Mobile medicine: VCU students travel to provide health care to the underserved

By Grace McOmber
School of Medicine

On a chilly Saturday morning in October, first-year Virginia Commonwealth University medical student Julia Ball and five of her peers piled into a 3:30 a.m. carpool headed toward the Rockingham County Fair Grounds near Harrisonburg, Virgininia. But instead of Ferris wheels and funnel cake stands, the 111-acre grounds hosted medical tents, dental stations and a mobile optometry trailer. It was Ball's first time volunteering at a pop-up clinic organized by Remote Area Medical, a national organization that provides free primary health care services to underserved communities via mobile clinics.

As a Spanish interpreter at the event, Ball stepped in when needed during patient interactions and spent most of the day translating for a young family as they moved through the clinic's services. Ball learned the family had been waiting months to attend the event so their 2- and 6-year-old children could see a dentist for the first time. The parents, both hourly workers, had taken time off to ensure they got in line in time to receive care.

"There are just so many hurdles to this family getting the care they need. On top of the language barrier, they're uninsured, and coming to the clinic meant a lower paycheck," Ball said. "Seeing how much these parents sacrificed so their kids had this care is going to stay with me forever."

That family made up just four of the 323 patients seen that weekend, and Ball left the clinic inspired, motivated and committed to volunteering with RAM "any chance I can get." Sydney Williams, a third-year student in the School of Medicine and president of VCU's RAM chapter, said that's common for first-time volunteers.

"We call it the 'RAM bug.' You really fall in love with the experience," Williams said. "As devastating as it can be to see these people that have been failed by our systems, it's joyous to see how people are still able to come together."

A structure for service

Founded in 1985, Remote Area Medical coordinates, funds and staffs pop-up clinics around the U.S. to provide cost-free medical, dental and vision care to communities lacking adequate access to primary care. Community leaders apply to host a pop-up clinic and provide RAM with a facility to operate out of, often a school gymnasium, community center or church. RAM then provides all necessary medical equipment and coordinates with local health care providers and volunteers to operate the event. Services are open to anyone, no questions asked, and provided on a first-come, first-served basis. Over the course of the weekend, the volunteers see as many patients as possible, usually in the hundreds.

The organization has undergraduate student chapters throughout the country, including at the University of Virginia, co-founded by Williams and childhood friend Katherine Ladocsi. Both described the experience as transformative, and when the two arrived at VCU in 2023 -- Williams at the School of Medicine and Ladocsi at the School of Dentistry -- they knew they wanted to continue that work.

Williams and Ladocsi, who serves as vice president, helped start a RAM chapter for VCU graduate students in 2024, organizing volunteer groups that have since traveled to nine pop-up clinics in rural settings throughout Virginia and North Carolina. Since its founding, interest from students has outpaced available travel slots, and the group now selects volunteers for each clinic through a raffle system.

"It's a good problem to have, and I think it shows how interested VCU students are in working with the community," Williams said. "It's an opportunity for us to learn about a different type of care and the challenges that come with working in underserved groups."

First-year Tanisha Roy was one of the medical students selected to travel with the group to the pop-up in Harrisonburg. She spent that Saturday shadowing Denee Moore, M.D., faculty advisor for RAM and an associate professor in the Department of Family Medicine and Population Health. Moore encouraged Roy to take the lead in asking patients about their medical history and concerns, which, up until that weekend, Roy said she had only practiced in simulation exercises.

"It was really cool to practice those skills in a real setting and see how Dr. Moore used her experience and knowledge about the community to ask more specific questions," Roy said. "It was a bit overwhelming at first, but I learned so much in that one day."

Moore has volunteered at RAM pop-up clinics for the past 15 years, starting when she herself was a preclinical student at the School of Medicine. Serving as faculty advisor, she said, means supporting continued student participation in one of her "most memorable experiences from medical school."

"Attending RAM pop-up clinics solidified my career trajectory," Moore said. "These clinics helped me build the knowledge and skills that are critical for delivering high quality primary care in medically underserved communities."

Bridging the gap

By the time student volunteers arrive at a clinic around 6 a.m., the parking lot is almost always full of patients, many of whom arrived the night before, lined up and eagerly waiting to be admitted. Over the course of the weekend, medical, dental, pharmacy, nursing and undergraduate students assist throughout the clinic, either as general support or in a position aligned with their field. Volunteer health care professionals provide a range of services from general physicals, dental cleanings and eye exams to more specialized care like tooth extractions, glaucoma testing and on-site prescription glasses. For many patients, it is the first time they have seen a medical provider in years, Williams said.

People with limited or no health insurance often delay seeking care because of the cost barrier, leading to worse outcomes as health concerns go unaddressed. Over the years, Ladocsi and Williams have seen the consequences of this in RAM pop-up clinic attendees, from a man who needed multiple teeth pulled at once to a woman who could no longer drive because her glasses prescription was so long expired.

"It can be a really emotional experience," Williams said. "You spend a lot of time talking to these patients over the course of the clinic, and hearing everything they have gone through and the hoops they jumped through just to get something like a new pair of glasses is heart wrenching."

In addition to having high populations of uninsured and underinsured patients, the towns and counties hosting RAM clinics are more likely to be affected by the nationwide primary care physician shortage. According to Ladocsi, RAM collects data on the needs of each hosting community, which can help attract federal and state resources to the area. The goal, she said, is to decrease the need for outside groups like RAM to come in and provide basic health care services.

"I think of RAM as more of a bridge than a band-aid solution," Ladocsi said. "The number of patients that rely on these clinics shows to policymakers how badly more support is needed."

As Williams and Ladocsi look to their final year of medical and dental school, both said they are motivated to continue working in underserved communities, following the example of the many practitioners they have met at RAM clinics.

"Being in health care is already a demanding job, so it's really inspiring to see these doctors putting in so much effort on their days off and for free," Ladocsi said. "That's the kind of provider I want to be in the future."

This story was originally published on the School of Medicine's website.