Clinical Experience: Any Suggestions?

[kypdurron5]

I'm looking for a little personal advice here; there have been many threads along these lines, but my question is pretty specific, so bare with me. As with many others, "clinical" experience is by far the weakest portion of my application. My major is done, my GPA is forever set in stone, I've accumulated all the honor societies and college activities that I can, but I have absolutely no medical connections. Assuming I don't get in this cycle (that's 2 now), I have only 6 months to improve my application from where it is now if I'm to reapply ASAP for the 2008 cycle (June/July). [I'm long-winded, so I've put the highlights in bold]

The typical suggestions to get more relevant experience are research, EMT, phlebotomy, and clinical volunteerism. For me research is out, there just aren't any opportunities where I live. EMT is out because there is no EMT-B in TN; you can only go for the next step up which is 16 credit hours over 2 semesters. Many hospitals and blood donation centers do on the job training in phlebotomy, making it easy to get into; not where I live, I've checked every possibility. I've done my time volunteering in a hospital. There are basically two possibilities; you either do something that has NOTHING to do with patients, or you volunteer on a floor where you're not allowed to so much as touch a patient. It wasn't completely useless, the nurses were very accommodating and were helpful in making sure I got to see ultrasounds, minor patient care "things," etc. Still, most of the time I just sat around; they simply weren't allowed to let me do anything for liability reasons. Therefore, I think I've gotten all I can out of hospital volunteering.

This leaves shadowing. Before you ask, no, I have no friends, no family, no friends of the family, no friends of friends, no family of friends, etc. that have any personal connections to physicians. I live in a medical-free zone. That pretty much leaves cold-calling, which I'm hesitant to do. I just don't envision physicians agreeing to expose their patients to some anonymous pre-med student. Finally, I COULD ask my PCP, but it would absolutely kill me to do so. I just think it would be inappropriate to ask my own doctor for some shadowing time.

So there's my gauntlet, the same one I've struggled with for the past 2 years that I've been "seriously" seeking clinical exposure. Does anyone have a (constructive) suggestion? The one complication I haven't mentioned is that I can't pass up the opportunity to work right now; it would simply be lazy not to do so. I'm not going to be unproductive while I can be making real money and do something to save for my future, no matter how paltry it may be. So for anyone who's done some shadowing, is it realistic that I could possibly find a doctor (probably through cold-calling) to shadow for a few hours in the morning, maybe 8-11? It's not that I'm unwilling to make sacrifices (such as quitting my job), but since "clinical experience" is so nebulous, it's a little difficult to quantify the reward for such an action. I thus feel constrained to "fitting" it into my day. Thoughts? Thanks.

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[spicedmanna]

I have one possible lead you might not have considered:

Try becoming a CNA (certified nursing assistant). The training is pretty minimal (how minimal depends on where you take your classes; you'd need to google this) and the clinical exposure is good. CNA's are in high demand in hospitals, clinical centers, and nursing homes these days. If you go this route, I doubt you'd have much trouble finding both a job and decent exposure to pt's, all at once. Check it out.

Here's another:

If you don't care if your patients are living, you can work as a diener. Essentially, in this role, you assist a pathologist in performing autopsies. If "smelling" patients are a valid criteria for clinical experience, and you are curious about what prosectors do (the pathologist in charge of the post-mortem dissection), this could be a good job. I think the training is on-the-job, too. The only trouble with this job is that there won't be any therapeutic interaction between you and your deceased patient, or much of any other interpersonal interaction, for that matter...

 

[Encrypted]

I have one possible lead you might not have considered:

Try becoming a CNA (certified nursing assistant). The training is pretty minimal (how minimal depends on where you take your classes; you'd need to google this) and the clinical exposure is good. CNA's are in high demand in hospitals, clinical centers, and nursing homes these days. If you go this route, I doubt you'd have much trouble finding both a job and decent exposure to pt's, all at once. Check it out.

Since most of us are college students and can only probably work during the summer, will hospitals hire us for only 2-3 months?

 

[crimsonkid85]

at your college, does your pre-med committee continue to help out even after you've graduated? if so, you could contact them and as them for a couple of people who might be willing...

 

[DieteticMD]

I agree - you have to cold call. I just recently moved to a new city out west and my whole family is east coast. Needless to say I don't know anybody in town, including medical persons. I found the wedsite of the hospital I wanted to volunteer/shadow at and sent an email (thru the contact us page). I have since been set up with the "head of education" (teaching hospital) and am now on the top of the list for all shadowing/research projects/volunteering!

Just stick your neck...

 

[muffindoctor]

I definitely had the same problem. Now I have two physicians to shadow!

I go to a school that also has a medical school so I went to the university hospital website to find the names of doctors that work there. Then I went to the university directory (which I have access to as a student) and looked up those names in the directory to get their e-mail addresses. I contacted a few of these people while trying to focus on those that were more likely to have the time, graduated from a med school that I'm interested in, have a certain specialty, etc. The email basically told them that I was pre-med at the university, interested in their specialty, and wanted to shadow them. I sent 6 e-mails and got 2 back!

I see that you went (go?) to University of Tennessee...maybe you can do something similar?

It's almost the same as a cold call but your e-mail may be slightly more legitimate if they are affiliated with you by being part of the same university.

ps...sorry...I am also long-winded!

 

[NashvilleWill14]

Have you thought about a summer program?

Quillen College of Medicine at ETSU has some great (and free) summer programs that can get you over 120 hours of hands-on clinical shadowing experience in a variety of medical fields along with some admissions counseling and basic medical training. I did it last year and it was simply an amazing experience.

You can find some info here although I am unsure if they are accepting applications yet this year.

 

[magguilli5]

I don't know about anyone else, but I've had my EMT background counted as worthless, and even used against me in interviews. I was a NY EMT for 3 years, working for volly and commercial agencies, and even the Director of EMS on campus. One interviewer called EMS medical care 'too acute' to be considered real medical experience. Others have said they're skeptical because we have preconceived notions of how to interact with patients. In any case, what I considered to be the strong point of my application so far has only worked against me...

 

[kypdurron5]

I don't know about anyone else, but I've had my EMT background counted as worthless, and even used against me in interviews. I was a NY EMT for 3 years, working for volly and commercial agencies, and even the Director of EMS on campus. One interviewer called EMS medical care 'too acute' to be considered real medical experience. Others have said they're skeptical because we have preconceived notions of how to interact with patients. In any case, what I considered to be the strong point of my application so far has only worked against me...

Wow, "too acute?!" What if you want to be an ER doc, isn't that "acute" medicine? That's just insane!

 

[LizzyM]

There is a lot of turnover among certified nursing assistants so getting a job just for the summer (or through a temp staffing agency) should be easy. Many of these workers want some summer vacation with their kids and nursing homes are happy to have someone fill in during the summer. Be prepared to work hard & get your hands dirty and you'll really get a chance to get some hands-on experience. It isn't an experience of being a doctor but a chance to see things closer to a patient's point of view.

Muffindoctor had an excellent suggestion. You might also ask your undergrad alumni office if they have any undergrad alumni in your area who are now physicians. I know some docs who are very receptive to having a fellow alumnus of their undergrad institution work shadow them.

Rather than ask your PCP for some shadowing time, ask if he (she) knows of another doctor in your community who might be willing to take you on as a shadow. That way you aren't putting your PCP in a position of saying yes or no to a direct request to shadow.

 

[kypdurron5]

Rather than ask your PCP for some shadowing time, ask if he (she) knows of another doctor in your community who might be willing to take you on as a shadow. That way you aren't putting your PCP in a position of saying yes or no to a direct request to shadow.

That's a very good point, I hadn't thought of that!

 

[spicedmanna]

I don't know about anyone else, but I've had my EMT background counted as worthless, and even used against me in interviews. I was a NY EMT for 3 years, working for volly and commercial agencies, and even the Director of EMS on campus. One interviewer called EMS medical care 'too acute' to be considered real medical experience. Others have said they're skeptical because we have preconceived notions of how to interact with patients. In any case, what I considered to be the strong point of my application so far has only worked against me...

Wow. Sorry to hear that. Interviewers are not immune to prejudice and misinformation. I'll keep my rant to a minimum, since it's off-topic.

From my observation, the patient care algorithms that EMT's use on a call are used all the way up the EMS food chain, including the trauma surgeon, with obvious additional capabilities added at each level. The fundamentals of EMS care remain the same, however, no matter what level of care you can provide. So whatever with this not being real medicine; you are assessing and caring for the patient. It's not internal medicine, no, but it is considered a crucial leg of emergency medicine.

EMT's are seeing the patients at their rawest. Even if the crap hasn't actually hit the fan, and it's a priority three call (minimal), the patient and their families often feel like it has. You need to be able to deal with the emergent emotional and social aspects related to caring for and transporting the patient as well as the family/friends involved (actually many doctors aren't very good at this aspect, so...). In essence, you are treating everyone, and trying to provide the patient with some dignity in the midst of their struggle. You are sometimes calming everyone down, continually reassuring the patient and family, and even convincing them to seek medical care in the first place. In my experience, no two calls are exactly the same; you need to be creative and improvise as you go.

Oh well, whatever. It's sad to hear you report that there is so much misunderstanding. No, being an EMT isn't akin to being a medical doctor, but it does put you on the front line, and gives you very decent exposure to the care of patients. I doubt medical schools could expect more than that.

 

[Wizard of Oz]

Want my advice? Dedicate all fire power to a high MCAT.

Med schools really don't expect you to have that much clinical experience, per se, just a little bit of something to show that you have given it adequate.

Here's my pedigree--former nurse aide and patient care technician, EMT-B certified, personal trainer with EKG experience, full-time medical technologist, previous academic research career, Master's degree with publications.

NONE of that had any effect until I posted a 30+ MCAT. Whether it's true or not, grades and MCAT are viewed by schools as indicators of your ability to study, which is all you really need to excel on the USMLE.

Best of luck.

 

[kypdurron5]

Want my advice? Dedicate all fire power to a high MCAT.

Med schools really don't expect you to have that much clinical experience, per se, just a little bit of something to show that you have given it adequate.

Here's my pedigree--former nurse aide and patient care technician, EMT-B certified, personal trainer with EKG experience, full-time medical technologist, previous academic research career, Master's degree with publications.

NONE of that had any effect until I posted a 30+ MCAT. Whether it's true or not, grades and MCAT are viewed by schools as indicators of your ability to study, which is all you really need to excel on the USMLE.

Best of luck.

Alas, I've already done that >). I started with a 27 without much "worthwhile" studying, and then put a pretty decent amount of effort into it and came out with a 33. I thought for sure I would get in with a 3.9 and a 33, but so far I've been wrong again. As for clinical experience I've really been nailed on that at interviews at two different schools. The first actually sent me a rejection letter saying "Should you wish to reapply, we recommend you seek hands-on clinical experience." At another school my interviewer basically said "So you really don't have exposure to medicine, do you?" This was AFTER I talked about my volunteer experiences >). He may have just been trying to be confrontational, but I was waitlisted....so I don't know.

To the topic of research... My undergrad institution was really gung-ho on "bench" (chemistry) research. In the biology department there was ecological research, and some more bench projects...but nothing with mammals and certainly nothing even approaching the topic of humans. Thus, when I've thought about "research" I've always envisioned bench work. I don't want to become a doctor so I can do that but just on a more complex level. The more I think about it though, the more I am interested in doing clinical research in conjunction with clinical practice. What kind of research do premeds get involved in that makes them more attractive to research-oriented schools? Is it usually undergrad bench stuff, or maybe just "helping out" in some way with a clinical research project at a local teaching hospital?

 

[sunnyjohn]

I don't know about anyone else, but I've had my EMT background counted as worthless, and even used against me in interviews. I was a NY EMT for 3 years, working for volly and commercial agencies, and even the Director of EMS on campus. One interviewer called EMS medical care 'too acute' to be considered real medical experience. Others have said they're skeptical because we have preconceived notions of how to interact with patients. In any case, what I considered to be the strong point of my application so far has only worked against me...

Your interviewer was/is a boo-boo head. Anyone who can deal with the wackos you have to put up with in EMS and still provide quality care is gold in my book. Maybe she/he siad that as a curveball in the interview just to see how you would react?

 

[sunnyjohn]

Alas, I've already done that >). I started with a 27 without much "worthwhile" studying, and then put a pretty decent amount of effort into it and came out with a 33. I thought for sure I would get in with a 3.9 and a 33, but so far I've been wrong again. As for clinical experience I've really been nailed on that at interviews at two different schools. The first actually sent me a rejection letter saying "Should you wish to reapply, we recommend you seek hands-on clinical experience." At another school my interviewer basically said "So you really don't have exposure to medicine, do you?" This was AFTER I talked about my volunteer experiences >). He may have just been trying to be confrontational, but I was waitlisted....so I don't know.

Hmmm how sharp are you interview skills? Sometimes folks come off as cold in an interview even though they think they did well.. (Please don't take that as an attack)

I read your profile. Sine you said you worked had 12 hour days, perhaps you should play up that angle. It shows maturity and an abiltiy to work hard.

 

[kypdurron5]

Hmmm how sharp are you interview skills? Sometimes folks come off as cold in an interview even though they think they did well.. (Please don't take that as an attack)

I read your profile. Sine you said you worked had 12 hour days, perhaps you should play up that angle. It shows maturity and an abiltiy to work hard.

I don't think I come off as cold at all; in fact, I think I connect with people really well one-on-one. I've been doing over the phone customer service for last 4 years or so, and my verbal reasoning score was the highest both times (most recently with a 13). As for the 12 hour days, I wasn't saying that I was working 12 hours, just that I got up around 8 and didn't back home until around 8 pm. About half the day was school, and half the day was work. My point is that there just wasn't much more time before or after to do a ton of volunteering/shadowing, and I still had to take into account homework, studying, and maybe even some fun. One interviewer said "ok, so you were taking 18 hours and working 20 hours a week...hrrmm, so what did you do in all your spare time?" My point here is..."what spare time?!" I know there are people who manage to work, take a full schedule, and still do these other activities during the semester...but I just don't see how there are enough hours in the day. One guy left a comment saying "well you shouldn't have holed yourself up trying to get your 3.9." Again, my point is just that I had a very busy schedule, and very busy days, every day.

 

[sunnyjohn]

I don't think I come off as cold at all; in fact, I think I connect with people really well one-on-one. I've been doing over the phone customer service for last 4 years or so, and my verbal reasoning score was the highest both times (most recently with a 13). As for the 12 hour days, I wasn't saying that I was working 12 hours, just that I got up around 8 and didn't back home until around 8 pm. About half the day was school, and half the day was work. My point is that there just wasn't much more time before or after to do a ton of volunteering/shadowing, and I still had to take into account homework, studying, and maybe even some fun. One interviewer said "ok, so you were taking 18 hours and working 20 hours a week...hrrmm, so what did you do in all your spare time?" My point here is..."what spare time?!" I know there are people who manage to work, take a full schedule, and still do these other activities during the semester...but I just don't see how there are enough hours in the day. One guy left a comment saying "well you shouldn't have holed yourself up trying to get your 3.9." Again, my point is just that I had a very busy schedule, and very busy days, every day.

1. CNA (certified nursing Aide) is the way to go if you want to get that hands on experience "quick and dirty'. I enjoyed my time as a CNA. The training was 120 clock hours w/a certification test. I got hired both on an ICU ward and in a nursing home p/t. Make sure your local hospital will hire CNAs. Some locales only use them in nursing homes. Also, make sure you know the 411 on any hospital unit BEFORE you take the gig. Being a CNA on a floor with a toxic work environment is HELL.

2. I had a few friends that were able to get OJT training as a telemetry tech/ Health unit Coordinator (HUC) in a hospital. It was not as hands on, but they were right there with the docs and nurses on the floor.

3. As a CST I've also had students shadow me when I worked for an organ bank. They took call with me and went in the OR and everything (no scrubbing but they saw it all). I know a few students who were able to graduate to corena retrieval jobs after and intense shadowing OJT/experience. As a surgical Tech I think CSTs are better at the OR stuff, but students with OJT do just find retreiving corneas in the morgue.

Good Fortune and Good luck. With your great GPA and MCAT score I really think its just a matter of adding a few more school and waiting to hear back before you get in. It shows you what a crap shoot this whole process really is.

 

[63768]

i think the best route is to go with shadowing. training to be a CNA and a phlebotomist requires time and commitment to be good at what you're doing, and in the end, you spend more time learning to do your job than interfacing with patients since you're only short term.

go with shadowing. as LizzyM said, ask your PCP if he/she knows any physicians you could shadow. if you're near a medical school, call up the dept of your choice and ask about shadowing (or you could show up and ask in person). ask any premed advisors if they can help you. ask other premeds how they did it.