satellite of the free Good Neighbor Health Clinic in White River Junction, Vt., also introduces students to the realities of providing care to uninsured

patients with chronic conditions. For patients with high blood pressure, high cholesterol, or diabetes, the cost of medications can be daunting. "One pill can be so expensive that it wipes out an entire month's income," says fourthyear Theodore Yuo, who has helped raise money for the clinic. Now, a local pharmacy provides medications to the clinic for one dollar above wholesale. And, Yuo adds, students are learning that "there are other ways of treating these illnesses than the most expensive."

Coordinators hope to expand the clinic's services and offer counseling on diabetes, tobacco, and healthy lifestyle choices. "A patient's health-care needs [go] well beyond their visit to a provider's office," says second-year James Town. "We've helped them identify lifestyle issues they can target, such as diet,

exercise, and smoking cessation." The students have also set up a website containing health tips.

Money: The "growth-limiting factor" in the clinic is funding, says Laquer. Yet students find innovative ways to raise money, holding raffles, talent shows, and even a triathlon. The clinic has also been supported by grants— including a $20,000 "Caring for Community" award from the Association of American Medical Colleges.

The clinic's latest honor was Dartmouth's 2007 Martin Luther King, Jr., Social Justice Award, in the student organization category. The "Mascoma Clinic's success," says M.D.-M.B.A. student Jessica Morgan, "is indicative that community service is an integral part of life here at DMS."