Article: "Shadowing: Thinking outside the [clinical] box."

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The interviewer solemnly looked down at the papers scattered before him. Interrupting his own seemingly deep thought, he quickly glanced up at the nervous applicant, "I see that you have 10 hours of formal physician shadowing." After taking in a breath that was perceivably deeper than before, he continued, "So, tell me, do you feel that was enough exposure? Are you confident that those 10 hours were representative of the profession, representative enough for you to validly spend the rest of your life on this journey through medicine? Did those 10 hours render the entire spectrum of medicine [from the highest highs to the lowest lows] for your consideration? Are you confident that pursuing an MD is the correct pursuit for you?"

For many applicants, the aforementioned scenario is not far from experiential-reality, in fact, it is the firsthand account that one of my former students shared with me. Some individuals that aspire to attend medical school might feel that they are forced into shadowing physicians. That their hands are essentially tied and, if they substitute the experience with other modes of "surveying" [read: volunteering, talking with their physician-parents, reading SDN, watching all the seasons of Grey's Anatomy, et al.], they will be nonetheless skewered by their interviewer in regards to this gaping extracurricular-hole. In all reality, those same individuals would likely characterize the opening conversation as a "badgering" or "grilling" of the interviewee. However, is it really?

Stepping back, perhaps the most important pre-requisite for medical school admissions is possessing a thorough and balanced perspective of what "being a physician in today's healthcare environment" entails. If the closest thing an applicant has to clinical experience is watching Dr. Quinn, Medicine Woman, despite their 3.8 GPA and 32 MCAT, they are going to have a hard time getting admitted anywhere in the US.

This hurdle/hoop/requirement arises for good reason: nothing about being a physician is easy. Medical school is strenuous. Residency is grueling. Fellowship is draining. Practicing is stressful. Before you jump out of a plane, you need to have a parachute on your back; likewise, before you start your pursuit of an MD, you need to know what you are getting into.

What about other advanced degrees? Do they require shadowing? Does a law school applicant need to shadow a cohort of lawyers before pursuing a JD? If they do not, they should. Turning back the hands of time to when I seriously considered enrolling in law school, shadowing was far from a pre-requisite for admittance. I had a near-perfect GPA in my hand and an excellent LSAT score in my back pocket. I knew that I "liked arguing with people" and that I enjoyed all the legal drama television shows -- that is enough to make a good decision, right? Well, lucky for me and my sanity (but unlucky for my naivety and idealistic view of law), I decided to shadow a cohort of lawyers before submitting my application. Needless to say, I never applied to law school.

"Okay," you think in agreement, "the merits of shadowing before pursuing professional degrees are credited". What about the utility of shadowing for a degree that, at first glance, doesn't require the same amount of time, tears, and money to obtain? For example, an MBA...

In a previous article, I explored how to determine the total cost of obtaining an MBA via the traditional 5- or 6-year MD/MBA program. Analyzing that total cost in conjunction with your motivations or benefits largely determined if the degree was "worth it or not". However, no matter what those motivations might be (whether working as a healthcare consultant, pharma executive, department chair, hospital CEO, etc.), are you certain that an MBA will help you reach those goals? Why -- because they both involve a "business" backdrop? Without spending time to actually observe and learn about your proposed endpoint, how do you know if that is really a position in which you would want to end up? The answer is that you cannot and therein lays the merits of shadowing outside the clinical box.

As a premedical/medical student, you might feel that the opportunity to shadow people in the business world to be one that does not rear its head often -- and it is completely appropriate to feel that way. You will be waiting a very long time to shadow if you delay the experience until your medical school offers an official elective in "successful upper-level management in health systems" or "leadership in healthcare consulting"... it just isn't going to happen. You need to take initiative and be fully dedicated to seeking out your own opportunities. Initially, that might put you back on your heels, "Whoa now! I have a packed schedule between class, studying, volunteering, group work, shadowing physicians, curing cancer and saving the world!" Not a problem. No matter how busy your schedule is, the beauty of shadowing is that often it can be done around your timeline (you just need to work ahead). 4 hours during the semester, a week during summer vacation, an afternoon here and there during residency: flexibility is a wonderful thing. You might find the prospect of cold calling offices and navigating through secretaries unnerving, but it will get easier. Have a well-thought-out description of why you want to shadow, what you hope to gain from the experience and your timeline.

Shadowing can and should be fit into your schedule if you are serious about pursuing an MBA. Think outside the clinical box. Explore your possibilities on a firsthand basis when possible rather than rely on speculation. Save yourself the time and money to see if the MBA "is the correct pursuit for you".

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