Assistance with Clinical Experience Issue

[mreyno18]

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I am currently a 3rd year, so I plan on applying this next cycle. I have a great GPA, lots of TA / tutoring hours, good MCAT, some leadership experience, NCAA D2 athlete, 360 research hours, and am part of an honors program.

My issue is I lack clinical experience. I switched to being pre-med from engineering during my sophomore year, so my clinical experience started in Fall/Spring 2019/2020 and due to COVID most of it was shut down in March 2020.

• I was involved in clinical volunteering and had racked up about 50 hours of volunteering at a nursing home and 10 hours volunteering at a hospital when they got canceled due to COVID and they haven't restarted the volunteer programs yet.
• I only have 22 shadowing hours, but am trying really hard to find hospitals in my state that are allowing shadowing currently.
• I went on a pre-med international volunteering trip last winter in Guatemala for a week.
• I worked as a PCA (personal care assistant) for an elderly paralyzed woman last summer which SDN has told me mixed results about whether it's clinical experience or not.
• I am applying to 30+ summer pre-med internships, which I was supposed to do last summer but were canceled and I have high hopes that I will be accepted to at least one that is planning on happening this summer. They will start right before I submit the application right away in June, so I will be putting it on my AMCAS.

So what I need help with is determining if this is enough? Especially with COVID challenges... What can I do that will actually be helpful for my AMCAS application in the clinical experience section that is available during COVID times during the next 6 months before I apply?

 

[Bored_Conscious]

Seems like you got a lot of good things going for you, however, as you know you need the clinical experience/shadowing.

In regards to shadowing, I know a hospital in my area is starting to open up their observation programs again. Keep on the look out and reach out to hospitals you have contacted in the past. In addition, have you tried reaching out to private practices to see if you could have any luck with shadowing there?

In regards to clinical experience, 60 total hours at a nursing home and hospital volunteering is most definitely on the low side. How many hours do you have as a PCA? Could you describe that experience a bit more? I can't imagine it not being considered clinical experience. With your previous experience as a PCA, I think you have a pretty good shot at being a PCT/PCA (Patient Care Technician/Patient Care Associate) and that is undoubtedly one of the best experience you can get in regards to patient interaction/clinical experience in my personal opinion. (It is essentially a CNA if you are okay with that kind of work). Of course, there are other clinical experience opportunities you can gain such as scribing, hospice/hospital volunteering, CNA, Clinical research coordinator (maybe), etc.

Also, not quite sure what these "pre-med internships" consist of but by next summer you will already be applying and I recommend getting your hours in prior to application rather than putting it down as "projected hours" as it don't hold much value.

Lastly, not sure what you did as a pre-med volunteer in Guatemala but that seems more like non-clinical volunteering. Unless you can tell me more about it, I can't imagine a pre-med doing much clinical volunteering internationally. Seems more like voluntourism.

 

[mreyno18]

How many hours do you have as a PCA? Could you describe that experience a bit more?

I worked a PCA (personal care assistant) for an older adult women who was a paraplegic.
My daily tasks included: bathing, transfers, dressing, grooming, basic housekeeping and laundry, helping her with her physical therapy exercises, range of motion, and stretching, and helping her do daily tasks. Basically I did what a CNA does, but I’m not certified and I work in their home instead of in a care facility.
I have 300 hours doing that last summer.

 

[mreyno18]

With your previous experience as a PCA, I think you have a pretty good shot at being a PCT/PCA (Patient Care Technician/Patient Care Associate) and that is undoubtedly one of the best experience you can get in regards to patient interaction/clinical experience in my personal opinion. (It is essentially a CNA if you are okay with that kind of work). Of course, there are other clinical experience opportunities you can gain such as scribing, hospice/hospital volunteering, CNA, Clinical research coordinator (maybe), etc.

As a NCAA athlete, double major, research, and everything else, I don't have time to work during school. This is one of my fears. I really was relying on volunteering for clinical experience and I've reached out to everywhere local and no one is doing volunteering right now. So I am really scared that I would gain anything more come June.
I am leading a fundraising project with students from the pre-med club for the local children's hospital currently and will be doing that next semester too. Obviously not clinical experience, but you know....

 

[mreyno18]

Also, not quite sure what these "pre-med internships" consist of but by next summer you will already be applying and I recommend getting your hours in prior to application rather than putting it down as "projected hours" as it don't hold much value.

They are summer internships at hospitals all over the country. They all consist of a mix of clinical research, physician observation, rounding with residents, presenting research, etc.

 

[Bored_Conscious]

They are summer internships at hospitals all over the country. They all consist of a mix of clinical research, physician observation, rounding with residents, presenting research, etc.

Sounds interesting. Go for it. I was mostly just curious.

 

[Bored_Conscious]

As a NCAA athlete, double major, research, and everything else, I don't have time to work during school. This is one of my fears. I really was relying on volunteering for clinical experience and I've reached out to everywhere local and no one is doing volunteering right now. So I am really scared that I would gain anything more come June.
I am leading a fundraising project with students from the pre-med club for the local children's hospital currently and will be doing that next semester too. Obviously not clinical experience, but you know....

That is understandable. Have you considered PRN? You definitely seem busier than I am, however, I won't cut myself short and say I wasn't busy myself. Luckily, my job offered a PRN position so as long as I go in a minimum of 3 12-hour shifts per week every 6 weeks, I am good to go. Maybe you could do the same? If not, either drop some commitments to pursue the necessary clinical experience (something I would be very opposed to and I am sure you would be as well), keep searching for other opportunities through volunteering, or drown yourself by adding more work (we are surprisingly adaptive in terms of workload I found...one way or another you always find a way).

The options I gave you may not even be necessary, however. To be continued...

 

[Bored_Conscious]

I worked a PCA (personal care assistant) for an older adult women who was a paraplegic.
My daily tasks included: bathing, transfers, dressing, grooming, basic housekeeping and laundry, helping her with her physical therapy exercises, range of motion, and stretching, and helping her do daily tasks. Basically I did what a CNA does, but I’m not certified and I work in their home instead of in a care facility.
I have 300 hours doing that last summer.

I am a just a pre-medical student who hasn't applied yet and will apply next cycle as well. However, I do not know why other SDNers would have potentially said this is not "clinical experience". It does not matter if you are a licensed CNA or not. A PCT, from what I've been told, is a way for hospitals to hire people to do CNA tasks without the CNA pay due to licensing...lol.

In my eyes, this is 100% clinical and involves more actual relevant clinical experience than volunteering in a hospital refilling empty glove boxes. The only "downside" in my eyes regarding your PCA experience is that it is only ONE patient. You weren't able to provide care to a variety of patients, however, this could also be seen in a positive. You truly got to establish a relationship with this individual and provide individualized attention. Maybe other adcoms could correct me, but I personally classify this as clinical experience.

So, with that, it seems like you do have decent number of clinical experience hours and you are good to go! Unless someone corrects me of course and says that it is not clinical...

 

[LizzyM]

I am a just a pre-medical student who hasn't applied yet and will apply next cycle as well. However, I do not know why other SDNers would have potentially said this is not "clinical experience".

Is a person in their home who needs assistance with activities of daily living "a patient"? When the care provider goes in to provide services, do they say, "I'm going to see my patient?" I think that most would say, "I'm going to see the lady I take care of."

When I have my hair washed at the salon, am I a patient? When someone washes my hair in my home because I'm living with paralysis, am I now a patient? If I feed a child a bowl of infant oatmeal is he a patient? If I feed an elderlly person a bowl of cereal, is she a patient?

When you are in someone's home providing personal services, it is a good experience that helps you get comfortable with providing intimate care to someone who is not a member of the family However, it is in the home, not in a clinical setting with other patients. There are no licensed providers on the premises and there may never be (the person may go to a clinical setting for clinical services rather than having a doctor who makes house calls.) Clinical experience requires being with patients in a clinical setting. Being in the home of a person with a disability becomes a gray zone that cause some people in the disability community to bristle.

Do you see where we are going with this?

 

[Bored_Conscious]

Is a person in their home who needs assistance with activities of daily living "a patient"? When the care provider goes in to provide services, do they say, "I'm going to see my patient?" I think that most would say, "I'm going to see the lady I take care of."

When I have my hair washed at the salon, am I a patient? When someone washes my hair in my home because I'm living with paralysis, am I now a patient? If I feed a child a bowl of infant oatmeal is he a patient? If I feed an elderlly person a bowl of cereal, is she a patient?

When you are in someone's home providing personal services, it is a good experience that helps you get comfortable with providing intimate care to someone who is not a member of the family However, it is in the home, not in a clinical setting with other patients. There are no licensed providers on the premises and there may never be (the person may go to a clinical setting for clinical services rather than having a doctor who makes house calls.) Clinical experience requires being with patients in a clinical setting. Being in the home of a person with a disability becomes a gray zone that cause some people in the disability community to bristle.

Do you see where we are going with this?

I see where you are going with it. Guess it makes it a bit more finicky, however, plenty of students put hospice volunteering as clinical no?

Of course, some hospice experiences let you go to an actual clinical facility but I know plenty of hospice volunteers (myself included) where we go visit the patients at their home. Personally, I would tell my friends and family that I am visiting a patient at their home but who knows.

 

[Mr. Nightmare]

I see where you are going with it. Guess it makes it a bit more finicky, however, plenty of students put hospice volunteering as clinical no?

Of course, some hospice experiences let you go to an actual clinical facility but I know plenty of hospice volunteers (myself included) where we go visit the patients at their home. Personally, I would tell my friends and family that I am visiting a patient at their home but who knows.

The difference here is this: although the volunteers are at the home of the patient, they are from a particular hospice agency. And the volunteers must abide by the rules of the hospice program they belong to.

 

[LizzyM]

I see where you are going with it. Guess it makes it a bit more finicky, however, plenty of students put hospice volunteering as clinical no?

Of course, some hospice experiences let you go to an actual clinical facility but I know plenty of hospice volunteers (myself included) where we go visit the patients at their home. Personally, I would tell my friends and family that I am visiting a patient at their home but who knows.

Yes! Because a hospice patient is a patient who is under the care of a physician and who is terminally ill. That is somewhat different than a person with a disability who in stable condition and living in their own home with some assistance with activities they are not able to perform on their own.

Being employed by or volunteering to assist someone who has a disability is laudable but it is not a substitute for a clinical experience with patients in a clinical setting.

 

[Bored_Conscious]

Yes! Because a hospice patient is a patient who is under the care of a physician and who is terminally ill. That is somewhat different than a person with a disability who in stable condition and living in their own home with some assistance with activities they are not able to perform on their own.

Being employed by or volunteering to assist someone who has a disability is laudable but it is not a substitute for a clinical experience with patients in a clinical setting.

I see. Now that I think about it some more, you are correct. Looking back, the patients I volunteered with were under the care of a physician. That did not cross my mind.

I see where OPs PCA experience becomes slightly questionable in regards to being clinical experience. Good to know.

 

[Bored_Conscious]

The difference here is this: although the volunteers are at the home of the patient, they are from a particular hospice agency. And the volunteers must abide by the rules of the hospice program they belong to.

Yup, it seems like LizzyM was trying to get that point across as well. Hopefully, OP can find some opportunities soon. That's really all the advice I could give them.

 

[deleted1025488]

Keep in mind you don't HAVE to submit your application by May 1st; you can easily (hopefully) be able to find a volunteer opportunity by then, and if need be you could spend a lot of time during May-July in clinical settings so then you're ready for applying a bit later...so you still have a lot of time...not the end of the world...

 

[mddoc]

Is a person in their home who needs assistance with activities of daily living "a patient"? When the care provider goes in to provide services, do they say, "I'm going to see my patient?" I think that most would say, "I'm going to see the lady I take care of."

When I have my hair washed at the salon, am I a patient? When someone washes my hair in my home because I'm living with paralysis, am I now a patient? If I feed a child a bowl of infant oatmeal is he a patient? If I feed an elderlly person a bowl of cereal, is she a patient?

When you are in someone's home providing personal services, it is a good experience that helps you get comfortable with providing intimate care to someone who is not a member of the family However, it is in the home, not in a clinical setting with other patients. There are no licensed providers on the premises and there may never be (the person may go to a clinical setting for clinical services rather than having a doctor who makes house calls.) Clinical experience requires being with patients in a clinical setting. Being in the home of a person with a disability becomes a gray zone that cause some people in the disability community to bristle.

Do you see where we are going with this?

What about if the assistance has been prescribed/recommended by a doctor?

 

[LizzyM]

What about if the assistance has been prescribed/recommended by a doctor?

It is still what is called "custodial care" and not clinical service. A doctor can tell someone with seizures that they shouldn't drive anymore but being their Uber driver is not a clinical experience.

 

[LiteralLungs]

It is still what is called "custodial care" and not clinical service. A doctor can tell someone with seizures that they shouldn't drive anymore but being their Uber driver is not a clinical experience.

Hey @LizzyM I have a question for you that is related to this thread. I have been working as an assistant in an inpatient setting with patients who have neurodevelopmental issues. There are therapists that design behavioral protocols that I implement as treatment. This behavioral therapy is combined with medication management given by a team of nurses and physicians. As I said, my role is to implement the patients' behavioral protocols, teach them to perform activities of daily living, manage severe behavioral issues, etc. I could consider this clinical experience, no?

 

[candbgirl]

As a NCAA athlete, double major, research, and everything else, I don't have time to work during school. This is one of my fears. I really was relying on volunteering for clinical experience and I've reached out to everywhere local and no one is doing volunteering right now. So I am really scared that I would gain anything more come June.
I am leading a fundraising project with students from the pre-med club for the local children's hospital currently and will be doing that next semester too. Obviously not clinical experience, but you know....

Then maybe you should seriously consider a gap year or two. You don’t want to apply with holes in your application. Med Schools will be there when you are ready. And your international trip will not impress ADCOMS. There are numerous threads about this subject . Many ADCOMS consider it “voluntourism”. And that’s not good. Your experiences and service should be in the US. I know many people are using COVID as an excuse. Totally understandable but you need to be aware that many applicants will have extensive ECs despite COVID. So slow down and do it right. You only want to do this once.

 

[LizzyM]

Hey @LizzyM I have a question for you that is related to this thread. I have been working as an assistant in an inpatient setting with patients who have neurodevelopmental issues. There are therapists that design behavioral protocols that I implement as treatment. This behavioral therapy is combined with medication management given by a team of nurses and physicians. As I said, my role is to implement the patients' behavioral protocols, teach them to perform activities of daily living, manage severe behavioral issues, etc. I could consider this clinical experience, no?

If the facility is "in-patient" and the people you treat are "patients" and not "residents" then you might be on firm footing to call it "clinical".

 

[mddoc]

It is still what is called "custodial care" and not clinical service. A doctor can tell someone with seizures that they shouldn't drive anymore but being their Uber driver is not a clinical experience.

With all due respect, I don't feel that giving care to an individual who may be chronically ill, but not necessarily acutely ill as to require hospitalization should be seen less as a patient who is admitted in a hospital. I have worked in both settings. In addition, I have seen/heard others who advise students say that patient aide assistants who work in home settings are gaining patient care/clinical experience. It is not necessarily the setting but the exposure to patients that is taken into account. Clearly this depends on the person one is speaking to. I also feel that comparing this work to one who is an Uber driving or getting their hair done in a salon is also problematic, but this is just my opinion. I can respect you have a differing view.

 

[LizzyM]

With all due respect, I don't feel that giving care to an individual who may be chronically ill, but not necessarily acutely ill as to require hospitalization should be seen less as a patient who is admitted in a hospital. I have worked in both settings. In addition, I have seen/heard other who advise students say that patient aide assistants who work in home settings are gaining patient care/clinical experience. It is not necessarily the setting but the exposure to patients that is taken into account. Clearly this depends on the person one is speaking to. I also feel that comparing this work to one who is an Uber driving or getting their hair done in a salon is also problematic, but this is just my opinion. I can respect you have a differing view.

We are talking about the experience needed to test one's interest in a career in medicine. We are also talking about having respect for people living with disabilities who are people, not patients. Providing the daily assistance they need may be a good way to test your interest in a career in nursing but I would argue that it is not a an adequate way to test one's interest in a career in medicine. If it is in addition to time spent in outpatient or hospital settings, then fine, but to be in the home of someone with a disability is not, given their disability alone, sufficiently clinical.

 

[mreyno18]

We are talking about the experience needed to test one's interest in a career in medicine. We are also talking about having respect for people living with disabilities who are people, not patients. Providing the daily assistance they need may be a good way to test your interest in a career in nursing but I would argue that it is not a an adequate way to test one's interest in a career in medicine. If it is in addition to time spent in outpatient or hospital settings, then fine, but to be in the home of someone with a disability is not, given their disability alone, sufficiently clinical.

@LizzyM I value your opinion so much! Thank you for your insight on my PCA experience. I definitely realize now that although good life experience and shows good character traits, I will be putting my PCA work as nonclinical work on AMCAS.
My question is what do you suggest for someone in my standing... Who is very busy (3 season college athlete) and was relying on volunteering but that got shut down, so they only have like 60 hrs of clinical volunteering and 25 hrs of shadowing so far. I am looking for shadowing experiences right now, but what else can I do? What else should I do to find clinical experiences?

 

[LizzyM]

I hate to suggest leaving the woman you currentlly care for, because I feel for her, but you could take the skills you have and work as a PCT in a hospital setting and get your clinical experience quite quickly.

You could also plan for a gap year after college. This pandemic won't last forever and after vaccines become widely available (summer 2021), I believe that volunteer and shadowning opportunities will open up with proof of vaccination.