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Bringing Contraceptive Counseling to a Student Run Free Clinic

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By Adrian Ziaggi, Mika Connolly, Rachel Tullio, and Bryna Torre
University at Buffalo Jacobs School of Medicine

Hello from Buffalo, NY! We are second year medical students at the University at Buffalo Jacobs School of Medicine and co-presidents of the MSFC Buffalo chapter. One of the unique activities we coordinate as part of our chapter is contraceptive counseling at the Lighthouse Free Clinic.

Lighthouse Free Clinic is a medical student-run organization that partners with community physicians to provide free healthcare to uninsured and underserved patients in Buffalo. The clinic provides a range of primary care services including contraceptive counseling by our MSFC volunteers. Patients can indicate on their intake forms whether they are interested in seeing a contraceptive counselor during their visit or if they are referred from the clinic’s STD testing services.

The MSFC contraceptive counseling program began two years ago as a result of conversations with the student managers of the Lighthouse Free Clinic. The managers reached out to MSFC about the need for birth control information and education among the patient population, and so MSFC partnered with some of Buffalo’s OB/GYN residents to establish trainings for medical students interested in volunteering at the Lighthouse Clinic. Bryna Torre, currently a third year medical student and the founder of the University at Buffalo chapter of MSFC, spearheaded the program’s development.

Bryna grew interested in birth control education while doing research into the impact of contraceptive counseling. “I myself was never counseled on birth control by my doctors, and I’ve spoken with one too many women who felt their only option was the birth control pill despite there being much more effective and convenient methods available. I believed that the best way to overcome this lack in knowledge amongst patients was to go straight to the medical school and provide opportunities for future physicians to become educated on birth control. Our hope was that medical students would carry these skills with them for the benefit of their future patients as they enter their clerkships, and ultimately their careers.”

Following Bryna’s direction, our goal as MSFC volunteers is both to educate our peers about reproductive health and birth control, and also to share this information with patients at the clinic. We hope that our services inform patients about birth control options and empower them to make safe, personalized decisions about the care that is best for them.

Contraceptive counselors at the clinic are all medical students who have undergone a training session, which is organized and run by our MSFC chapter, using materials assembled by previous student leaders. In training, we discuss the different birth control options available, the methods by which these options work to prevent pregnancy, side effects, and the contraindications. We also teach our volunteers how to conduct the counseling interview, how to get a prescription for the patient at the clinic, and where to refer them in the event that they choose a method we cannot provide. At the Lighthouse Free Clinic, we offer free condoms, and our physician volunteers can prescribe the pill, the patch, or the ring. We typically refer out to Planned Parenthood and other local clinics for any other form of contraceptives (including IUD placement).

We start out with a questionnaire to get to know the patient and their needs better, including what forms of contraceptives they have used in the past and why they liked it or not, as well as if there is any family or past medical history that would indicate high risk for hormonal methods. Then we run through a visual diagram of different forms of contraceptives, starting from the most effective (IUDs, implants), the next effective (the pill, the patch, the ring, the shot), and least effective (pull out method, fertility awareness). We always end by stressing that though we recommend using the most effective forms, condoms are the only way to prevent STD transmission. We like to use Bedsider.org’s diagram to guide our discussion and to hand to the patient for reference.

We are grateful to have this opportunity to have a positive impact on the local community, especially those who are medically underserved, while at the same time practicing our skills and educating our peers about contraceptives. Please feel free to email [email protected] if there are any specific questions you have for us regarding our contraceptive counseling program!