<p>Student-run clinics (SRCs) serve dual roles of providing essential healthcare services for underserved patients and in facilitating critical learning opportunities for students. However, the goals of service can conflict with the goals of learning. In the context of SRCs, this raises numerous dilemmas whose unintended consequences can have far-reaching effects. Similarly, while systemic inequities fuel the impetus for SRCs, they also simultaneously expose the operational vulnerabilities of these organizations. These can generate difficulties navigating the fine line between providing for our society’s vulnerable patients and subjecting these patients to an enterprise that prioritizes training in ways that burden patients. Without an emphasis on sustainable reforms and continued resource investment to support changes, SRCs risk not only failing to meaningfully impact their patient populations but also unintentionally reinforcing the very inequities they aim to address. While some of these challenges have been individually addressed in the literature, attempts to characterize the range of potential conflicts and approaches to formulating best practices for addressing them remain limited.</p>