Can I legally scrub-in while shadowing?

[mariambaby3]

In NY state, am I (an undergraduate) legally allowed to scrub into surgery in a hospital? Stuff that I may be doing: helping cut sutures, holding the patients skin together while the surgeon applies sutures, helping wipe away blood on the patient. Is this allowed?

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[Pacna]

It may not be strictly legal, but every OR in the country does it.

 

[armybound]

I know what I wouldn't want to be doing without malpractice insurance coverage..

As a pre-med shadower I think I'd feel lucky just to be in the OR.

 

[Mt Kilimanjaro]

You know as much about surgery as a third year med student on his first day of the clerkship. But said med student is covered by a malpractice policy. I wouldn't want to get deposed before medical school.

 

[mariambaby3]

Suppose if we (as an undergrad shadower) were to undertake such an activity (scrubbing into surgery), should we talk about it in our AMCAS application if we got something meaningful out of it, despite being legally dubious?

 

[mcloaf]

It may not be strictly legal, but every OR in the country does it.

Uh this is definitely not true. No surgeon I shadowed would ever let a random premed touch a patient, more because you're not covered by insurance than because they think you'll **** up.

 

[Ismet]

Suppose if we (as an undergrad shadower) were to undertake such an activity (scrubbing into surgery), should we talk about it in our AMCAS application if we got something meaningful out of it, despite being legally dubious?

You got something meaningful out of cutting some string or wiping blood? Anything legally dubious should be kept out of AMCAS. You can say you observed surgery and describe what you learned, but saying that you were allowed to cut the suture doesn't impress anyone.

 

[Pacna]

Uh this is definitely not true. No surgeon I shadowed would ever let a random premed touch a patient, more because you're not covered by insurance than because they think you'll **** up.

I cut excess suture strings, held clamps, stabilized a kid's arm while the doc was resetting it (radius + ulna complete fractures). I feel like it was pretty routine.

 

[armybound]

If I were reviewing your application I'd be positively impressed by shadowing a surgeon. I'd be negatively impressed by your performance in the OR which may or may not be ethical or legal.

 

[mcloaf]

I cut excess suture strings, held clamps, stabilized a kid's arm while the doc was resetting it (radius + ulna complete fractures). I feel like it was pretty routine.

You did it therefore it's done in "every OR in the country"?

 

[Pacna]

You did it therefore it's done in "every OR in the country"?

Calm down. 😛

From what I've read, it's pretty common.

 

[ComradeDoktor]

It may not be strictly legal, but every OR in the country does it.

I have definitely NEVER heard of this happening. I would advise the OP to avoid those kinds of situations. It's not essential to your education, the patient doesn't benefit, and there's risk involved. Trying to "help" in the OR would be a purely selfish move and I think admissions officers would see it that way.

 

[mcloaf]

Calm down. 😛

From what I've read, it's pretty common.

Right, I know disagreeing with your generalizations is a strong indication that I am super uncalm. Don't worry, friend, I'm ok.

 

[Pacna]

Anyways, back on topic.

There are some stories in this thread about people being involved with procedures while shadowing: http://forums.studentdoctor.net/showthread.php?t=962657

It still doesn't answer your question about whether you should use the examples in your application or not, but maybe you could message some of those peeps and ask them if they used them? Just an idea. 👍

 

[Ismet]

Anyways, back on topic.

There are some stories in this thread about people being involved with procedures while shadowing: http://forums.studentdoctor.net/showthread.php?t=962657

It still doesn't answer your question about whether you should use the examples in your application or not, but maybe you could message some of those peeps and ask them if they used them? Just an idea. 👍

I read through that thread, and the people who did more than watch were either not shadowing (aka they were working, probably as a CNA or EMT or something) or they were otherwise trained and most likely had clearances/certification to do those things. That's completely different from being an untrained undergrad who is allowed to touch a patient.

Sorry, pre-meds assisting in the OR is definitely the exception, not the norm.

 

[Pacna]

I read through that thread, and the people who did more than watch were either not shadowing (aka they were working, probably as a CNA or EMT or something) or they were otherwise trained and most likely had clearances/certification to do those things. That's completely different from being an untrained undergrad who is allowed to touch a patient.

Sorry, pre-meds assisting in the OR is definitely the exception, not the norm.

Hmm... I don't suppose my being an EMT would have anything to do with it? I know the doc personally. He offered to have me shadow him, actually. Now I feel lucky!

 

[TheLastofUs]

I thought it was common to being doing hernia repairs by the end of your shadowing experience?

 

[cheechootrain]

It took me months and was a huge hassle for me to shadow in the OR. You have to know the right people to even get in. Mind this was a teaching hospital, the doctors were very welcoming and informative. However, I wasn't allowed to scrub in due to malpractice insurance policy etc. I just watched and eavesdropped on their conversations.

Actually, the anesthesiologist and/or nurse were very helpful and talked to me during the operations and explained some of the stuff that was happening. For example, if you ever see a doctor grab a big metal hammer, you know it's going to get messy.

 

[Spinach Dip]

I thought it was common to being doing hernia repairs by the end of your shadowing experience?

I wish!



First day I shadowed an anesthesiologist, he told me: "Don't touch ANYTHING going into or attached to the patient.... EVER." He then explained that it had to do with liability and so on. If something happened, they wanted to be able to say that the empty-headed shadow in the corner could not have possibly had anything to do with it.

(By the end, they did teach me how to push the 'silence alarms' button on the vent 😛 .... I learned loads from watching and speaking with the doctors I was shadowing.)

 

[circulus vitios]

I shadowed an FM resident and he had me do a red reflex test on an infant. It was negative, but he never checked my work. I thought that was pretty ****ed up.

 

[Ismet]

I shadowed an FM resident and he had me do a red reflex test on an infant. It was negative, but he never checked my work. I thought that was pretty ****ed up.

All you did was shine a light in the kid's eyes and make sure the red reflexes were symmetrical and without spots. He probably checked it in two seconds before doing the fundoscopy or pupil response

 

[circulus vitios]

All you did was shine a light in the kid's eyes and make sure the red reflexes were symmetrical and without spots. He probably checked it in two seconds before doing the fundoscopy or pupil response

I was with him the entire time we were with the patient. He never checked my work. I mean it's impossible to screw up a red reflex test, but still. I can't believe he trusted me that much.

 

[Ismet]

I was with him the entire time we were with the patient. He never checked my work. I mean it's impossible to screw up a red reflex test, but still. I can't believe he trusted me that much.

I am sure he checked the pupil response. I was taught to check the red reflex when doing the pupil response to minimize the number of times you have to blind the patient. Maybe he never told you he checked it? But like you said, it's hard to mess up, and abnormalities are rare.

 

[ChiDO]

Um, if the Dr says hey, scrub in with me...u do it, since obv it has been setup for you. And you can write w/e u want in your personal statement. No one is going to read a shadowing experience and think about the "legality" of the situation...

 

[dsoz]

I did plenty of stuff with the physician that I shadowed. I didn't write about it. Was it cool from a pre-med point of view? yes. Did I share some stories with my family (within HIPPA rules)? Yes. Did I tell random strangers in an essay? No need.

Every one of the adcom members has done what you did at one point. They probably did it so many times that they wish that they never need to do it again. To them, it is not cool anymore, it is a task to get done as quickly as possible.

My vote is to be glad you get to try out simple procedures, but don't crow about it from the top of the mountain.

dsoz

 

[Ost3oclast]

It may not be strictly legal, but every OR in the country does it.

Lol no

 

[alpinism]

You know as much about surgery as a third year med student on his first day of the clerkship. But said med student is covered by a malpractice policy. I wouldn't want to get deposed before medical school.

Lol wut?

I read through that thread, and the people who did more than watch were either not shadowing (aka they were working, probably as a CNA or EMT or something) or they were otherwise trained and most likely had clearances/certification to do those things. That's completely different from being an untrained undergrad who is allowed to touch a patient.

Sorry, pre-meds assisting in the OR is definitely the exception, not the norm.

There is no training for cutting sutures because you can never cut them the right length until you become an attending.

I shadowed an FM resident and he had me do a red reflex test on an infant. It was negative, but he never checked my work. I thought that was pretty ****ed up.

And you did it anyway. Taking advantage of a poor infant like that, treating her like a lab rat. Sickening. What if you poked her eye out.

 

[alpinism]

Um, if the Dr says hey, scrub in with me...u do it, since obv it has been setup for you. And you can write w/e u want in your personal statement. No one is going to read a shadowing experience and think about the "legality" of the situation...

Exactly. No one cares.

 

[911 Turbo]

Calm down. 😛

From what I've read, it's pretty common.

lmao



waitwut



no its not, not at all





seriously why would you let some 19 year old kid even get near a surgery? no reason he should even be in the OR

 

[Ost3oclast]

lmao



waitwut



no its not, not at all





seriously why would you let some 19 year old kid even get near a surgery? no reason he should even be in the OR

I see the suspension is gone. Welcome back!

 

[NontradCA]

lmao



waitwut



no its not, not at all





seriously why would you let some 19 year old kid even get near a surgery? no reason he should even be in the OR

What about the surg techs? They could be 19 and they're always in the OR. Btw, observing a surgery is the most boring thing ever.

 

[Spinach Dip]

Btw, observing a surgery is the most boring thing ever.

Are you a pre-med/med student? Because years 3 and 4 are going to be torture for you. 😉 😉

 

[Ismet]

Are you a pre-med/med student? Because years 3 and 4 are going to be torture for you. 😉 😉

3rd and 4th year consist of much much more than surgery. He can suck it up for several weeks, plus med students are usually allowed to do a bit more than just stand in a corner and watch.

 

[Geebeejay]

Um, if the Dr says hey, scrub in with me...u do it, since obv it has been setup for you. And you can write w/e u want in your personal statement. No one is going to read a shadowing experience and think about the "legality" of the situation...

I wouldn't it find it hard to believe that a medical school might be hesitant to accept a candidate who is so willing and eager to breach his SOP. By all means, write about what you want, but I think it would be smart to leave out the part where your premed hands were inside a patient's body cavity. No one will be impressed and some might question your maturity or your judgment skills.

 

[EnginrTheFuture]

I have heard numerous Deans of Admissions talk about how they feel it is unethical for pre-meds to go abroad and do things beyond their training/experience level on mission trips. I am sure they have the same opinion of US operating rooms. At the very least, learning how to keep a sterile field, and having experience watching that process should be had before scrubbing on a real patient. Personally, I feel a pre-med can be competent enough to follow directions and be just fine scrubbing in... but some pre-meds are dumb and adcoms see them a lot 🙂 Also, I feel like it may make you sound influenced by a "glorified" view of medicine (the "coolness" of being part of your first surgeries). This is something that is looked down upon at a lot of schools.

If I was in your position, I would not mention that you scrubbed into a surgery. I feel there is little upside to stating you scrubbed in versus stating you shadowed in the OR... but it comes with a potential negative reaction. Talk about it to your family and friends however you please, but you are paying the ADCOM to judge you!

 

[NontradCA]

Are you a pre-med/med student? Because years 3 and 4 are going to be torture for you. 😉 😉

Yes I'm pre-med, but I figure there's a lot of other issues to keep me occupied when I get to that point. The burden of learning, pre/post op etc. I was just saying that I think simply scrubbing into a surgery to observe is boring as it pertains to this thread.

 

[mvenus929]

It may not be strictly legal, but every OR in the country does it.

No. Just no. Teaching hospitals may be more likely to let pre-meds into the OR (when I was on surgery, we had to figure out how to get the pre-med student scrubs so she could observe in the OR), but the liability for the hospital is so high that I highly doubt the vast majority of community hospitals even let pre-meds into the OR without lots and lots of waivers, let alone scrubbing in.

 

[Buzz Me]

If you get to do it, great. Just be careful. You're not covered by malpractice insurance while you're a pre-med.

Don't write about specifics on your app. Just list it as clinical experience.

I've never been allowed to let pre-meds/undergrads scrub into cases with me.

 

[Irish1234]

I think you practice under the licence of a nurse or physician when you scrub in.

 

[katiemaude]

I think you practice under the licence of a nurse or physician when you scrub in.

Legally this might be true. I work in an OR as a tech, and I have no license and only training by the hospital. I work under the license of the RNs on my team. Anything I do involving any potential liabilities - the wrong name on a specimen, a specimen sent improperly, tourniquets not applied correctly, putting a patient's legs into stirrups and possibly dislocating a hip, SCDs not turned on before surgery - I make sure to double and triple check, even though a nurse is supposed to supervise. Techs have been deposed and "thrown under the bus" by RNs for such problems (even when the actions that were not theirs, but they were in the room and easy to blame) and were subsequently fired. Why an RN would allow a premed to get anywhere near the surgery is beyond me. How would they defend it in a patient safety report, should one need to be filed?

As for letting a premed go scrubbing in, I can't IMAGINE the stupidity of this surgeon and the OR staff. Surgical infections are a huge problem and knowing how to maintain a sterile field isn't an innate thing. You have to know what you are doing. I guarantee that the hospital was unaware or they would have had a fit if they knew. Observe? OK, sure. We've had the occasional premed do that but generally only in our huge ortho ORs where they could stay at least 10 feet away from the sterile field.

I agree with whoever said that the ADCOMs probably won't be impressed with your minimal surgical assistance, only the fact that you have seen a few surgeries. Better not to risk someone's outrage and just be thankful for the experience.

 

[Geebeejay]

I think you practice under the licence of a nurse or physician when you scrub in.

You would only be able to practice under the license of a nurse or physician if you practice within your scope of practice. People such as techs or phlebotomists or other ancillary staff with certifications but not licenses are negligent when they exceed their scope of practice, and the surgeons malpractice insurance will no longer cover them. They will likely simply lose their jobs, no questions asked and no chance to defend themselves, but they could also face legal recourse.

As nothing more than a curious premed, you don't have a scope of practice.

 

[PreMedOrDead]

No. Just no. Teaching hospitals may be more likely to let pre-meds into the OR (when I was on surgery, we had to figure out how to get the pre-med student scrubs so she could observe in the OR), but the liability for the hospital is so high that I highly doubt the vast majority of community hospitals even let pre-meds into the OR without lots and lots of waivers, let alone scrubbing in.

Agreed. But, when I was still doing my shadowing all that was required to shadow in the OR was a bit of HIPAA info.

 

[sweetjesus]

I'm a second-year undergrad student and I've done over 80 heart transplants on a pre-clinical porcine model. I was brought to a heart retrieval and the surgical staff asked me to scrub in to help him (this includes cutting, cautery, suction, and etc, basically a resident's job). I would have said no if there was a more qualified person in the room, but there wasn't and I was his best option to successfully retrieve the organ.

Legally speaking, since I worked at the hospital as a research staff, I'm covered by the hospital insurance. On top of that, the surgeon at the end of the day has the ultimate say in the OR because he/she/they have the ultimate liability for the case. If they feel like you are ready and skilled enough, they will ask you to scrub in and assist because they either a) need the help or b) would like to teach you because you're talented/have connections.

I would definitely say do it so you have a feeling of what it's like to be in an OR, but if it's not meaningful (like mentioned above), don't do write it on an application. Admission panels are usually composed of medical students, staff, and teaching staff, so they can easily see through your bs if you're useless; however, if it had a significant personal impact and case impact, then for sure: you should write about it on your application.

 

[stickgirl390]

I got to scrub in on a double bypass as a premed, but all I was allowed to do was stand next to the surgeon. #WorthIt

 

[Microbug]

I'm a second-year undergrad student and I've done over 80 heart transplants on a pre-clinical porcine model. I was brought to a heart retrieval and the surgical staff asked me to scrub in to help him (this includes cutting, cautery, suction, and etc, basically a resident's job). I would have said no if there was a more qualified person in the room, but there wasn't and I was his best option to successfully retrieve the organ.

Legally speaking, since I worked at the hospital as a research staff, I'm covered by the hospital insurance. On top of that, the surgeon at the end of the day has the ultimate say in the OR because he/she/they have the ultimate liability for the case. If they feel like you are ready and skilled enough, they will ask you to scrub in and assist because they either a) need the help or b) would like to teach you because you're talented/have connections.

I would definitely say do it so you have a feeling of what it's like to be in an OR, but if it's not meaningful (like mentioned above), don't do write it on an application. Admission panels are usually composed of medical students, staff, and teaching staff, so they can easily see through your bs if you're useless; however, if it had a significant personal impact and case impact, then for sure: you should write about it on your application.

This sounds super illegal. In most hospital in NYC, there is a strict no UG in OR policy. There are certain exceptions through some pathways/programs like Mt Sinai OR observership program, but even then you can only watch. Can I ask what hospital this is?

 

[FutureSurgical]

I've "scrubbed in" on a few surgeries just to be able to get close so the surgeon could show me what's going on. My hands had to be up at shoulder-height at all times and once I stepped away, they considered me "non-sterile" (whether that was technically true or not) so I could only stand back and watch on a TV screen.

 

[FroYoOreo]

In the hospital that I shadowed, they required one to sign a bunch of legal papers (with attending physician's signature and the medical director's signature), with terms prohibiting you from touching or contacting any patient. The process take 30 days. However the surgeon that I scrubbed basically just let me in without contacting the observership office. But another doctor requires me to complete the process before coming in to shadow her. Rule of thumb: don't touch a patient.

 

[Matthew9Thirtyfive]

Both hospitals I worked in did not permit anyone to scrub in unless they were an employee or had hospital privileges. People shadowing could stand in the back or next to the anesthesiologist if they let them (they almost always did).

 

[Detective SnowBucket]

The closest I got was setting a cast after they put pins in a guy's hand when I was shadowing an ortho team. Didn't even scrub in for that but one of the med students that was there was telling me about how she got to hold a guy's bicep for reinsertion when she shadowed and stuff. Also mind you that this was at a military teaching hospital so they were actually pretty chill about it all, more then the nurses somehow.

 

[OrthoTraumaMD]

You can do it as long as you fill out the proper paperwork and are 18 or older. I do it all the time with students but they have to go through all the admin crap which takes time.


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