Purpose
Approximately 13.2% of South Carolina’s population has diabetes. Comparison of zip codes in the south showed northern Columbia, SC’s diabetic amputation rate was the highest of all zip codes analyzed. Seeing patients who struggled to get their diabetes under control, this led students to start Medical Students Making Change (MSMC) which is led by University of South Carolina School of Medicine Columbia students in collaboration with free medical clinics in South Carolina.

Methods
Medical student volunteers review HBA1cs from the clinics, contact eligible patients, and enroll those meeting inclusion criteria (adults >18 years old, diagnosed type 2 diabetes or prediabetes based on HBA1c, and access to a phone). Biweekly phone calls between volunteers and patients focus on assessing goals, as well as addressing barriers. New medical student volunteers start as first-year medical students and take on increasing responsibilities as they progress through medical school. First-year students call the patients and discuss their glycemic control. Second-year students apply to become volunteer team leaders and are in charge of a group of volunteers. Third-year students choose a specific focus area (volunteers, expansion, leadership, finance, research) and become experts in this area within the organization. Fourth-year students are in charge of a specific focus area and train the classes below them to ensure a seamless transition once they graduate.

Results
Of patients enrolled (n=71), the average initial HBA1c value was 9.63%, and HBA1c decreased by an average of 0.64%.

Conclusion
The clinic’s high HBA1c average highlights a need for interventions and the role that medical students can play in diabetes education through service learning. The model of this stepwise leadership progression can offer a useful framework for increasing leadership capacity and responsibility throughout medical school.