Clinical Experience FAQ

The Big Picture

What counts as clinical experience?

It helps to think about what professional schools want to know about you based on your clinical experience. As they read your application, they will ask questions like:

  • Does this applicant know what they’re getting into before committing to an expensive, time-intensive career path? Is their perspective sufficiently concrete and gained from personal experience?
  • Has this applicant started to develop a good "bedside manner" and ability to care for people from diverse backgrounds who have medical needs?
  • What is this applicant’s career vision? Where do they see themselves longterm?
  • Is this applicant ready to navigate in hospital and clinical environments and work successfully as a team member within them?

No single experience is likely to cover all four of these aspects of clinical experience, so most students do some of each. 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, discuss rewards and challenges of the profession, and gain insight on what you might want in your career.
  • Hospital / Clinic / Hospice volunteering: longer-term, active opportunity in which you provide a service to the clinical setting. This can give you a sense of the culture within a unit of the hospital or other care facility 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.
  • Volunteering with patient populations: Opportunities outside of the hospital/clinic setting interacting with individuals with medical needs, such as working at a summer camp with kids with health issues; spending time with elderly individuals who are navigating dementia, Alzheimer's, and other conditions; assisting with health screenings for at-risk populations.
  • Working / volunteering as an Emergency Medical Technician: after a course and certification test, Emergency Medical Technicians respond to emergency situations. Great opportunity to gain hands-on skills, but does not provide familiarity with the hospital setting or work of physicians. Some Princeton students train with Princeton First Aid and Rescue Squad.
  • Working as a Certified Nurse Assistant (CNA): after a course and certification test, CNAs work alongside nurses to provide direct care to patients. Training is available through community colleges and through care facilities like nursing homes. Check your state's Department of Health for a list of training facilities.
  • 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.
  • Clinical research: 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. Research also gives students access to mentors in the field and a sense of what it's like to work within an academic medical/research environment. 
  • Volunteering through Hotline/Counseling opportunities: many students value the opportunity to develop active listening and counseling skills in these helping roles.

Don't limit yourself 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 by medical professionals and med students, 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.
 

Is clinical experience required?

A few medical schools will specify a minimum number of hours in patient-facing roles or shadowing. A few will require a letter of recommendation from a physician who can speak to your readiness for the profession. Most, if not all of them, are seeking to enroll students who show commitment to the investment required to become a physician. Medicine is an evidenced-based profession, so it's unsurprising that admissions committees will seek evidence of your motivation that is grounded in experience, not in the abstract.

Every year, we have a few medical school applicants with very high GPAs and MCATs who have relatively weak experience of and knowledge in healthcare settings. They often struggle to articulate their motivation for medicine in their application and interviews, and are unsuccessful in the admissions process. Most of them spend a year gaining additional experience and then gain admission in a future cycle, but they would have saved a lot of time and emotional stress gaining the clinical experience prior to their first application. 

Beyond medical school, there are some health professions programs that do have more specific, explicit requirements. Many Physician Assistant programs require a minimum number of hours spent directly caring for patients (often about 1,000 hours minimum with a recommendation for more). Many veterinary schools similarly seek minimum hours of animal care under the supervision of veterinarians. Explore the requirements for careers of interest in the Exploring the Health Professions section of our website.

Volunteering

How much clinical volunteering do I need?

Generally, your clinical experiences in college will probably include volunteering because you likely don't have the training required for a paid position where you're interacting with patients, 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, civic engagement in other settings -- tutoring, coaching kids, helping the elderly -- are also valued, 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?

I volunteer at a hospital 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.

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, you might be 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.  

If you want a more active role, consider spending the summer gaining a certification as an EMT or Certified Nursing Assistant, which will give you hands-on skills that you can use to care for patients. We've had students who pursued certification and then worked part-time during the school year or full-time post-graduation in these positions.

Shadowing

How do I find someone to shadow?

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.

  • Local: email HPA and request our list of local physicians in the Princeton area who are open to having students shadow them. [on pause during COVID-19]
  • Away from Princeton: Reach out to a Princeton alumni via the Tigernet Alumni Directory and LinkedIn’s Princeton alumni community. In LinkedIn, you can enter keywords like “physician” (1900 results), “physician assistant” (650 results), “public health” (9500 results). Cast a wide net with a concise, professional yet friendly message and see if you receive responses. If you live in a more isolated area, you might also just search for your hometown and use Princeton as your initial means of connection, then see if they can connect you to health professionals in the area.
  • The Center for Career Development 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 Development has a great list of starting questions for informational interviews.
 
For more ideas, read through our Shadowing Tips handout.
 

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

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.

We do recommend logging your hours and your personal reflections on each shadowing experience for yourself. That way, you'll be able to easily calculate your total hours when you apply and you'll have a record of how you've grown through each experience.

My roommate's parents 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?

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, prehealth advisers, 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.

How many hours should I spend shadowing physicians?

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. Spread your time out across different shadowing opportunities with physicians or other health professionals in diverse specialties, types of practice (e.g., private practice vs. hospital, in-patient vs. outpatient) to maximize the learning experience. The more that you can shadow physicians with whom you have something in common, the more it may help you think about yourself in the role later. If you're a humanities concentrator, look for physicians with a similar academic background; if you're interested in MD/PhD, try to shadow physician-scientists or MDs who run their own labs. A couple of the goals behind shadowing are to see enough that you understand the rewards and challenges of day-to-day doctoring, and that you gain insight from folks who are doing the kinds of things you want to be doing.

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?

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! 

International Experience

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?

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.
 

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?

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 GHP 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 links on our website for 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.
 

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?

There has been a recent proliferation of companies that coordinate this kind of abroad experience, and they have pros and cons (as outlined in this NPR podcast: 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 summer programs in which Princeton prehealth 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 (SAFE) is the best place to start.