Is scribing considered clinical experience by all schools?

[Gladiolus23]

I'm very confused on how to go about deciding on a clinical job. I am looking to increase my clinical experience and currently have opportunities to work as a medical assistant or a medical scribe. The medical assistant job is definitely more hands-on as I would be required to take vital signs, give injections to patient, etc. (apparently, the doctor will train me to do so, but I'm not really sure if this is legal since I'm not certified 😕 btw, is this legal?)

And well, the medical scribe is basically following the doctor around and documenting everything (no direct interaction or examination of patient).

I've heard many adcoms say that good clinical experience is direct patient experience. Does this mean scribing is not considered proper clinical experience? Is it looked at more like shadowing? I need to decide if I should scribe during my gap year or not, but I only want to do so if it will be counted as clinical hours.

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[baratheonfire]

It's clinical everywhere

 

[Goro]

It's definitely clinical, but I personally consider it glorified shadowing.

I'm very confused on how to go about deciding on a clinical job. I am looking to increase my clinical experience and currently have opportunities to work as a medical assistant or a medical scribe. The medical assistant job is definitely more hands-on as I would be required to take vital signs, give injections to patient, etc. (apparently, the doctor will train me to do so, but I'm not really sure if this is legal since I'm not certified 😕 btw, is this legal?)

And well, the medical scribe is basically following the doctor around and documenting everything (no direct interaction or examination of patient).

I've heard many adcoms say that good clinical experience is direct patient experience. Does this mean scribing is not considered proper clinical experience? Is it looked at more like shadowing? I need to decide if I should scribe during my gap year or not, but I only want to do so if it will be counted as clinical hours.

 

[puglover94]

It's definitely clinical, but I personally consider it glorified shadowing.

So do you regard medical assisting or CNA experience higher than scribing?

 

[doctorleospaceman]

It's definitely clinical, but I personally consider it glorified shadowing.

I'd say it depends a lot on the situation. While AMCAS forces you to put things in specific categories, the personal experience and what you learned or got from it matters way more than the basic classification. (Which is what matters in interviews). Some people get nothing from scribing except a faster WPM while for others it's a significant part of their decision to pursue medicine.

 

[LizzyM]

It is employment which shadowing is not. You either earn your wage or you are dismissed. It is clinical in that you are at the bedside of a patient while you are doing your job. You are interacting with physicians and, I presume, with other members of the health care team.

 

[Goro]

Yes, as long as the medical assistant is not merely sitting at the front desk and logging people in.

So do you regard medical assisting or CNA experience higher than scribing?

Agree 100%. People who scribe usually have tons of hours doing it, and that has to count for something.

I'd say it depends a lot on the situation. While AMCAS forces you to put things in specific categories, the personal experience and what you learned or got from it matters way more than the basic classification. (Which is what matters in interviews). Some people get nothing from scribing except a faster WPM while for others it's a significant part of their decision to pursue medicine.

Kudos to my learned colleague for being spot on, as usual. I hadn't thought about it this way and any employment experience is a good thing. While my mindset was that there was little direct patient contact, there are more things going on, as the wise LM points out.👍

It is employment which shadowing is not. You either earn your wage or you are dismissed. It is clinical in that you are at the bedside of a patient while you are doing your job. You are interacting with physicians and, I presume, with other members of the health care team.

 

[baratheonfire]

It's definitely clinical, but I personally consider it glorified shadowing.

Why do you consider scribing to be so trivial?
I put a lot of effort into this, and after I began working with my physician she was able to see 30+ patients a day, instead of 15-16. I do have a lot of volunteering experience in hospitals but only as a scribe did I feel like I was really making an impact.

 

[dentaldiva_4]

Scribing is definitely good clinical experience not only are you attached to the hip of the physicians, you are learning from there interactions with patients and about the medical decision making process and best of all you're getting paid which is hard to come by for a pre-health job that doesn't require spending some kind of money on extra school or certification. You can't get nearly as much experience and hours shadowing as you can scribing.


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[Goro]

My view is that you're shadowing the doctor, not interacting with nor doing anything for the patients.

Why do you consider scribing to be so trivial?
I put a lot of effort into this, and after I began working with my physician she was able to see 30+ patients a day, instead of 15-16. I do have a lot of volunteering experience in hospitals but only as a scribe did I feel like I was really making an impact.

 

[Allergic to Toradol]

My view is that you're shadowing the doctor, not interacting with nor doing anything for the patients.

Traditionally, I would say this is accurate considering the "role of the scribe" information that the scribing companies publicize. But in my experience (which may not necessarily be representative of all scribe companies or providers), I interacted with the patients quite frequently and was asked to go check up on the patients condition, is the pain wearing off, feeling any better/worse, etc. multiple times per shift. I even got to help with minor procedures sometimes when the overnight staff was thin, i.e. fracture reduction or I&D's.

 

[Goro]

This is 100% laudable, but unfortunately, all we see on apps is "Scribe, Victory Memorial Hospital, 2015-2016, 1000 hrs."

Traditionally, I would say this is accurate considering the "role of the scribe" information that the scribing companies publicize. But in my experience (which may not necessarily be representative of all scribe companies or providers), I interacted with the patients quite frequently and was asked to go check up on the patients condition, is the pain wearing off, feeling any better/worse, etc. multiple times per shift. I even got to help with minor procedures sometimes when the overnight staff was thin, i.e. fracture reduction or I&D's.

 

[SValley]

All of my interviewers so far have spent a significant amount of time asking about it/picking my brain on what I have learned. Two of my interviewers have been the dean/assistant dean of admissions. One an intensivist. Scribing is what you make it. The better you get, the more involved the physicians become in teaching you etiology, pathology, medical decision making, etc. When you're really good, they start pimping you like an intern and even though you'll get it wrong 99.97% of the time, you'll learn. You also get to learn the intricacies within hospital systems; observation vs. inpatient, RVUs, multi-disciplinary rounds, grand rounds, coding for the highest level of billing, hospital acquired conditions, attending M&Ms, and so much more.

TLDR; scribe. as a hospitalist/trauma scribe if possible. don't be mediocre at it.

 

[LizzyM]

I do think that scribes are able to go into greater detail in the AMCAS application than just the job title, location and dates and if they are selected for interview, the interviewer can probe for more details. They certainly meet the criteria of being close enough to smell patients and they are certainly witnesses to whatever nastiness happens whether olfactory or verbal.

 

[Matthew9Thirtyfive]

All of my interviewers so far have spent a significant amount of time asking about it/picking my brain on what I have learned. Two of my interviewers have been the dean/assistant dean of admissions. One an intensivist. Scribing is what you make it. The better you get, the more involved the physicians become in teaching you etiology, pathology, medical decision making, etc. When you're really good, they start pimping you like an intern and even though you'll get it wrong 99.97% of the time, you'll learn. You also get to learn the intricacies within hospital systems; observation vs. inpatient, RVUs, multi-disciplinary rounds, grand rounds, coding for the highest level of billing, hospital acquired conditions, attending M&Ms, and so much more.

TLDR; scribe. as a hospitalist/trauma scribe if possible. don't be mediocre at it.

This was my experience as an OR tech. Most of them just passed instruments, suctioned, and cut suture. They learned what they needed to know to do the bare minimum of the job.

But the ones who went above that (myself included) got so much more out of it. I got to go on rounds, write notes, go down to the ED to help put in chest tubes, make incisions, bovie, clamp, cut, throw stitches, staple bowel, deliver babies, and even do almost an entire angioplasty start to finish (peripheral). I got to do all that because I was super motivated and learned about my cases the night before and knew my anatomy.

Clinical experience is what you make of it. I'm hoping clinicals in med school are like that too.

 

[Hospitalized]

It's definitely clinical, but I personally consider it glorified shadowing.

Gross misunderstanding and generalization of the role. :/

See:

All of my interviewers so far have spent a significant amount of time asking about it/picking my brain on what I have learned. Two of my interviewers have been the dean/assistant dean of admissions. One an intensivist. Scribing is what you make it. The better you get, the more involved the physicians become in teaching you etiology, pathology, medical decision making, etc. When you're really good, they start pimping you like an intern and even though you'll get it wrong 99.97% of the time, you'll learn. You also get to learn the intricacies within hospital systems; observation vs. inpatient, RVUs, multi-disciplinary rounds, grand rounds, coding for the highest level of billing, hospital acquired conditions, attending M&Ms, and so much more.

TLDR; scribe. as a hospitalist/trauma scribe if possible. don't be mediocre at it.

 

[Mad Jack]

My view is that you're shadowing the doctor, not interacting with nor doing anything for the patients.

Most of the scribes I've seen basically do just this. There may be exceptions, but a lot were nursing students that just wanted to do the minimum to get a paycheck while in school without having to be a CNA.

 

[Pinocytosis]

It's definitely clinical, but I personally consider it glorified shadowing.

Spot on. I currently work as both a scribe and a technician/aide. It goes without saying that being an aide is wayyyyy "more" clinical. I'm pretty sure I'm going to have to have PTSD from call bells and chair alarms.

 

[Hospitalized]

Spot on. I currently work as both a scribe and a technician/aide. It goes without saying that being an aide is wayyyyy "more" clinical. I'm pretty sure I'm going to have to have PTSD from call bells and chair alarms.

More clinical? Yes. More learning how to be a physician? No. In my opinion, it's apples to oranges.

 

[Matthew9Thirtyfive]

More clinical? Yes. More learning how to be a physician? No. In my opinion, it's apples to oranges.

Being a scribe is not learning how to be a physician. It's learning what physicians do and how to make them more efficient. Learning to be a physician is called...

...wait for it...

Med school.

And residency, but that'd be too long of a punchline.

 

[Hospitalized]

Being a scribe is not learning how to be a physician. It's learning what physicians do and how to make them more efficient. Learning to be a physician is called...

...wait for it...

Med school.

And residency, but that'd be too long of a punchline.

You learn to write notes in medical school.

You learn to write notes as a medical scribe.

You write notes as a physician.

Let scribing be whatever you want it to be in your world. I'm not going to argue excessive details.

 

[baratheonfire]

My view is that you're shadowing the doctor, not interacting with nor doing anything for the patients.

Strange set of standards you have there. Not every clinical experience is meant to fulfill the same purpose. Scribing is just as important of a role in the healthcare team as being an MA.

 

[Matthew9Thirtyfive]

You learn to write notes in medical school.

You learn to write notes as a medical scribe.

You write notes as a physician.

Let scribing be whatever you want it to be in your world. I'm not going to argue excessive details.

You're not a med student. You're a scribe. It's good experience and you can be a huge asset. Let's not make it more than it is though.

You learn to write notes in med school. I learned to do them as an OR tech. You learn to suction, cut suture, close incisions, dress wounds, etc as a med student. I did all that as an OR tech.

But I was still just learning what a surgeon does and experiencing some of the details. I was not a med student.

 

[Goro]

Here are the four things Adcoms look for:

1) that you know what you're getting into
2) that you really want to be around sick and injured people, and their families, for the next 30-40 years
3) that you know what a doctor's day is like
4) that you show off your altruism, in the service of others.

Put your Lego into whatever box you want to. But stenography doesn't fit #1 or #2 for me, unless you really are interacting with the patients. And if you are, then let us know know on the app forms. there are plenty of places to mention this...it doesn't have to be in the list of volunteering vs employment vs clinical vs non-clinical.

Strange set of standards you have there. Not every clinical experience is meant to fulfill the same purpose. Scribing is just as important of a role in the healthcare team as being an MA.

 

[baratheonfire]

Here are the four things Adcoms look for:

1) that you know what you're getting into
2) that you really want to be around sick and injured people, and their families, for the next 30-40 years
3) that you know what a doctor's day is like
4) that you show off your altruism, in the service of others.

Put your Lego into whatever box you want to. But stenography doesn't fit #1 or #2 for me, unless you really are interacting with the patients. And if you are, then let us know know on the app forms. there are plenty of places to mention this...it doesn't have to be in the list of volunteering vs employment vs clinical vs non-clinical.

But you can check all of those requirements separately... You can be a scribe, and a hospital volunteer, and a habitat for humanity volunteer, and shadow doctors, etc.

 

[Goro]

You're still not getting what I'm trying to say, are you?

But you can check all of those requirements separately... You can be a scribe, and a hospital volunteer, and a habitat for humanity volunteer, and shadow doctors, etc.

 

[baratheonfire]

You're still not getting what I'm trying to say, are you?

I don't understand how you can apply that template of 4 items to every single activity someone takes part in. You can apply that to a candidate as a whole but how can every single activity be expected to fit that?
Being an MA doesn't fit #3 or #4 either.

 

[Goro]

*sigh*

We don't. Of the four things, which one(s) do you think scribing is closest to?

I suppose that being a hospital orderly/corpsman or combat medic might fulfill all four criteria, but no one thing does. Some obviously will fulfill more than one.

I don't understand how you can apply that template of 4 items to every single activity someone takes part in. You can apply that to a candidate as a whole but how can every single activity be expected to fit that?
Being an MA doesn't fit #3 or #4 either.

 

[baratheonfire]

*sigh*

We don't. Of the four things, which one(s) do you think scribing is closest to?

I suppose that being a hospital orderly/corpsman or combat medic might fulfill all four criteria, but no one thing does. Some obviously will fulfill more than one.

I see. Not sure what the argument initially was but it seems we're in agreement

 

[Goro]

👍

I see. Not sure what the argument initially was but it seems we're in agreement

 

[RogueUnicorn]

Here are the four things Adcoms look for:

1) that you know what you're getting into
2) that you really want to be around sick and injured people, and their families, for the next 30-40 years
3) that you know what a doctor's day is like
4) that you show off your altruism, in the service of others.

Put your Lego into whatever box you want to. But stenography doesn't fit #1 or #2 for me, unless you really are interacting with the patients. And if you are, then let us know know on the app forms. there are plenty of places to mention this...it doesn't have to be in the list of volunteering vs employment vs clinical vs non-clinical.

How can you possibly say someone who is literally working by following an attending around isn't checking box #1? And how does it fit #4? With all due respect you're an excellent resource to the premeds but it seems you're kind of making this one up on the fly.

 

[ojy77511]

As an inpatient hospitalist scribe, scribe experience has been valuable to me because i learned about different conditions, diagnosis, drugs, and treatments as i made rounds with physicians. Ive been interacting with nurses and physicians a lot, which has been great (but pretty tough interacting with CDI LOL) I saw hundreds of patients from disadvantaged backgrounds (homeless, psychotic, low income) and listened to every single one of them, recording information. I feel like i can check off 1~3 just by being a scribe. As for number 4, not too sure. I have done hospital volunteering, community service, and shadowing though. I highly recommend scribe.


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[nm06003]

Used to scribe. At one point I was looking at all the labs, X-rays, and biopsy reports for the doctor and would interpret and send tasks for nurses to call patient with results or have patient return. Not sure how legal this all was and whether I would mention any of this in an interview (definitely felt like I was stepping out of my scope). Truth be told, if I didn't look at all the stuff, the doctor wasn't going to either so someone was better than no one. After working with him so long I felt like I knew what the next step would be for the patient (worked in a specialty field). Cases were very redundant.


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[Hospitalized]

Here are the four things Adcoms look for:

1) that you know what you're getting into
2) that you really want to be around sick and injured people, and their families, for the next 30-40 years
3) that you know what a doctor's day is like
4) that you show off your altruism, in the service of others.

Put your Lego into whatever box you want to. But stenography doesn't fit #1 or #2 for me, unless you really are interacting with the patients. And if you are, then let us know know on the app forms. there are plenty of places to mention this...it doesn't have to be in the list of volunteering vs employment vs clinical vs non-clinical.

If scribing doesn't fit #1, #2, and #3, then no clinical experience does. Let me ask you this... what experience is "better" than scribing to fill #1 and #3? #2 I can see where being a tech or MA is slightly more applicable. But in my uninformed and lowly pre-med opinion, there are no better alternatives to #1 and #3.

 

[puglover94]

Worked as a MA and a scribe. Gained significantly more from being a scribe. It is definitely what you make it out to be. And I think working in the ED you'll probably gain alot more than just working in a clinic. And I know people from my team that worked as a CNA and a scribe. They all agree scribing has influenced their decision to pursue medicine way more. I'm not sure why working as a MA or CNA would be better... Just because of the more patient contact??? I learned so so so much more working directly with physicians and other health care providers. Granted our docs let us have patient contact (inform of results, check on Patients, help with minor procedures, etc). I highly recommend scribing over almost anything else (atleast CNA or MA)

 

[Goro]

I'm more impressed by people who actually interact with patients...you know, wheel them around, bring them ice water, talk to them.

If scribing doesn't fit #1, #2, and #3, then no clinical experience does. Let me ask you this... what experience is "better" than scribing to fill #1 and #3? #2 I can see where being a tech or MA is slightly more applicable. But in my uninformed and lowly pre-med opinion, there are no better alternatives to #1 and #3.

 

[puglover94]

I'm more impressed by people who actually interact with patients...you know, wheel them around, bring them ice water, talk to them.

So a basic er volunteer.

 

[Goro]

Wanna be more impressive? Volunteer in hospice, a nursing home, or with the developmentally disabled.

So a basic er volunteer.

 

[LizzyM]

I'm more impressed by people who actually interact with patients...you know, wheel them around, bring them ice water, talk to them.

I'm more impressed by employment in a clinical setting where one is close enough to smell patients. There is tremendous variety of opinion among adcom and therefore you need to realize that what looks like "random" is really just different assessments of the same data.

 

[Gladiolus23]

Yes, as long as the medical assistant is not merely sitting at the front desk and logging people in.

Is it okay if we volunteer as a medical assistant or do you prefer employment? It's easy to get a job as a scribe but MA positions seem to really like that certification :/

 

[Goro]

Either is fine. As the wise LizzyM points out, medical employment is super in her eyes. I like any sort of employment, given the poor job attitudes Millennials are bringing to residency these days.

Is it okay if we volunteer as a medical assistant or do you prefer employment? It's easy to get a job as a scribe but MA positions seem to really like that certification :/

 

[Gladiolus23]

@Goro @LizzyM I was wondering…is it legal for an uncertified student to administer medications or injections to the patient if trained by the clinic's doctor? The doctor who is considering me for a job at her practice says I will need to give hormone injections, run hormonal tests and replacement therapy etc. However she says she will train me to do all this even though I'm not certified as an MA or phleb. She also said I would take vital signs, which sounds reasonable but i'm not sure about the injections. I read an article where a patient died when an MA accidentally gave him an insulin overdose I didn't know pre-meds could do this, so I'm curious how such experience would be considered.

 

[Goro]

I'll punt this to my clinical colleagues. The rules may vary from state to state.

@Goro @LizzyM I was wondering…is it legal for an uncertified student to administer medications or injections to the patient if trained by the clinic's doctor? The doctor who is considering me for a job at her practice says I will need to give hormone injections, run hormonal tests and replacement therapy etc. However she says she will train me to do all this even though I'm not certified as an MA or phleb. She also said I would take vital signs, which sounds reasonable but i'm not sure about the injections. I read an article where a patient died when an MA accidentally gave him an insulin overdose I didn't know pre-meds could do this, so I'm curious how such experience would be considered.

 

[LizzyM]

@Goro @LizzyM I was wondering…is it legal for an uncertified student to administer medications or injections to the patient if trained by the clinic's doctor? The doctor who is considering me for a job at her practice says I will need to give hormone injections, run hormonal tests and replacement therapy etc. However she says she will train me to do all this even though I'm not certified as an MA or phleb. She also said I would take vital signs, which sounds reasonable but i'm not sure about the injections. I read an article where a patient died when an MA accidentally gave him an insulin overdose I didn't know pre-meds could do this, so I'm curious how such experience would be considered.

Check with the laws in your state. In some states, you may do so if under the direct supervision of a licensed provider.

 

[nm06003]

^^ this was true in my state


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[Dagrimsta1]

Here are the four things Adcoms look for:

1) that you know what you're getting into
2) that you really want to be around sick and injured people, and their families, for the next 30-40 years
3) that you know what a doctor's day is like
4) that you show off your altruism, in the service of others.

Put your Lego into whatever box you want to. But stenography doesn't fit #1 or #2 for me, unless you really are interacting with the patients. And if you are, then let us know know on the app forms. there are plenty of places to mention this...it doesn't have to be in the list of volunteering vs employment vs clinical vs non-clinical.

I don't understand the impulse of pre-med students to overthink this. I've volunteered in 2 hospitals in 2 different departments, shadowed 2 doctors, and worked in 2 medical offices (same ones where I shadowed). The current medical office where I am employed (#2) has been the one where I actually learned something. 150 hours of volunteering was a waste of time IMO. All I did was clean beds and act as a glorified delivery boy for no pay. My days consisted of walking from room to room. While it was excellent cardio, it was a complete waste of time. I learned little to nothing except how to properly put fresh linens on a bed. I would be lying if I said it was a total waste of time; I did learn a few interesting things like if you hear the words C-diff in a busy ER, RUN. Other than things like that, not too productive.

The medical office where I am currently employed has actually taught me wtf it's like to run an actual practice. While I'm not in the room during the exams, I talk to patients everyday whether it be after their exams or even on the phone. I have become a part of their lives. I am responsible for the improvement of their livelihood. While paperwork and sitting behind a computer may be repetitive, it has taught me more than any other experience. I advise pre meds to seek out opportunities like this. Find a place where you feel that your presence improves the lives of your patients. Don't volunteer simply to check off a box. It is boring, a waste of time and completely meaningless.

Point is, stop volunteering and doing medically related stuff to check off boxes. You don't need to become a PA/nurse/scribe/EMT/phlebotomist to get into medical school, you're gonna be paying a premium to learn all of this anyway.

 

[Jordan95]

I'm more impressed by people who actually interact with patients...you know, wheel them around, bring them ice water, talk to them.

Would scribing AND participating in volunteer medical work in rural areas in need of medical care be a good combination?

I really enjoyed volunteering at my local hospital but it just didn't feel "hands on" enough for me.

Thanks for any input,

 

[RogueUnicorn]

given the poor job attitudes Millennials are bringing to residency these days

what

 

[Goro]

Yes, outstanding combo.

Would scribing AND participating in volunteer medical work in rural areas in need of medical care be a good combination?

I really enjoyed volunteering at my local hospital but it just didn't feel "hands on" enough for me.

Thanks for any input,

 

[Matthew9Thirtyfive]

what

I've never been a resident, but I assume he is referring to young residents whose first job is residency and the entitlement many of them presumably feel. I know that many millenials joining the military now have an extremely unfounded sense of entitlement, as if the Navy owes them a certain amount of time off or that they shouldn't be required to work too much or too hard.

I'm sure that exists in residency to an extent.