How to document volunteer and shadowing experiences long since past?

[LeFauconPelerin]

Greetings, folks.

Non-trad-ish applicant here. Am five years out of undergrad, now coming back around to pursuing medical school, and am trying to figure out how to resurrect all the hoops I successfully jumped through back in the day. Also, I've very little sense for the threshold numbers adcoms are looking for, so I've no idea whether the amounts of time I have spent doing things are adequate.

During the summer after junior year in college, I completed a +300-hour joint internship at a private hospital and a public-health NGO, both based in Managua, Nicaragua. I spent 40+ hours a week for a month shadowing docs at the hospital, spending a week apiece in the ICU and ER and two weeks in the OR. Had fascinating experiences (for example, who knew that "amigdelectomía" is a false cognate? It's actually tonsil removal. How 'bout that?), including interpreting for some drug-addled ER patients and watching a doc take a hammer and chisel (literally) to some uncontrolled cell growth on a young woman's jawbone. Yipes. I then spent another month of 40- to 60-hour weeks working with the public health NGO, collecting demographic data from patients visiting rural clinics, writing up a report based on those data, interpreting for visiting medical and construction teams, and translating NGO letters to donors and funders.

I've still got contact with the doc who administered the hospital, as well as his wife, who ran the public-health NGO, but it's been six years now. I suppose I could ask for letters of rec., and they'd happily provide 'em, but I get to wondering about the statute of limitations.

The year after graduation, I spent ten months on a Fulbright doing public-health research in West Africa. My local partner was a doc with his own NGO, and I worked with him until some corrupt practices came to the floor and I rather rashly burned my bridges. (i.e., no LOR forthcoming from there.) I also spent two weeks shadowing in the ER and OR of a small urban hospital, which also had its share of fascinating incidents: removal of a football-sized uterine tumor, circumcision of a ten year-old, treatment of several brown widow-type spider bites, and myriad zemijahn crash victims. Unfortunately, that doc was a friend of Corrupt Doc #1 above, and while at some point I had a document certifying my time with them, it has probably gotten lost in the five moves I've made since then, and I no longer have any contact info.

Are these going to be useful/fruitful experiences? (I mean, I know there's gonna be some kind of knock about none of them having taken place stateside, but the fact is that I'm just not interested in *practicing* stateside...) Having never actually seen an AMCAS form or anything, I've no idea what sort of documentation or evidentiary requirements are in place.

Thoughts?

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[LizzyM]

The AMCAS application has an "experience" section. You can list up to 15 experiences in this section. Each experience has a number of cells to complete including Experience name, Experience type (research, employment, clinical volunteer, non-clinical volunteer, artistic endeavors, etc), start and end dates (month & year), average hours per week during that period, contact name and title, organization name, country, experience description. Letters of recommendation are welcome but not required. (Although not having a letter from a principal investigator with whom you spent a substantial amount of time in the recent past would raise a red flag.)

 

[Stratego]

You will fill in the experiences section as best you are able, providing what contact information you can. Don't worry about a lack of documentation. I certainly hope you have recent experiences in addition to those cited. Adcomms will want to see that. Stateside clinical experience and physician shadowing are generally necessary if you plan to attend a US med school. Abroad experiences should not stand alone. And don't forget community service. Sorry if that means more hoops for you to jump through. If you plan to apply next summer, it would be good to get things started if you haven't remained engaged in medicine in some way. If you are very lucky, because you do have the other experiences, adcomms may overlook the lack of the typical year and a half of recent activity. If you're not lucky, you'll be fine by the time you reapply in 2011.

LizzyM, the adcomm member posting above, has said in the past that she likes to see a year minimum of clinical experience.

 

[LeFauconPelerin]

Thanks for your comments, LizzyM and Stratego. I've got a couple follow-up questions.

What constitutes (or what is the point of) 'community service'? Is it necessarily pro-bono stuff? Is the point just to demonstrate you have a compassionate heart?

The reason I ask is because I'm currently working in the field of refugee resettlement, and during the year after I got back from West Africa I worked for AmeriCorps teaching reading to inner-city students. Both of these experiences involve work on behalf of marginalized, very low-income communities who don't always have the resources to serve as their own advocates. In my mind, if the point of the community service requirement is to demonstrate that you're an empathic soul, I would imagine these work experiences would demonstrate that. If the point is to demonstrate that you're willing to work for free (for example), then I'd probably need to do some other stuff.

In re: the clinical experience: you say a year and a half of 'recent' clinical experience is the rule of thumb? How recent is recent, and is there a general threshold that is considered adequate? (I know part B of that previous question is squishy, and the answer is probably "It depends.") Finally, would serving as a medical interpreter tend to satisfy the 'clinical experience' and/or 'physician shadowing' requirements?

I appreciate your guys' feedback.

 

[flip26]

Thanks for your comments, LizzyM and Stratego. I've got a couple follow-up questions.

What constitutes (or what is the point of) 'community service'? Is it necessarily pro-bono stuff? Is the point just to demonstrate you have a compassionate heart?

The reason I ask is because I'm currently working in the field of refugee resettlement, and during the year after I got back from West Africa I worked for AmeriCorps teaching reading to inner-city students. Both of these experiences involve work on behalf of marginalized, very low-income communities who don't always have the resources to serve as their own advocates. In my mind, if the point of the community service requirement is to demonstrate that you're an empathic soul, I would imagine these work experiences would demonstrate that. If the point is to demonstrate that you're willing to work for free (for example), then I'd probably need to do some other stuff.

In re: the clinical experience: you say a year and a half of 'recent' clinical experience is the rule of thumb? How recent is recent, and is there a general threshold that is considered adequate? (I know part B of that previous question is squishy, and the answer is probably "It depends.") Finally, would serving as a medical interpreter tend to satisfy the 'clinical experience' and/or 'physician shadowing' requirements?

I appreciate your guys' feedback.

Med schools want to see that you have clinical experiences in the US. All the foreign stuff is very cool, but you need to demonstrate an understanding of what you are getting yourself into in the US.

Is your medical interpreter work being done in the US? If so, that is great.

Your background is interesting and will probably serve you well, but you really should do some physician shadowing - say 4 to 5 different docs, 10+ hours each, or something like that...

The volunteer thing is pretty unavoidable. Yes, it is partly about the altruism. Doing for others for no remuneration in return...sounds like you have done some volunteer stuff, but what you really need is US clinical experiences, including shadowing of physicians, to have all your bases covered.

 

[tulli]

So not really answering your question here, but I just have to say, you have some really amazing experiences listed there. Kudos to you for really trying to make a difference 🙂

 

[Stratego]

1) What constitutes (or what is the point of) 'community service'? Is it necessarily pro-bono stuff? Is the point just to demonstrate you have a compassionate heart?

The reason I ask is because I'm currently working in the field of refugee resettlement, and during the year after I got back from West Africa I worked for AmeriCorps teaching reading to inner-city students. Both of these experiences involve work on behalf of marginalized, very low-income communities who don't always have the resources to serve as their own advocates. In my mind, if the point of the community service requirement is to demonstrate that you're an empathic soul, I would imagine these work experiences would demonstrate that.

2) In re: the clinical experience: you say a year and a half of 'recent' clinical experience is the rule of thumb? How recent is recent, and is there a general threshold that is considered adequate? (I know part B of that previous question is squishy, and the answer is probably "It depends.")

3) Finally, would serving as a medical interpreter tend to satisfy the 'clinical experience' and/or 'physician shadowing' requirements?

1) I'm sure each adcomm would explain differently. The explanation I like the best is that community service shows you can act outside of your own self interest, something necessay to function as expected in medicine (like not getting sleep at night when you are on call and sick patients need care).

Americorps activities are greatly valued by adcomms as a generalization, and this is a great EC to have. The refugee assistance will be equally valued and is unique as well. These together may well be enough to help overshadow other lackings.

2) I have read on SDN from adcomm posters that your application should reflect an ongoing interest in exploring the field of medicine, even if it's only two hours a week. My impression is that a year of clinical experience is the minimum, but I'm sure that isn't true everywhere (a squishy response). The thing is to make your application appeal to the broadest number of schools and get as close to 'average' as you can. I've had friends with great numbers apply fruitlessly with only 6 months of clinical experience who did get an acceptance the following year with 18 months worth.

3) Yes, medical translating is both clinical experience and shadowing. I know someone whose primary experience in both areas was doing this, who got accepted. The physicians were American, though the experience was abroad. She also had US based shadowing and clinical experience, but to a lesser extent.

 

[LeFauconPelerin]

@Stratego:

Thank you for your explanation regarding the 'ongoing commitment' to the field of medicine. That's useful information to file away...or, you know, implement immediately. My old MCAT score is so old at this point I need to retake anyway, and I've been doing nothing academic but linguistics and political science for three years. Since me 'n' Ye Olde Sciences are gonna be spending some quality time together for the next several months before I tackle the testing beast again, I may as well get started with the shadowing/volunteering now.

@tulli:

A couple recommendations for you. A) Wanderlust. B) A passion for languages. C) A passion for a woman who is as stubborn as you, and whom you love to much to run roughshod over with your life plans.

C especially tends to lead to lots of interesting compromises from a career/work perspective, and led directly to both my AmeriCorps time and my current Refugee career.

@flip:

Is the thinking with the 4-5 different docs that you'll be exposed to a broader variety of possible specializations? Is there any importance attached to seeing different settings (hospital vs. private practice vs. community clinic)?

The interpreting thing hasn't happened yet, but I'm getting TONS of Iraqi refugees, and a few Congolese refugees...and in both cases, a lack of access to medical care because of linguistic barriers is a huge problem. I'm not allowed to go interpret for them as part of my job -- I've got "better" things to do, according to my bosses -- but it'd be something I would definitely enjoy doing in my 'free' time. (The kid is 2 years old day after tomorrow, so the idea of 'free' time is approaching laughable. Anyone who has experience going through medical school with 1-3 rugrats is strongly encouraged to PM me to discuss and enlighten.)

 

[flip26]

@flip:

Is the thinking with the 4-5 different docs that you'll be exposed to a broader variety of possible specializations? Is there any importance attached to seeing different settings (hospital vs. private practice vs. community clinic)?

I think the variety of docs and settings is a positive for an applicant - some premeds load up on the "glamor" shadowings (surgery, etc) but have little exposure to primary care. And most premeds only do stuff in hospitals, missing out on free clinics, etc.

My point, really, is that you don't have to accumulate a ton of hours in shadowing - I didn't; I think I had around 50 hours total, spread amongst 4 or 5 different kinds of docs. But I did have a substantial clinical volunteering record - approx 500 hours over 2 years. And I did volunteering at a hospital and a free clinic, again getting a variety of experiences.

If I am reading your posts correctly, your biggest "hole" is lack of exposure in US clinical settings. This stuff is critical...no way around it...but you have other stuff in your background that rounds out your profile very nicely, so you don't have to overdo the typical premed stuff, but you do need to have something to show med schools that you have investigated medical practices in the US.

 

[LizzyM]

In terms of the 1 year clinical mentioned above, by that I generally mean a few hours per week for at least an academic year in a traditional applicant. That said, it is possible to get an interview and get admitted without that much clinical experience.

For a non-trad, US citizen who does not wish to practice medicine "State-side", I think that admissions officers would be very forgiving of a lack of clinical exposure in the US. Extensive living experience abroad is far more valuable in that situation than clinical experineces in US hospitals.

 

[Mopp22]

Posted in the wrong forum. There is a separate forum for non-traditionals. You could find some useful advice there.

 

[LeFauconPelerin]

If I am reading your posts correctly, your biggest "hole" is lack of exposure in US clinical settings. This stuff is critical...no way around it...but you have other stuff in your background that rounds out your profile very nicely, so you don't have to overdo the typical premed stuff, but you do need to have something to show med schools that you have investigated medical practices in the US.

Thank you for that insight, flip. If I'm able to do some interpreting it'll likely be in the 'less glamorous' settings...but I'll wager in this particular context (working with new arrivals) those would be the most rewarding settings anyway. Hooray for a substantive reason to renew my lapsed Arabic study sessions!

For a non-trad, US citizen who does not wish to practice medicine "State-side", I think that admissions officers would be very forgiving of a lack of clinical exposure in the US. Extensive living experience abroad is far more valuable in that situation than clinical experineces in US hospitals.

LizzyM, I appreciate your saying that. I have occasionally gotten the sense from reading postings on SDN that adcomm's members' minds are these impenetrable, unfathomable things, and just because I see things a certain way doesn't at all mean they'd see it similarly...so your words are reassuring. I also appreciate your setting a fairly concrete threshold to aim for in terms of shadowing/clinical hours. Many thanks.

 

[flip26]

LizzyM, I appreciate your saying that. I have occasionally gotten the sense from reading postings on SDN that adcomm's members' minds are these impenetrable, unfathomable things, and just because I see things a certain way doesn't at all mean they'd see it similarly...so your words are reassuring. I also appreciate your setting a fairly concrete threshold to aim for in terms of shadowing/clinical hours. Many thanks.

I would be careful with interpreting LizzyM's advice on this, in the following sense: I think it is high risk to apply without sufficient exposure to US clinical stuff with an app that says something along the lines of "my interests lie in practicing medicine outside the US, hence I didn't spend any time investigating US med"...see my point? I would not fashion an app that has a "tunnel vision" aspect like that - the chief goal of med schools is to train physicians for practice in the US. Sure, some end up elsewhere, but I would be careful about expressing that as my primary goal of attending med school.

Focus on med schools with global/international health programs.

 

[LeFauconPelerin]

@flip:

I understand completely, and concur. I think what I meant to convey in response to LizzyM's feedback was less a "Whew, I'm off the hook!" and more of a "Thank goodness they'll at least attribute *some* value to the experiences I, myself, felt were valuable." Certainly your advice, which has struck me as level-headed and trustworthy, would indicate a need to spend some QT with physicians stateside learning how they do their thing...and I'm not in the least bit opposed to that. In fact, I intend to hop right on it. (Turns out one of my tennis partners is an opthalmologist, and another is an internist. Fertile options, those...)

Thanks again for trying to ensure I didn't read myself into a corner following LizzyM's advice.