Clinical Experience

What is Clinical Experience? Shadowing
How Important Is Volunteering? Physicians in Tigernet 
Making the most of hospital volunteering Volunteering Abroad
Do I need US-based clinical experience?  

What is Clinical Experience?

Question: HPA says we have to get “clinical experience” or “clinical exposure” before medical school but I don’t really know what this means. What experience is best? Why do I need it?

Answer: Medical schools want to be confident that students understand what they’re getting themselves into—that they’re committing to an expensive, time-intensive path of study with reasons based in concrete experience rather than abstract understanding. Additionally, they’re seeking to admit students who are service- and people-oriented, and who have started to develop their own ’bedside manner’ skills: spending time with those in need in clinical settings is a great way to demonstrate your service orientation and to gain comfort in working with sick people.

Here are a few common ways that students gain clinical experience:

  • Shadowing: short-term, passive opportunity to get a glimpse into a certain specialty by following a doctor in their day to day work. You may have a chance to see how a physician interacts with their patients, to pick someone’s brain about the satisfactions and frustrations of practice. Could lead to longer-term mentoring relationship. 
  • Volunteering: longer-term, active opportunity in which you provide a service to the hospital/clinic. This can give you a sense of the culture within a unit of the hospital over time, allow you to interact with the team within the unit (nurses, techs, physicians, etc.), and, in some units, you may have the opportunity to interact directly with patients and their families.
  • Becoming an EMT: after a course and certification test, EMTs respond to emergency situations. Great opportunity to gain hands-on skills, but does not provide familiarity with the hospital setting or work of physicians.
  • Scribing: paid position in which you follow doctors as they visit with patients and take notes for them, so that they can focus on the patient. Scribing has become a popular glide year activity.
  • Clinical research: depending on the study, students may be able to assist in enrolling patients or administering tests, which can help develop interpersonal skills and provide better understanding of the patient experience. Doing research also gives students access to mentors in the field.
  • Other opportunities that may help students build similar skills: working at summer camps with kids with disabilities, providing health education, working as a Certified Nursing Aide or Phlebotomist, providing language translation, working as a doula.

Students shouldn't limit themselves to one type of experience or one setting - the broader and more diverse the exposure to health and health care, the better! In addition to active experience, reading books about medicine, attending talks like our Doctor Is In speaker series, watching documentaries, keeping up with articles posted on our Facebook page about medicine, and taking health-related courses will further prepare students for medical school and their future careers. 


How important is volunteering?

How important is volunteering for pre-med students?  Is a student who works at a hospital or lab and shows interest in medicine less competitive than one who also volunteers?  If volunteering is crucial, how much of it should be done?

Answer: This is a very difficult question to answer--an all-too-common question, but a hard one. No one should make you volunteer. If you're not sincerely interested in serving your community in some way then you should not do it. However, many pre-meds cite a desire to help others as one of their main reasons for pursuing medicine, and many medical schools are interested in training physicians who see their work as a service to society and to individuals. If you are asked at a medical school interview some day why you want to become a doctor (and someone is sure to ask you that question) and you tell them that you take satisfaction in helping others, you have very little credibility if you've never volunteered your time in service to other people less fortunate than yourself, or if your most recent volunteer work was in high school. Why would anyone believe you if they don't see evidence of volunteering during your college years? Generally, your clinical experiences in college should include some volunteering, but we cannot quantify the amount - how much of your health-related experience is for pay, or through an internship, or shadowing, or true volunteer work is all up to the individual. In addition to clinical experience, volunteering in other relevant ways - tutoring, coaching kids, helping the elderly - all "count," so don't turn down those opportunities just because you don't think med schools will be interested in them. Hopefully you chose Princeton with full knowledge and appreciation of its motto re: being "in the nation's service"....right?


Making the Most of Hospital Volunteering

Question:  I've been volunteering at UMCPP here in town and to be honest I don't find it very interesting.  I'm wondering if you could help me.  Why do med schools insist that we volunteer in a hospital?  Can I do something different?  It's pretty frustrating. 

Answer:  You probably want to focus on the things you do enjoy about being in the clinical setting and not the things that are tedious or uninteresting.  Medical schools do not “insist” on hospital volunteering per se, but they do value applicants with experience interacting with patients, and before one goes to medical school and obtains proper qualifications and skills, one is left with volunteering as the main means for gaining patient contact.  A few things to remember:

  • If your frustration comes from a lack of contact with physicians, and the patients you see are asleep, then you're volunteering at a less than optimal time of day. When scheduling your volunteer work, think beyond what is best for your schedule. Volunteer in the mornings or afternoons, possibly on weekends if you have to, not late in the evening when the docs have gone home and the patients are sleeping.  And remember: we have a list of local physicians who have volunteered to have you shadow them--it's on our website.  You might try contact some of these physicians in order to have more interaction with doctors.
  • Students often experience more than they realize when serving as a volunteer. Write down your experiences. Spend a little time recording conversations you've had with patients or conversations you've overheard between doctors and staff. The more detailed you are with your note-taking, the better equipped/informed you'll be when asked to discuss your volunteer work. (It may even help you better understand why you're volunteering in the first place.)
  • Lastly, remember this isn't about your doing something you find interesting as much as it is about backing up your desire to work in a profession where serving others is at the heart of all you do. To be blunt, it's not about you, it's about what is needed to be done in order to help a hospital help its patients. Tasks like comforting patients, talking with them and their families, transporting them, etc. are essential experiences in your development as a caregiver.  


Do I need US-based clinical experience?

Question: All of my volunteering and shadowing has been abroad. I feel like I’m able to do more and see more abroad than I could in the US. Will this be a problem for medical school?
 
Answer: If you plan to practice in the United States, it would benefit you to have familiarity with the way that healthcare is organized and delivered in the US. You can gain some of this through GHP classes, reading on your own, following the news, etc., but your own expectations for what it means to be a doctor or work with a healthcare team are often best informed by what you have seen/experienced in shadowing and volunteering.  If you have an interest in global health, try reaching out to physicians in the US who work in that sphere. If you worked with US-trained physicians abroad (e.g., attended a mission where US-based doctors go abroad to work with patients), see if there’s a way to shadow them when they’re back in the US—it could be particularly interesting to observe them in both settings.
 
It will also benefit you to gain familiarity with the diversity of patients that you’ll see in the US. Many students don’t have significant exposure to certain patient populations: elderly individuals, those from lower socio-economic backgrounds, others who are underserved in the US system. Gain cultural competency in the US as well as abroad—volunteering, medical or not, can be a great way to do this—so that you’ll be better able to serve all patients.
 
Volunteering and shadowing abroad can add valuable perspective, of course. Do be careful that you’re not overstepping what you should be doing as an individual without medical training. It makes us nervous when students talk about doing more abroad than they can here—you do not want to perform any procedures or otherwise interact with patients in ways that are beyond your training. Before heading off to gain clinical experience abroad, take a look at the guidelines provided by the Association of American Medical Colleges for providing patient care outside of the US.


Physicians in Tigernet

Question:  Hi HPA - Next summer I am hoping to be in San Francisco working for a nonprofit organization.  If all goes right, I’ll get this job I’m hoping for.  I’ll have some time after my employment finishes, and maybe even before it starts, to do something else.  I was wondering if you knew of any job shadowing or clinical opportunities in the Bay Area or maybe in Chicago, since that’s where I’m from and I could stay with my parents.  I’d like to secure a short term (1-3 weeks) shadowing position.
 

Answer:  We recommend that you use the Tigernet Alumni Directory available on the Career Services website.  You should be able to find a Princeton alumnus-physician in San Francisco or Chicago who has volunteered to host/mentor/talk to Princeton students.  This avenue has worked well for many other Princeton students.  The alumni in the directory are hoping to be mentors to current students.  Also, don’t forget that the HPA site has a list of local Princeton-area physicians to shadow during the regular school year. 


Shadowing Health Professionals

Finding Opportunities

Question:  I’m interested in shadowing opportunities for the break. What should I expect to get out of the experience? Do you have any recommendations for how I should go about finding a shadowing position?

Answer:  Shadowing can an excellent way to gain exposure to and become informed about the everyday practice of medicine. Working closely with a healthcare provider and his/her staff in an office helps you to learn about expectations in the field and the challenges and rewards of practicing medicine. A shadowing experience also allows you to build a relationship with a mentor in the field and ask questions, ultimately helping you to decide if this path is the right one for you.

In terms of locating shadowing opportunities, HPA has a list of local physicians in the Princeton area who are open to having students shadow them. If you’re going home for break, you might reach out to a Princeton alumnus physician by first looking at the Tigernet Alumni Directory. Career Services also offers "Princeternships" with pre-identified alums, and you can apply to participate in these shadowing opportunities through HandShake. The deadline to apply for January Princeternships is in November, and the deadline for Spring Break Princeternships is in February. 

When you contact a physician, tell the person where you found them, give a brief introduction of yourself, and what in particular interests you about their background, position, or organization. Let the doctor know that you'd be interested in any shadowing opportunities that they can provide. If your first contact is by email, attach a copy of your resume and let them know that you're happy to connect by phone if it's helpful. If your first contact is by phone, have your calendar available in case the physician wants to schedule something right away. Try to have an idea of what you're looking for when you shadow in case you are asked. You also might want to check out your peers’ Princeternship blogs to get a sense of what they have gained from shadowing experiences in the health professions.

If the doctor can't accommodate you for shadowing, you might see if they would just be willing to talk with you for an hour or so, and then put together a list of questions you might like to know more about in pursuing your interests in medicine (this is often called an "informational interview"). Career Services has a great list of starting questions you may want to ask here.

Documentation?

Question:  I shadowed a physician over the fall break. Do I need a letter or other documentation to provide proof of the experience?

Answer:  No – you sign a statement of integrity when you apply to medical school stating that you are portraying your experiences honestly, and this will suffice. You will be asked to provide contact information for each activity that you report in your application so that schools could follow up on the experiences if desired, but for the most part, they will trust that you are being truthful in your application.

Shadowing Guidelines

Question: I have some family friends who are doctors and they’ve agreed to let me shadow them over break, but they haven’t had students shadow before and asked me what to expect. What should I tell them?

Answer: Excellent question! We want shadowing experiences to be positive for students and for the physicians who are providing this valuable opportunity. A group of medical school personnel, pre-health advisors, ethicists, and others have collaborated to developed Guidelines for Clinical Shadowing Experiences for Pre-medical Students. We encourage you to read through them so that you can provide a summary for the physicians, and you can also provide them with a copy of the guidelines, or a link to the document.

Hours

Question: I am in the process of setting up some shadowing with an orthopaedic surgeon, and his assistant has asked me how many hours I wanted to shadow for. What is typical?

Answer: It depends on what you’ll be doing as you shadow and what you want to get out of it. Generally, if you’re just observing and asking a few questions, about 3-4 days full time will give you a good sense of what’s going on. Spreading your time out across a few different shadowing opportunities with physicians or other health professionals in different areas may maximize the learning experience.  

Full-Time Shadowing This Summer

Question: Hi HPA – a physician friend of my family told me I could come in and shadow her all summer. Is this sufficient clinical experience for medical school applications?

Answer: Shadowing is a valuable way to gain exposure to how a doctor thinks and what their work looks like day to day. You spend time learning from watching a physician interact with patients. Generally, shadowing is a shorter-term experience; after a few days, you’ve gained a fair amount of insight on how that doctor does her work. To complement the insights gained from shadowing, we recommend seeking experience where you have an active role and personal responsibility for being a part of the health care team, even if your role is as simple as making sure that beds are made and patients have water. Additionally, shadowing is largely a passive experience and is mainly for your benefit. We encourage you to supplement your shadowing experience with something more hands-on that helps others. It may be that the physician you plan to shadow already has this in mind and will allow you to sit with patients or their families as they wait for the physician or assist administrative staff with tasks – pure shadowing is a good first step, but something where you are able to contribute to and not just benefit from the clinical experience is recommended. After all, part of the reason you want to be a doctor is to help others – demonstrate that interest by finding ways that you can help! For more ideas, see our Internships & Volunteering FAQs online.

Do I need to Volunteer/Shadow in the US?

Question: All of my volunteering and shadowing has been abroad. I feel like I’m able to do more and see more abroad than I could in the US. Will this be a problem for medical school?
 
Answer: If you plan to practice in the United States, it would benefit you to have familiarity with the way that healthcare is organized and delivered in the US. You can gain some of this through GHP classes, reading on your own, following the news, etc., but your own expectations for what it means to be a doctor or work with a healthcare team are often best informed by what you have seen/experienced in shadowing and volunteering.  If you have an interest in global health, try reaching out to physicians in the US who work in that sphere. If you worked with US-trained physicians abroad (e.g., attended a mission where US-based doctors go abroad to work with patients), see if there’s a way to shadow them when they’re back in the US—it could be particularly interesting to observe them in both settings.
 
It will also benefit you to gain familiarity with the diversity of patients that you’ll see in the US. Many students don’t have significant exposure to certain patient populations: elderly individuals, those from lower socio-economic backgrounds, others who are underserved in the US system. Gain cultural competency in the US as well as abroad—volunteering, medical or not, can be a great way to do this—so that you’ll be better able to serve all patients.
 
Volunteering and shadowing abroad can add valuable perspective, of course. Do be careful that you’re not overstepping what you should be doing as an individual without medical training. It makes us nervous when students talk about doing more abroad than they can here—you do not want to perform any procedures or otherwise interact with patients in ways that are beyond your training. Before heading off to gain clinical experience abroad, take a look at the guidelines provided by the Association of American Medical Colleges for providing patient care outside of the US.

Shadowing Abroad

Question: Hi HPA—I’m interested in learning more about medicine abroad and I was accepted to the Atlantis Project to shadow physicians. The trip is very expensive—do you think that it’s worth the price?

Answer: It’s hard to quantify the benefits of this program and others like it relative to the expense. There are many ways to shadow without paying a high price for it, such as reaching out to alumni physicians or participating in a program like the Summer Health Professions Enrichment Program (which provides a stipend) or the Premed Volunteer Program at St. Mary Medical Center. There are also funded IIP internships and Health Grand Challenges internships that provide exposure to health care in international settings. There is no expectation that premed students participate in international health experiences—there are many ways to develop cultural competence in the US and abroad that don’t involve an expensive price tag.

We would also caution you against programs that seem more like “voluntourism,” where you may be asked to perform tasks that you aren’t qualified to perform, or which may negatively affect the local culture (see articles like “The Risks (and Unexpected Benefits) of Sending Health Students Abroad” for more details). We recommend looking for programs that follow the AAMC guidelines for students during clinical experiences abroad (and being sure that you follow them yourself). Atlantis is one of the programs that does adhere to these guidelines, and we’ve had students who had positive experiences with the program. The program outlines suggestions on how to fundraise; to our knowledge, Princeton students have not received university funding for the program.


Volunteering Abroad

Question: I recently saw an ad for a program that places volunteers abroad in medical internships, but it costs a lot. What do you think of the program? Can HPA help me find funding?

Answer: There was a recent story on NPR about the proliferation of companies that coordinate this kind of abroad experience that lays out some of the issues surrounding this kind of program: The Risk (and Unexpected Benefits) of Sending Health Students Abroad. We at HPA feel most comfortable with programs that are partnering with campus programs like IIP and PICS – that way, we know that you have support from Princeton and that the programs have been vetted. We maintain a list of programs in which Princeton pre-health students have participated on the Clinical Experience page of our website, but we do not endorse any particular programs; we recommend considering what these programs offer critically, and using the AAMC and ADEA guidelines for providing patient care internationally as you evaluate organizations. Also keep in mind that there are many vulnerable and underserved populations in the US who would benefit greatly from your assistance as a volunteer for the summer – do not feel that you can only make a difference by traveling abroad. As for funding, the Student Activities Funding Engine is the best place to start.