��’s LIC Program prepares future physicians for underserved communities

Medical student Libbie Milks speaks with high school students about medicine as part of the LIC.

At ��’s Heritage College of Osteopathic Medicine, medical students discover that family medicine is more than diagnosing and treating illness, it’s about building long-term relationships and understanding patients’ lives in context.

The Continuity in Family Medicine: Longitudinal Integrated Clerkship (CFM LIC) is a selective, yearlong program for third-year medical students provided by the Office of Rural and Underserved Programs. Designed for those interested in rural and urban underserved communities, it immerses students in the realities of family medicine, transforming how they see their future roles as physicians.

A year of continuity, not just rotation
Unlike traditional clerkships, where students rotate through specialties every few weeks, LIC students spend an entire academic year in the same family medicine practice. They see patients at least half a day each week or a full day every other week, often following those same patients into hospital care when needed.

This model helps students see the full story of care: how medical decisions, social challenges and patient resilience unfold over time. Each student manages a continuity panel of patients across age groups and conditions, learning to think beyond isolated visits.

“There’s a lovely phenomenon in working in such a sparsely populated area where you begin weaving this web of connections with patients, co-workers, family and friends,” shared LIC student Libbie Milks. “You see how easily patients fall through the cracks and how health literacy deficiency is as much a burden on community health as heart disease.”

High school students practice using a stethoscope.

Beyond the exam room: Projects rooted in community need
LIC students deepen their understanding of care by designing quality improvement (QI) projects or community engagement projects tailored to local needs.

For Libbie Milks, this meant returning to her hometown to spark high school students’ interest in medicine.

“I knew I wanted my project to focus on teaching outreach,” she said. “It felt only natural to give back to the schools and surrounding areas that got me to where I am today.”

She led interactive lessons across 10 high school classes, from basic biology to advanced anatomy, helping students hear their own heartbeats with stethoscopes and connecting medical knowledge to daily life.

“Students are truly sponges,” Milks reflected. “They pick up on even the most seemingly insignificant details. What you say matters.”

For LIC student Sean Diment, the project took shape after a patient shared she had only $5 left for food until payday.

“It almost felt ironic to me that a health center does not have all the resources needed to promote health, especially nutrition,” Diment said.

Inspired by that patient and supported by the Southeast �� Food Bank, Diment launched an in-clinic food pantry, stocking nutritious staples like canned beans, chicken, rice and sanitary products. Within a month, over 50 people used the pantry.

“Food is an essential pillar of health,” Diment said. “If patients don’t have access to nutritious foods, they will struggle to make the right lifestyle changes and ultimately have worsened health.”

Real-world practice, reflection and growth
Throughout the LIC, medical students witness firsthand how social determinants from food insecurity to insurance barriers shape patient health.

“The zip code you were born in determines so much about the resources available to you,” Diment noted. “Physicians, especially in primary care, are tasked with addressing so much of these issues.”

The LIC model also offers stability: students return weekly to the same clinic, building trust with patients and honing clinical and teamwork skills that prepare them for residency.

“The relationships you make in the LIC go so far,” added Diment. “This program has been the highlight of my year.”

A foundation for compassionate care
The LIC is guided by instructors Sharon Casapulla, Ed.D., director of Rural and Underserved Programs; Scott Rogers, M.D., former associate dean of clinical education; and Cleveland Clinic family medicine physicians Robert Bales, M.D., and Amy Zack, M.D. The program teaches students to combine medical knowledge with adaptability, advocacy and compassion. At the year’s end, each student presents their project findings and writes a reflection paper capturing what they’ve learned.

“This experience reinforced my decision to pursue family medicine,” Diment said. “Family medicine physicians become like family to their patients. It’s a very sacred relationship.”

Since the 2016 launch of the LIC program, 93 Heritage College students have completed the CFM-LIC. Seventy percent of matching LIC students matched into primary care specialties following graduation.

“By graduation, LIC students carry more than clinical skills: they leave with a deeper appreciation for continuity, community engagement and the power of listening,” said Casapulla. “These are essential to prepare them to care for underserved populations.”

Twelve students are participating in the program this year, supported by 10 volunteer preceptors.

“It truly is an amazing and defining point in my medical education,” Milks shared. “I would do it again in a heartbeat.”

More about the program can be found in the Longitudinal Integrated Clerkship (CFM-LIC) | ��

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