Is clinical research considered clinical exposure?

[VandyMan11]

I know this has been asked a million times but whenever I go through the answers to this question I keep seeing mixed answers.

I am a clinical research coordinator at a local hospital (Not at a biotech company or research center). Since its not a big research powerhouse with hundreds of research staffs I actually have a good amount of responsibilities and I interact with patients on a regular basis. These are patients coming in with legitimate illness that needs treatment, not volunteer subjects. Once they are diagnosed they can choose to enroll in a study where they will receive the experimental treatment/procedure.
I screen charts, enroll patients in a study, explain what the study will entail, get consents and follow up with them after treatment. A lot of the interaction involves asking questions and getting to know how the illness/treatment is affecting/improving the patients lives. I do this before they are enrolled and every time afterwards they come in for follow up as part of standard post op care. Of course all of this happens in person with me facing the patient. I am also present during treatment and procedure to ensure that protocols are followed and required data are collected.
I have 100 hrs of shadowing and honestly wasn’t learning anything new past the 80 hr mark so I decided to forego scribing opportunities to get a job as a CRC. I have a poster presentation and a publication as contributing author from ~600 hours of bench research in undergrad, so I was hoping this job would count towards clinical exposure. I also have nonclinical volunteering so I would say I have displayed my share of altruism.

I keep seeing that clinical research counts as research and not clinical experience. If this is true, I really find it strange that hospital volunteering, (which at 90% of the time consists of pushing people around in a wheelchair) or scribing (I don’t see a big difference between scribing and shadowing) count as clinical exposure but not Clinical research. In my defense, being a CRC exposes you to much more in depth patient care experience, with more autonomy. If this really isn’t clinical exposure, I need clarification on what constitutes clinical exposure and what the medical schools expect the applicants to get out from them.

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[LizzyM]

You've used the word "patients" several times leading me to lean toward calling this a clinical experience when you are face-to-face with patients. Chart review -- less clinical as you aren't with the patient. (you could do a 100% chart review study and we'd call it research but would not call in clinical experience).

The problem is when "clinical research" is with people who are not patients meaning that it doesn't meet my definition of "clinical" and while it is "research" the autonomy that you, or even your local PI, have is non-existent as you strictly follow a protocol that is handed to you by a sponsor and have no opportunity to analyze samples, analyze data, view results or draw conclusions.

You like doing what your are doing and, let's hope, you are getting paid to do it. You have bench research, you have shadowing, you have non-clinical volunteering. You are now interacting with patients who are potential research subjects. Call it clinical employment and call it a day.

 

[M&L]

i would see what ELSE you have going on, and balance it out. For example, if you have a lot of clinical experience hours, call this one research. If you have a lot of research, but not enough clinical experience, call this clinical experience. Keep in mind though, that if you do that, make sure you adjust description accordingly.

 

[Goro]

OP, you're dealing with research subjects, not patients, in my book.

 

[VandyMan11]

OP, you're dealing with research subjects, not patients, in my book.

But what would be the reasoning behind that? These are sick people, coming into the hospital with vascular diseases, ulcers, infections, etc, in need of actual medical treatment. Since I deal mostly with surgical equipments, my patients choose to enroll in a study in which they will be subjected to a new surgical equipment vs old one or surgical intervention vs therapy. Nonetheless , these are needed medical treatments for existing diagnosis that will hopefully produce better outcome. I know there are a lot of clinical studies out there with artificial, healthy voluntary subjects but 100% of the subjects I deal with are here because they need treatment and their procedures get covered by the insurance as necessary medical encounters.
Maybe they are both subjects and patients but to say they are only subjects and not patients would be a stretch in my opinion. What exactly would be the definition of ‘patients’ in clinical context then?

 

[Goro]

But you're not doing anything for them other than enrolling them and making sure they show up. That's logistics, not true patient interaction.

It also skews your app to one that is research intensive, but away from one that is altuistic.

 

[VandyMan11]

But you're not doing anything for them other than enrolling them and making sure they show up. That's logistics, not true patient interaction.

It also skews your app to one that is research intensive, but away from one that is altuistic.

I’n not sure if you are missing the description of my job or misunderstanding the nature of my job. At least in my opinion its not something that can be dumbed down to ‘logistics’ as you keep adamantly suggesting. I discuss patients with the PI and whether they are apt to undergo the study treatment. I am the one who explains what the treatment entails and administer baseline tests. On top of making sure the patients show up, I talk and interact with them to collect data on how the illness and treatment are affecting their lives. I am also present during their visits and surgeries to make sure everything goes according to protocol.

I see that you are heavily focused on the altruistic aspect of the application and maybe that is because you are adcom at a DO school which heavily focuses on primary care and altruism, but I have nonclinical volunteering which reflects that side of the application.
But in terms of patient exposure and working in a clinical setting, I would say I cannot get more in depth viewpoint into patient care unless I transition into CNA or EMT.
What you are suggesting is I go off do ‘altruistic’ clinical volunteer which is mostly getting water for inpatients and wiping down chairs in the hospital lobby, especially given the limited nature of clinical volunteer nowadays due to resurgence in Covid.

 

[Goro]

I’n not sure if you are missing the description of my job or misunderstanding the nature of my job. At least in my opinion its not something that can be dumbed down to ‘logistics’ as you keep adamantly suggesting. I discuss patients with the PI and whether they are apt to undergo the study treatment. I am the one who explains what the treatment entails and administer baseline tests. On top of making sure the patients show up, I talk and interact with them to collect data on how the illness and treatment are affecting their lives. I am also present during their visits and surgeries to make sure everything goes according to protocol.

I see that you are heavily focused on the altruistic aspect of the application and maybe that is because you are adcom at a DO school which heavily focuses on primary care and altruism, but I have nonclinical volunteering which reflects that side of the application.
But in terms of patient exposure and working in a clinical setting, I would say I cannot get more in depth viewpoint into patient care unless I transition into CNA or EMT.
What you are suggesting is I go off do ‘altruistic’ clinical volunteer which is 90% getting water for inpatients and wiping down chairs in the hospital lobby, especially given the limited nature of clinical volunteer nowadays.

Hmmmm....touched a nerve, didn't I?

I still see, from your description, a lot more on the research than the clinical side.

Apply and see how the cycle shakes out. That's all you can do.

 

[VandyMan11]

Hmmmm....touched a nerve, didn't I?

I still see, from your description, a lot more on the research than the clinical side.

Apply and see how the cycle shakes out. That's all you can do.

No you have not ‘touched a nerve’. I am not angry but just confused. I am not sure where you are getting that impression. I am just genuinely confused about how scribing can get away as extensive clinical experience but not what I am doing. You get paid as a scribe too, and you are not even allowed to directly interact with a patient but it is still considered a standard clinical exposure while it is far away from the ‘altruism’ that you keep mentioning.
And yes, not all of my 40hr week is with spent with patients so I am going to carve out a portion of my work hrs to clinical exposure on my app.

Again, I am not trying to interrogate anyone or anything.
It’s just that given the description of my job, you didn’t give a satisfactory answer to why you wouldn’t consider it clinical experience as you have first stated. At least be kind enough to explain why scribing counts but my job doesn’t.

 

[bobow98]

I don't usually comment on this section - I clicked premed by accident while trying to get back to the MD forums.
First of all, no need for either of you to be trolling each other. Just agree to disagree and leave - this is advice and you can take it or leave it. When you hear something you don't like, just walk away. Also, I expect more of a faculty verified expert than something as basic as "too much research, not altruistic." Like seriously dude? Have you ever done any clinical research? This reeks of ignorance.


Second of all, clinical research coordination is a good clinical exposure. You're actually more clinical exposure from this job than research. Anyone who does real research in a clinical setting knows this.
I'd make sure you shore up the part of your app that actually suggests you have critical thought toward these research studies from a more big picture perspective. The clinical research coordinators I work with are in charge of helping with screening and identifying good candidates but don't have much chance to publish the actual findings because they are driven by fellows and faculty and/or sponsors. Make sure you ask your faculty for chances to do some retrospective chart work to show you can produce if you want to be productive.

Please behave, both of you, or a mod will lock this ASAP.

 

[VandyMan11]

I don't usually comment on this section - I clicked premed by accident while trying to get back to the MD forums.
First of all, no need for either of you to be trolling each other. Just agree to disagree and leave - this is advice and you can take it or leave it. When you hear something you don't like, just walk away. Also, I expect more of a faculty verified expert than something as basic as "too much research, not altruistic." Like seriously dude? Have you ever done any clinical research? This reeks of ignorance.


Second of all, clinical research coordination is a good clinical exposure. You're actually more clinical exposure from this job than research. Anyone who does real research in a clinical setting knows this.
I'd make sure you shore up the part of your app that actually suggests you have critical thought toward these research studies from a more big picture perspective. The clinical research coordinators I work with are in charge of helping with screening and identifying good candidates but don't have much chance to publish the actual findings because they are driven by fellows and faculty and/or sponsors. Make sure you ask your faculty for chances to do some retrospective chart work to show you can produce if you want to be productive.

Please behave, both of you, or a mod will lock this ASAP.

Thanks so much for the reply and clarification.

I was not trying to troll anyone, I was genuinely trying to find out why my experience would/wouldn't be considered clinical exposure and I was only getting more confused with the responses I was getting. It was a rather frustrated tone of voice if anything, although that is also completely on me.

 

[candbgirl]

Thanks so much for the reply and clarification.

I was not trying to troll anyone, I was genuinely trying to find out why my experience would/wouldn't be considered clinical exposure and I was only getting more confused with the responses I was getting. It was a rather frustrated tone of voice if anything, although that is also completely on me.

Not really. Your first post indicated to me that you wanted a specific answer and anything less wouldn’t be acceptable. And that’s what happened. Now go do what @Goro said and apply and see what happens. You obviously love what you are doing, feel very important doing it and have no desire to look at anything else. That’s okay . It’s your application so your choice. Good luck.

 

[VandyMan11]

Not really. Your first post indicated to me that you wanted a specific answer and anything less wouldn’t be acceptable. And that’s what happened. Now go do what @Goro said and apply and see what happens. You obviously love what you are doing, feel very important doing it and have no desire to look at anything else. That’s okay . It’s your application so your choice. Good luck.

Okay, so Im already getting conflicting information from ‘experts’ in this thread. I have a physician and LizzyM saying it is clinical, and I have @Goro saying its not. He has not offered any reasoning past “its logistics, not altruistic” which also applies to a lot of other passive, paid experiences that are considered standard clinical exposure. I honestly expected a more expert answer that explains why its not considered clinical given the description of my job. He has still not provided an explanation to why scribing is considered good clinical exposure but not shadowing+clinical research. I have seen advice thrown around here that even discharging patients at the lobby or being a telemedicine director is a robust exposure.

Its not that I’m looking for a specific answer. I need to know why what I am doing is not good enough so I can do correctly. And for that I’m going to need more than a sneering “go ahead and apply” response.

 

[Goro]

I don't usually comment on this section - I clicked premed by accident while trying to get back to the MD forums.
First of all, no need for either of you to be trolling each other. Just agree to disagree and leave - this is advice and you can take it or leave it. When you hear something you don't like, just walk away. Also, I expect more of a faculty verified expert than something as basic as "too much research, not altruistic." Like seriously dude? Have you ever done any clinical research? This reeks of ignorance.


Second of all, clinical research coordination is a good clinical exposure. You're actually more clinical exposure from this job than research. Anyone who does real research in a clinical setting knows this.
I'd make sure you shore up the part of your app that actually suggests you have critical thought toward these research studies from a more big picture perspective. The clinical research coordinators I work with are in charge of helping with screening and identifying good candidates but don't have much chance to publish the actual findings because they are driven by fellows and faculty and/or sponsors. Make sure you ask your faculty for chances to do some retrospective chart work to show you can produce if you want to be productive.

Please behave, both of you, or a mod will lock this ASAP.

In my defense, I have done clinical research and have two papers published with it. I also have a project that is also clinical.
I have taken your advice, put the OP on Ignore, and will not comment further in this thread.

 

[candbgirl]

I wasn’t going to respond but nothing in life gets 💯 in every situation.. You like @LizzyM s response. You don’t like @Goros. That just fine, but to continue he to try to get @Goro to change his response is at best wasting time. Yet, It’s what you have decided to do and how you are using your time. What are you going to do if you are at an interview and one of your interviewers thinks like @Goro and brings up this issue? Go off on him? Tell him he’s sneering at you? Say prove it to me that this isn’t clinical in a better way? I’m not accepting your answer because another ADCOM said it did? How do you think that will work out?
At some point you have to move on. As I said before, your application, your choice on what to include.

 

[VandyMan11]

I wasn’t going to respond but nothing in life gets 💯 in every situation.. You like @LizzyM s response. You don’t like @Goros. That just fine, but to continue he to try to get @Goro to change his response is at best wasting time. Yet, It’s what you have decided to do and how you are using your time. What are you going to do if you are at an interview and one of your interviewers thinks like @Goro and brings up this issue? Go off and him? Tell him he’s sneering at you? Say prove it to me that this isn’t clinical in a better way? I’m not accepting your answer because another ADCOM said it did? How do you think that will work out?
At some point you have to move on. As I said before, your application, your choice on what to include.

Again, I don’t want him to change his opinion. I need explanation to why my job would not count towards clinical work. He has provided no reasoning beyond “its logistics, not altruistic”, when I have already explained in my original post that I deal with ill, in-need patients on a regular basis, face to face.

If he is right, it means I will have to dedicate next coming months to another responsibility. But before doing so I need more than a blanket statement that “its not”

 

[LizzyM]

We don't always agree among ourselves. Goro calls nursing home volunteering as "clinical" while I see it as meeting people who are residents in a "home" and not "patients" when they are going about their day enjoying meals, entertainment, crafts and so forth.

You can learn through interactions with others about the lived experience of people whose lives are different than your own and who will someday be your patients and that can be a valuable experience whether it is called "clinical" or "non-clinical".

 

[candbgirl]

OP, you're dealing with research subjects, not patients, in my book.

But you're not doing anything for them other than enrolling them and making sure they show up. That's logistics, not true patient interaction.

It also skews your app to one that is research intensive, but away from one that is altuistic.

Hmmmm....touched a nerve, didn't I?

I still see, from your description, a lot more on the research than the clinical side.

Apply and see how the cycle shakes out. That's all you can do.

In my defense, I have done clinical research and have two papers published with it. I also have a project that is also clinical.
I have taken your advice, put the OP on Ignore, and will not comment further in this thread.

These are @Goro’s response. You keep saying “it’s logistics, not altruistic”. What he actually said is in the second quote. My interpretation of that is different than yours but, again, that’s how life is.

I’m not sure why you feel that you have to change your whole game plan for your application based on a specific response on a premed forum. Is it because you think @Goro might be right? Otherwise you could move ahead happy in the knowledge that @LizzyM said what you are doing is fine?

Again, it’s your application, it’s your choice on how to fill it out and what to include. You are the one who has to believe and be passionate about your activities.

 

[Bonne Nuit]

I am not an adcom, but I recently participated in a premed panel with other med students and adcoms from a few DO and MD programs. A premed participant had a very similar question to your initial post: she was just getting started as an assistant on a clinical project and she wanted to know if she was OK to file this under "clinical" on her AMCAS. She was concerned because her other clinical hours were low due to COVID restrictions.

The immediate question that everyone wanted to know is: "What are your actual responsibilities as an RA?" And her answer was kind of similar to how you described your duties: new participant paperwork, patient follow-up, data collection/analysis, showing the participants where to go and what to do, and answering participants' questions. The participants in her study were all cancer patients, I believe.

One adcom gave this a definitive "NO". The adcom said that the only time they consider clinical research as "clinical experience" is if the RA takes patient vitals themselves and/or assists in performing the procedures. They used the example of a sleep study where the RAs had lots of hands-on patient contact as "acceptable" clinical experience from a clinical research project.

The other adcoms wouldn't give a definitive answer and said that it will entirely depend on how the young woman chooses to write about this experience on her AMCAS. These adcoms said that it wouldn't be seen as clinical if she only listed her duties resume style. To call it clinical, they said, she needed to have a strong justification for doing so that was evident in her writing. They said that her essays should focus ("reflect") primarily on what she learned about the patients and the physician-patient interaction through her RA duties. If she could sell this through her writing, the adcoms said they would be willing to accept it as clinical experience.

I now want to address this side point that you've raised a few times now. You've indicated that you think it's unfair or unreasonable that scribing and hospital volunteering are considered robust clinical exposure when there are lots of passive duties. I agree that these activities can sometimes be passive and not everybody gets a lot out of them. But it's not like people with crappy, passive clinical hours are just skating into medical school; they end up writing about it stupidly and this kills their application. On the other hand, I've seen some incredible primary/secondary writing from students who made their bread-and-butter hospital volunteering a central focus of their application. Maybe you see a theme developing here: it's all about what you get out of your clinical experiences and how you sell it.

The bottom line is that this is apparently a mildly controversial issue among adcoms, which means you need to be very cautious. If you're committed to using your research experience to count for virtually all of your clinical hours next cycle instead of more "standard" clinical premed activities, you better be crystal clear in your writing that your duties were extremely patient focused and de-emphasize the random administrative tasks that you listed in your first post. Because honestly, if you described your research to me like you described it in your first post, I would struggle to see how you could call that clinical, too.

If you can write well about this, great. It could be just fine. But if you are unable to pull this off - that is, if adcoms can't tell from your application that this was high-quality patient contact as well as research - it's going to really hurt you, I think.

Good luck to you.

 

[WheezyBaby]

I think it depends on the extent of your interaction with them. If the interaction one gets via pushing beds can be considered clinical, I think this can as well. Patient enrollment can be an involved back and forth working through patient questions / concerns. If you're limited to a script though, I would lean toward not as there isn't really any sort of dynamic interaction

 

[dulapeep]

^ I think it all depends on what you do. I am a CRC as well and work with one of our largest studies - I work with patients most of the day every day taking + recording vitals, taking medical histories, recruiting, performing EKG's, etc, in addition to all of the regulatory/office/admin work that the job requires. I run all of my study's visits myself with the exception of performing blood draws + the occasional nursing visit that requires IV's and meds. I have a very different experience than my coworker - also a CRC - who works almost exclusively with survey-based research and manages our tissue repository. I was also at first pretty nervous that my experience could be discounted as not being clinical just based on the title alone, but it's all about how you frame your experience.

 

[GoSpursGo]

I'm honestly surprised to find this question is controversial. As someone who routinely cares for patients enrolled on clinical trials and based on the description you've given here, there is no doubt in my mind that your responsibilities are clinical.

Sure, as outlined above there are some CRC positions that should not be considered clinical (ie filing survey results). But if you're directly interacting with and enrolling patients in a therapeutic clinical trial, I really don't see how that's not clinical. Just make sure you very clearly describe your role in the description.