BACKGROUND: The Integrated Longitudinal Clinical Clerkship (ILCC) is seen as an enabling learning space for medical students and empowering preceptors. The presence of ILCC students in hospitals contributes to delivering health services and sustained improvement in the quality of health services in those facilities. This study explored health professionals' perceptions of the impact of a South African medical university's ILCC on health professionals' workload and service delivery in district hospitals. METHODS: We conducted in-depth interviews with 33 purposively recruited health professionals for this study. Participants from six district hospitals were asked about health workforce workload and service delivery factors linked to the ILCC program. Thematic analysis was conducted using NVIVO. Ethics approval was obtained from the Walter Sisulu University (WSU) Faculty of Health Sciences Human Research Ethics Committee (ref: 033/2018). RESULTS: Regarding the effect of WSU's ILCC on health professionals' workload, it was found that while students contributed positively to their competencies, there were negative consequences in terms of the time spent orienting new students at the beginning of the ILCC block. In terms of service delivery quality, the findings indicate that students enhance the quality of health services
the presence of medical students encourages clinicians to refresh their knowledge and improves patient experiences at the facility. However, the initial integration of students can slow down service delivery due to the time required for teaching, which may also lead to diminished trust from patients. CONCLUSION: The ILCC approach at WSU offers a medical education platform and addresses rural medical needs. Both the university and healthcare providers should optimise the longitudinal clerkship approach. ILCC plays an essential role in improving healthcare systems, prioritising patient-centred care, and addressing public health challenges in rural communities of South Africa.