Recent clinical experience vs family medical emergencies

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I decided to apply to medical school as a nontrad this year, but both of my grandfathers were diagnosed with terminal cancer within two months of each other and it has left no possibility for volunteering. I took a leave of absence from my job (high school science teacher) to move 2000 miles back home to be the primary caregiver of my one grandfather, and I help with my other grandfather as well. I have taken over medication, appointments, etc for my first grandfather and assist my uncle with my other grandfather who is in inpatient hospice care. I currently spend 4-5 days/week in hospitals/hospice. The other complication is that my grandfather receives care both here and at his other home 13 hours away where there is a major research hospital so we are constantly on the move.

My background: I was pre-med in undergrad. I am from a very small town rural area and wanted to learn more about other cultures and the rest of the world before medical school.

My college stats (2001-2005):
3 yrs: neuroendocrinology/surgery research
1 summer: Neuroscience intern at major research hospital
1 summer: Intern for gay/lesbian youth health program
2 yrs: executive board of gay and lesbian student org
1 yr: ER volunteer

My stats (2006-2012):
2005-2006: international healthcare ngo
2005-2007: health outreach volunteer, needle exchange for IV drug users
2006, 2 months: medical shadowing scholarship to Amazon rainforest
M.A. in area studies focusing on Latin American culture, languages; fully funded fellowship (let's call it like a "top 10 university")
1 yr: teaching science in South America (in Spanish)
3 yrs: bilingual high school science teacher (urban school with underserved population), head teacher of afterschool (40 hrs/wk + 11 hrs/wk) and private tutor (5 hrs/wk), on all sorts of volunteer equity committees for the school
tidbits: Spanish bilingual, extensive travel (Asia, Africa, Latin America, Europe), formal academic study of 5 other languages
cGPA: 3.88, scGPA: ~3.75, all other GPA: 3.97, GRE:1520/1600, MCAT: 33Q

The problem: I have not been able to volunteer to get recent clinical experience due to my family obligations. I might get some shadowing in before the AMCAS (perhaps 4-5 days worth) is due in June, but other than that my most recent clinical experience was in 2006. Before 2006, I did all the typical ECs (leadership, ER volunteer, tutoring, medical missions), but will no recent clinical experience really damage my chances?

I really don't want to delay another year because I am already 29, and I have known since undergrad I want to be a surgeon - I just wanted to learn some other things before committing to medical school.

Thanks for reading!

I'm very sorry about your grandfathers.

Originally Posted by coquito

but will no recent clinical experience really damage my chances?

I vote no. Your story is so full of meat that it's hard to get excited about a little bit of extra gravy. (Vegan accommodation: your story is full of protein...) A couple days of shadowing before you apply sounds fine.

Best of luck to you.

Thank you very much for your opinion and kind words.

Volunteer experience is viewed by adcom as important because:
1) It gives you "clinical" experience -so they know you know what being a doctor means.
2) It helps younger folks get out of the classroom and develop "maturity" and "empathy". That is, how to talk to people about life events without being terrified or wooden.

You are doing that with your family. Your work and volunteer experiences are stellar.

I second the condolences and implore you to take care of yourself and your loved ones.
Your application as you present it here is perfect as far as the humanity/maturity elements are concerned. Feel free to let that go.

I'm really sorry to hear about your situation....

I agree with Dr. Midlife.

Your shadowing and volunteer experiences aren't out of date. I mean, it's not like you shadowed Dr. Quin medicine woman.

I would also second that you shadow for a few days just before you apply, maybe in a type of practice you've never been around. I don't really even see this as being an issue in an interview but if they did bring it up you could say something like, "I had 200 shadowing hours in my undergraduate life in 2005. I used that to validate my decision then. Since then, I went back and shadowed in practice type x. That only served to reaffirm my memories of medical work and the practice environment."

Good luck!

I know the general consensus here at studentdoctor is that you need shadowing and clinical experience before you apply. However, from the numerous residents and med school students I've talked to in real life, none of them have ever mentioned clinical volunteering or shadowing. I've gotten separate responses such as church volunteering, taught dance (huh?), worked in a lab, summer law internship (pre-law -> pre-med), worked as a plebotomist. The volunteer on my floor got accepted to a D.O. school and helping out with phone calls at the nurse's station is his only volunteer work.

I know every case is unique, but I don't see you having any less of a chance than any of these people above me. I don't even know you, but your credentials makes me want you to be my doctor lol .

Originally Posted by coquito

I decided to apply to medical school as a nontrad this year, but both of my grandfathers were diagnosed with terminal cancer within two months of each other and it has left no possibility for volunteering. I took a leave of absence from my job (high school science teacher) to move 2000 miles back home to be the primary caregiver of my one grandfather, and I help with my other grandfather as well. I have taken over medication, appointments, etc for my first grandfather and assist my uncle with my other grandfather who is in inpatient hospice care. I currently spend 4-5 days/week in hospitals/hospice. The other complication is that my grandfather receives care both here and at his other home 13 hours away where there is a major research hospital so we are constantly on the move.

My background: I was pre-med in undergrad. I am from a very small town rural area and wanted to learn more about other cultures and the rest of the world before medical school.

My college stats (2001-2005):
3 yrs: neuroendocrinology/surgery research
1 summer: Neuroscience intern at major research hospital
1 summer: Intern for gay/lesbian youth health program
2 yrs: executive board of gay and lesbian student org
1 yr: ER volunteer

My stats (2006-2012):
2005-2006: international healthcare ngo
2005-2007: health outreach volunteer, needle exchange for IV drug users
2006, 2 months: medical shadowing scholarship to Amazon rainforest
M.A. in area studies focusing on Latin American culture, languages; fully funded fellowship (let's call it like a "top 10 university")
1 yr: teaching science in South America (in Spanish)
3 yrs: bilingual high school science teacher (urban school with underserved population), head teacher of afterschool (40 hrs/wk + 11 hrs/wk) and private tutor (5 hrs/wk), on all sorts of volunteer equity committees for the school
tidbits: Spanish bilingual, extensive travel (Asia, Africa, Latin America, Europe), formal academic study of 5 other languages
scGPA: 3.88, other GPA: above 3.95, GRE:1520/1600, MCAT: ? (it was 32 in 2004, but i hope to improve)

The problem: I have not been able to volunteer to get recent clinical experience due to my family obligations. I might get some shadowing in before the AMCAS (perhaps 4-5 days worth) is due in June, but other than that my most recent clinical experience was in 2006. Before 2006, I did all the typical ECs (leadership, ER volunteer, tutoring, medical missions), but will no recent clinical experience really damage my chances?

I really don't want to delay another year because I am already 29, and I have known since undergrad I want to be a surgeon - I just wanted to learn some other things before committing to medical school.

Thanks for reading!

First, 29 isn't that old, so even if you have to delay things a year to get some clinical exposure, no biggie. There's still plenty of time to become a surgeon. Second, although your family care story is compelling here on the nontrad forum, where people are generally pretty supportive, I'm going to play devils advocate and suggest that adcoms see multiple such stories each year. While your actions are laudable, im not sure they get you a bye. The problem with trying to use caring for loved ones as compared to more general clinical exposure is you aren't really going to get the same insight on the doctor side of the doctor patient relationship, as they interact with you as a family member different than with you as premed, and quite frankly the patient side of the equation is also different because it's not a stranger. You won't really get the kind of experience Lizzy M describes as "smelling the patient" if it's not some stranger.

Originally Posted by popopopop

I know the general consensus here at studentdoctor is that you need shadowing and clinical experience before you apply. However, from the numerous residents and med school students I've talked to in real life, none of them have ever mentioned clinical volunteering or shadowing. I've gotten separate responses such as church volunteering, taught dance (huh?), worked in a lab, summer law internship (pre-law -> pre-med), worked as a plebotomist. The volunteer on my floor got accepted to a D.O. school and helping out with phone calls at the nurse's station is his only volunteer work.

I know every case is unique, but I don't see you having any less of a chance than any of these people above me. I don't even know you, but your credentials makes me want you to be my doctor lol .

It's not volunteering per se, it's about clinical exposure -- getting that inside view of the doctor patient relationship, and what doctors do for a living. Adequate clinical exposure is an unwritten prerequisite for med school.

Thank you all very much for your thoughtful responses. I am a newcomer to forums so I was overwhelmed by your support.

To Law2doc: Thank you for your critical response. It is unfortunately true that the "dying grandparent" story must be very common in med school admissions, and I can't expect any special consideration.

I know that caring for an ill loved one is not the same as clinical experience, but I do have a lot of clinical exposure. I have been in operating rooms and missionary clinics abroad. I have hundreds of hours of work with a drug user street clinic and an ER. So I am not worried about my clinical exposure personally, but mostly I worry that admin officers would consider it too out-of-date (mostly prior to 2006). If I never had any clinical experience, I would definitely hold off. But I don't know if I can justify delaying application a year only to spend more recent hours volunteering in an ER again. It seems that if the point is to gain clinical exposure to make sure being a doctor is right for you then it wouldn't matter when the clinical experience was. Or is the point to show a recent commitment in the healthcare field?

That's why I am asking for your thoughts.

You should be fine. Your application is more robust than many Teach for America volunteers who have been doing essentially the same thing you've been doing but right out of undergrad without the years of experience in needle exchange & other clinical settings. The dying grandfather is not uncommon but caring for your grandfathers does give you some insight into families perceptions of health care delivery and with some reflection it may inform the way you choose to practice medicine and gives you some fund of knowledge about the care of the dying that might be useful.

Thank you all again for your support. I went offline for a while because actually, shortly after last posting, I lost both of my grandfathers within 9 days of each other, just three weeks before the MCAT (and my scores plummeted from AAMC average of 36.5 to 33 on actual on 4/28, sadly). Between hospital regulations on flu season, my planning funerals and getting wills worked out, and moving 2000 miles back to my 60 hr/wk job, I did not do any additional physician shadowing.

I think I will still apply this cycle, but the low MCAT and recovering from two deaths so close together means that this will be quite the challenge. I appreciate all your advice. Both kind words and honest opinions from strangers have helped a lot.

First of all, sorry for your loss.

I would encourage you to apply this year, 33 is a great MCAT score, and judging from the rest of your experiences I'm sure you will get a spot in a good medical school with no problem.

Don't worry about not shadowing, I never shadowed anyone and nobody in any of my interviews mentioned it. Although I know it is important for some people, it seems that the most important thing is that you've seen what doctors do on a daily basis, so you have some realistic idea of what the profession entails. I'm sure you got plenty of that during your other volunteer experiences, which by the way are more than enough and should make a very intriguing story.

As far as mentioning your recent loss, my advice is to only mention it briefly if you really feel the need. It sounds like you have had other really strong and valid motivations to go into medicine even before these events, so in my opinion I think you should try to focus on those in your personal statement, essays, and interviews.

Originally Posted by coquito

Thank you all again for your support. I went offline for a while because actually, shortly after last posting, I lost both of my grandfathers within 9 days of each other, just three weeks before the MCAT (and my scores plummeted from AAMC average of 36.5 to 33 on actual on 4/28, sadly). Between hospital regulations on flu season, my planning funerals and getting wills worked out, and moving 2000 miles back to my 60 hr/wk job, I did not do any additional physician shadowing.

I think I will still apply this cycle, but the low MCAT and recovering from two deaths so close together means that this will be quite the challenge. I appreciate all your advice. Both kind words and honest opinions from strangers have helped a lot.

You're beating yourself up for nothing. Listen, you've gained real-life experience in life, struggle, and death that no medical school in the world can recreate for you. These experiences and struggles culminate in you a sense of empathy for others facing similar difficult times. As a result, medical schools will respect the things you've faced and certainly not chastise you for not getting what you feel is the adequate amount of experience.

Your story, your background, your academic prowess, your 33 on the MCAT (which isn't as bad as you feel like it is), and your dedication in the face of tremendous adversity create a whole package applicant who will certainly call himself/herself a student doctor in 2013.

Lastly, any school who denies you on the basis of 'inadequate clinical exposure' or anything of the sort can, quite frankly, shove it. There are schools out there who appreciate the kind of applicant that you will enter as and those are the schools you're interested in. The others, well, you didn't want to be there anyway. Enough said.

Apply broadly, apply quickly, and hold on for the ride!

I've never participated in online forums before, and I am surprised by the kindness and encouragement that complete strangers take the time to give.

I know that a 33 is not bad in the grand scheme of things, but it was disappointing for me because it was two points below my lowest practice test. If my practice tests were more in line with the actual score, I probably wouldn't have been so bummed.

I am struggling because I have the added stress of knowing that if I do not gain acceptance into one of the two local schools (both top tier), my spouse and I will have to lose our business/income (based on tourism/climate and not re-locat-able) or spend most of the school year apart as I go off to somewhere else. We have discussed this, and we will definitely work it out, but it would be incredibly super-awesome to be able to stay where we are now. I knew that getting accepted at a specific school or two is nearly impossible, but we all have our dream schools. I'll still give them a shot and I'll add on the mid-tier school that's less than 2 hours away.

Thanks for helping me keep things in perspective

Originally Posted by coquito

I know that a 33 is not bad in the grand scheme of things, but it was disappointing for me because it was two points below my lowest practice test. If my practice tests were more in line with the actual score, I probably wouldn't have been so bummed.

2-3 points below your practice tests is pretty much par for the course. The people who perform at the level of practice or better seem to be the exceptions. Add in the fact that a 33 is more then respectable and you shouldn't beat yourself up over that score, especially with a ~3.8 backing it up.

Originally Posted by coquito

I've never participated in online forums before, and I am surprised by the kindness and encouragement that complete strangers take the time to give.

I know that a 33 is not bad in the grand scheme of things, but it was disappointing for me because it was two points below my lowest practice test. If my practice tests were more in line with the actual score, I probably wouldn't have been so bummed.

I am struggling because I have the added stress of knowing that if I do not gain acceptance into one of the two local schools (both top tier), my spouse and I will have to lose our business/income (based on tourism/climate and not re-locat-able) or spend most of the school year apart as I go off to somewhere else. We have discussed this, and we will definitely work it out, but it would be incredibly super-awesome to be able to stay where we are now. I knew that getting accepted at a specific school or two is nearly impossible, but we all have our dream schools. I'll still give them a shot and I'll add on the mid-tier school that's less than 2 hours away.

Thanks for helping me keep things in perspective

Remember, the best medical school in the nation is the one who accepts you!