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Part III: Clinical Experience for Premeds

Gaining Clinical Experiences in Medicine: Having clinical experience in medicine is absolutely essential for premedical students. As we mentioned earlier, medical schools do not want to take their chances on someone who does not know anything about the medical profession and has not thoroughly explored the field. The more thoroughly you explore the medical profession, the stronger your application. Remember, shadowing a parent who is a physician or having clinical exposure during high school is not sufficient clinical experience.

Does Paid Clinical Experience Count Both volunteer and paid clinical experiences add value to your medical school application. We encourage students to choose the experience that affords them the greatest opportunity to observe medical care in action and get an understanding of the medical profession. Volunteer experiences tend to be better in this regard, but some paid experiences can be valuable.

When Should I get Involved in Clinical Experience as a Premed? It is always wise to get involved in clinical experience early on. We recommend that you begin gaining exposure to clinical medicine during your freshman year. The good news is that you only need to spend 4 hours per week shadowing, volunteering, or working in a healthcare setting. What matters more is how long you have been involved in the experience and how consistently you have been doing it.

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Which Type of Premedical Clinical Experience is Best? There are many different ways to get clinical experience and some are better than others. Below we review some possible avenues through which you can gain clinical experience and we discuss the pros and cons of each.

1) Volunteering at a Hospital: Hospital volunteer work can be a positive experience, because it is in the hospital inpatient setting where you get see the real action. By getting exposure to medicine in this setting you can show the admissions committee that you like the hospital environment and the work that goes on in a hospital. You will be spending a great deal of time at hospitals during medical school and residency training. There are many different ways to get clinical exposure in a hospital setting but choose one where you can shadow physicians, interact with patients, and contribute. Often times busy county hospitals offer more opportunities for premedical students to get involved, observe, and learn than private community hospitals in suburban areas. Avoid choosing a volunteer program where you are only interacting with administrators and filing paperwork. If you are taking time to do clinical volunteer work, you should do something meaningful that will give you the chance to learn and boost your application to medical school.

2) Volunteering at a Clinic: Outpatient clinics are good venues to gain exposure to outpatient medicine. Like the hospital setting, if you are planning on working in a clinic, it would be more beneficial for you to work in the back office of the clinic, where you are shadowing physicians, as opposed to working in the front office, where you are only involved in laborious paperwork. Free clinics that cater to the underserved tend to offer premedical students more opportunities for involvement than private outpatient clinics in affluent neighborhoods, because the free clinics often have limited resources. In addition, sometimes through free clinics, you could become involved in health fairs or other community-based health initiatives that could further enhance your application, enable you to gain community service experience, and perhaps even take initiative in the community.

3) Serving as a Scribe: Premedical students can serve as a scribe in a regional hospital emergency department. Scribes have the opportunity to directly interact with patients, take a patient history, document pertinent medical information, work closely with physicians, and get exposure to the thought-process involved in making clinical decisions.

4) Serving as an Emergency Medical Technician (EMT): Obtaining an emergency medical technician license is a good way to learn about emergency medical care, to assume responsibility in patient-care, and to understand what it is like to be involved in the care of sick individuals. A few issues that are important to keep in mind if you choose to obtain an EMT license are the following:

• Just having an EMT license by itself is not sufficient to impress medical schools. You need to gain clinical experience using your license.
• EMT licensure gives you the chance to be involved in emergency medical care on the field, but it does not replace clinical experience in a hospital and clinic.
• Remember, becoming an EMT takes time because it requires that you take courses and pass examinations. Only commit to it, if it does not interfere with your premedical coursework.

5) Medical Interpreter: If you speak another language (especially Spanish), there may be opportunities for you to serve as an interpreter for physicians who have a large population of non-English speaking patients. This is a great opportunity to be involved directly in the care of patients. As an interpreter you have the opportunity to serve as a liaison between the physician and patient as you help take a patient history or provide information to the patient in their native tongue.

6) International Clinical Experience: Medical school admissions committees tend to look favorably upon clinical experience abroad in a developing country setting. This experience is only worthwhile if it is done right. Identify a legitimate, well-established organization, with which to travel abroad. Look for an experience that allows you to be on the front lines and assist in patient-care. Make sure you carefully assess the situation in the area you are traveling to, consider all safety issues, and take the necessary precautionary measures including immunizations and prophylactic medications. It is important to point out that international clinical experience by itself is not sufficient clinical experience. Most international clinical experiences last only a few weeks or a few months. Also, while working in a developing country setting can be impressive, admissions committees also want to see your commitment to caring for sick patients here in the United States.

Important Points About Clinical Experience:

• Consistency is Crucial: Find one or two good experiences and do them for extended periods of time. Do not jump around from medical practice to medical practice.
• Combine Outpatient and Inpatient Experience: It is good to have experience working in an inpatient setting as well as an outpatient setting. This way, you can show that you have seen different aspects of medical care and you understand the profession well.
• Avoid Working with Family Members: Do not volunteer in the office of family members. Go out into the real world and get out of your comfort zone. Admissions committees do not look favorably at clinical experiences with a parent, aunt, uncle, or sibling who is a physician.
• Focus on the Underserved: While it is not essential to work in a clinical setting that caters to the underserved, we have found that students tend to get the most out of these experiences. They are able to be more involved, they have the chance to learn more about the social issues surrounding healthcare, they gain a more mature understanding of the profession, and they demonstrate their compassion for the less fortunate. We have also found that students who gain clinical experience working in underprivileged areas tend to be more successful at gaining acceptance into medical school. In other words, every thing else being equal, the person who works in an underserved clinic as an undergraduate tends to get accepted to better medical schools than the person who worked in a private clinic that serves the affluent. In a way, if you are working with an underserved clinic, you are hitting two birds with one stone, because you are gaining clinical experience and serving the community as well.
• Identify a Physician Letter Writer Early: When you get involved in clinical experience, identify a physician who you could approach for a letter of recommendation later when you are getting ready to apply. Interact with this individual and make sure they get to know you and see your commitment. Spend a lot of time working with them to show them your passion.