Patients vs residents for clinical experience

[comura]

I know some make a big distinction between the two when in comes to clinical experience Other sources allude to med schools not really caring.

I'm torn on who to listen to...I live in a secluded area, and opportunities are hard to come by. I found an opportunity to work for an assisted living facility. The job description explicitly states I'll be working with residents (not patients) by assisting unit nurses and CNAs with answering call lights, refilling water, bed making, transport, delivering meals, supervision, digital visits, etc. Can I mark the opportunity as clinical or no?

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[AJS59]

I know some make a big distinction between the two when in comes to clinical experience Other sources allude to med schools not really caring.

I'm torn on who to listen to...I live in a secluded area, and opportunities are hard to come by. I found an opportunity to work for an assisted living facility. The job description explicitly states I'll be working with residents (not patients) by assisting unit nurses and CNAs with answering call lights, refilling water, bed making, transport, delivering meals, supervision, digital visits, etc. Can I mark the opportunity as clinical or no?

I mean presumably if you're involved in any of the described activities you will see a patient, right? And get to talk with them?

 

[LizzyM]

I mean presumably if you're involved in any of the described activities you will see a patient, right? And get to talk with them?

There's the rub. The people are not "patients". They are living in their small apartments but need help with some activities of daily living. If you babysit for a kid with cancer who is living at home, is that clinical?

 

[jacksparrow1]

There's the rub. The people are not "patients". They are living in their small apartments but need help with some activities of daily living. If you babysit for a kid with cancer who is living at home, is that clinical?

I see your point here and I am sure you have a better idea than I would. But I think the difference would be the correlations. Kid with cancer needing to be babysat doesn’t need to be babysat because of his cancer but the residents that need help with activities of daily living in an assisted facility need help because of their disability. So honestly I’m not sure, I lean towards patient care clinical experience (I know as an EMT over the last 5.5 years many facilities have transitioned in recent years to calling patients “residents” bc it is more comforting since at the end of the day that is their home) so idk that’s tough

 

[LunaOri]

Personally, I look favorably on applicants who can stomach working at a nursing home. That being said, you still need some clinical exposure in a hospital or doctor’s office (can be paid or unpaid) so you learn more about what the life of a physician is like.

 

[Mr.Smile12]

How much of your position is similar to

 

[LizzyM]

Sure, I give brownie points to people who work or volunteer with populations of people with disabilities but long story short, it is not a clinical setting and unless you are providing clinical services in one's home that generally require some kind of certification or license (you are starting IVs, inserting catheters, etc), I'm not likely to call it "clinical care".

As for the use of the term resident vs patient, I think that some in the nursing home business have been using the term resident for more than 30 years.

 

[AJS59]

There's the rub. The people are not "patients". They are living in their small apartments but need help with some activities of daily living. If you babysit for a kid with cancer who is living at home, is that clinical?

I completely skipped over the "assisted living facility" part yeah I see now.

 

[comura]

Personally, I look favorably on applicants who can stomach working at a nursing home. That being said, you still need some clinical exposure in a hospital or doctor’s office (can be paid or unpaid) so you learn more about what the life of a physician is like.

Isn't this what shadowing is for? So if I worked this job, and did some shadowing, would that be sufficient?

 

[comura]

How much of your position is similar to

Correct me if I'm wrong, but it's not so much WHAT I'm doing, but WHERE I'm at? Can't tell if you're suggesting that duties now determine whether the experience is clinical or not. A lot of the duties quoted from the job description appear to be the stuff hospital volunteers get to do (depending on the hospital/state).

 

[comura]

Sure, I give brownie points to people who work or volunteer with populations of people with disabilities but long story short, it is not a clinical setting and unless you are providing clinical services in one's home that generally require some kind of certification or license (you are starting IVs, inserting catheters, etc), I'm not likely to call it "clinical care".

As for the use of the term resident vs patient, I think that some in the nursing home business have been using the term resident for more than 30 years.

This would mean volunteering my time with hospice patients (at home) is not clinical? (non-clinical setting, no med professional present)

You mention starting IVs and inserting catheters... is this list of procedures inclusive? Upon doing a bit of research, the facility appears to do more than just serve as a nursing home (given our isolated location)...I just don't know how invasive their procedures get. If a nurse at the facility performs these 'other' procedures, does the resident become a patient? Does the experience become an acceptable form of clinical experience? (for those observing the procedure)

 

[comura]

Also, what is the fate of applicants with just this type of experience as their main clinical experience? Assuming everything else looks good, can this break an application?

 

[Mr.Smile12]

For me, it depends on what you do and the context of your interaction. I use guidelines from PA programs.

Pre-Admissions Healthcare Experience | Physician Assistant Program | Case Western Reserve University

Previous direct patient care is required and is an indication to the admissions committee of an applicant’s awareness of and commitment to a career ...

case.edu

Also, what is the fate of applicants with just this type of experience as their main clinical experience? Assuming everything else looks good, can this break an application?

It's hard to generalize. The issue will be if you are able to show a strong knowledge of why you want to be a physician instead of a PA or nurse. We will train you in an academic medical center so how familiar are you with it or the community centers where your rotations will be located? Do you talk with residents and attendings?

If it is the only experience you have within 100 miles of you, maybe some faculty members will consider that context. Again, it's impossible to predict without knowing your mission and fit with the institution.

Strong letters can provide adcoms with more insights and detail.

To the original question, it is safer to mark as nonclinical. Based on the responsibilities, adcoms can opt to score it as clinical if it meets our rubric and expectations.

 

[comura]

For me, it depends on what you do and the context of your interaction. I use guidelines from PA programs.

Pre-Admissions Healthcare Experience | Physician Assistant Program | Case Western Reserve University

Previous direct patient care is required and is an indication to the admissions committee of an applicant’s awareness of and commitment to a career ...

case.edu

It's hard to generalize. The issue will be if you are able to show a strong knowledge of why you want to be a physician instead of a PA or nurse. We will train you in an academic medical center so how familiar are you with it or the community centers where your rotations will be located? Do you talk with residents and attendings?

If it is the only experience you have within 100 miles of you, maybe some faculty members will consider that context. Again, it's impossible to predict without knowing your mission and fit with the institution.

Strong letters can provide adcoms with more insights and detail.

To the original question, it is safer to mark as nonclinical. Based on the responsibilities, adcoms can opt to score it as clinical if it meets our rubric and expectations.

The need to cite PA program expectations, and the lack of answers to my other questions post to other contributors speaks volumes. The expectation of "direct, hands on, healthcare experience" (quoted from the CWRU site you posted) cuts a lot of volunteer work out.

Going back to basics, the professional competencies by the AAMC was brought to my attention within the past few months. https://students-residents.aamc.org/media/15396/download

No where do these competencies specifically REQUIRE "direct, hands on, healthcare experience." Shadowing provides clinical exposure, having a set of other jobs and volunteer work can check other competencies???

 

[Mr.Smile12]

The need to cite PA program expectations, and the lack of answers to my other questions post to other contributors speaks volumes. The expectation of "direct, hands on, healthcare experience" (quoted from the CWRU site you posted) cuts a lot of volunteer work out.

Going back to basics, the professional competencies by the AAMC was brought to my attention within the past few months. https://students-residents.aamc.org/media/15396/download

No where do these competencies specifically REQUIRE "direct, hands on, healthcare experience." Shadowing provides clinical exposure, having a set of other jobs and volunteer work can check other competencies???

Not disagreeing. I point it out because many medical school faculty teach PAs too, and/or they support their programs. I have my issues where PAs require so much more experience in health care and direct patient experience explicitly than medical school students. Yes, they are different professions but they are meant to work in a complimentary way. In a way the standard for such experience is higher than medical students. These are the opinions that committees address all the time, and I'm not sure a consensus opinion will resolve this theoretical discussion.

From my last response, if it is the only meaningful experience you have because of what was available to you -- your original question -- all i can say is that this information may be considered when considering the quality of your experience. I cannot predict committee decisions.

 

[LizzyM]

The need to cite PA program expectations, and the lack of answers to my other questions post to other contributors speaks volumes. The expectation of "direct, hands on, healthcare experience" (quoted from the CWRU site you posted) cuts a lot of volunteer work out.

Going back to basics, the professional competencies by the AAMC was brought to my attention within the past few months. https://students-residents.aamc.org/media/15396/download

No where do these competencies specifically REQUIRE "direct, hands on, healthcare experience." Shadowing provides clinical exposure, having a set of other jobs and volunteer work can check other competencies???

My definition of clinical experience which I came up with more than a decade ago, requires that one be in close proximity of patients but does not actually putting hands on them.

I would point out that PA programs came out of the desire to find a pathway for highly skilled medics from the military to use those skills in the civilian world. While perhaps that focus on experience should/could be rolled back for PA programs, it makes no sense to raise that expectation for pre-meds, particularly when the expectations in respect to academic achievement, research, and community service are so much higher for pre-meds than PAs.