suggestions for good clinical experiences?

[dz88]

I'm stumped for clinical experiences: should I volunteer in the ER or become an EMT/Paramedic. I'm worried b/c isn't EMT a dangerous job?

any other good clinical ECs?

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[madonna]

I'm stumped for clinical experiences: should I volunteer in the ER or become an EMT/Paramedic. I'm worried b/c isn't EMT a dangerous job?

any other good clinical ECs?

clinics, hospitals have other opps that ER and why would you say EMT is dangerous?

 

[DropkickMurphy]

The biggest risk in EMS is finding out that it's nothing like what you probably expect. Check out www.traumacentral.com/forums to talk to some veteran EMT's and medics to find out what it is really like. Basically, as a former EMS clinical instructor, I recommend AGAINST people becoming EMT's for reasons than true dedication to prehospital care.

If you want a good "clinical" job, I would suggest phlebotomy. The pay is better than EMS, and the schooling (in places where it is required) is far shorter than EMS. Not to mention if you become proficient with a needle, your patients once you get into medical school will appreciate it!

 

[dz88]

wow, thanks for the phlebotomy suggestion, i looked into it, and it looks cool!

Any other suggestions?

 

[DropkickMurphy]

Not really, because most other programs require extensive school (paramedic takes 1-2 years in most places now; respiratory therapy is 2-4 years, etc)

 

[ASDIC]

The biggest risk in EMS is finding out that it's nothing like what you probably expect. Check out www.traumacentral.com/forums to talk to some veteran EMT's and medics to find out what it is really like. Basically, as a former EMS clinical instructor, I recommend AGAINST people becoming EMT's for reasons than true dedication to prehospital care.

If you want a good "clinical" job, I would suggest phlebotomy. The pay is better than EMS, and the schooling (in places where it is required) is far shorter than EMS. Not to mention if you become proficient with a needle, your patients once you get into medical school will appreciate it!

I strongly disagree that pre-hospital cannot be used to gain valuable clinical experience. The experience that the premed wud want is to understand medicine as a provider and being an EMT is the best possible choice. Furthermore, as an EMT you being to understand the patient and be confident in skills, something that medical schools teach students.

 

[Rendar5]

I strongly disagree that pre-hospital cannot be used to gain valuable clinical experience. The experience that the premed wud want is to understand medicine as a provider and being an EMT is the best possible choice. Furthermore, as an EMT you being to understand the patient and be confident in skills, something that medical schools teach students.

I don't think that was ever implied in the post you were responding to.

 

[brodaiga]

EMT, ER volunteer

 

[DropkickMurphy]

Most EMT students do not really learn anything beyond glorified first aid in a real sense (even defib is now a first aid skill) and in most cities, where most of us live, you are not going to see any situation where you are challenged by your patient. Most BLS providers wind up doing non-emergent transfers and never see a critical or even serious patient unless there is something really major going on- i.e. plane crash, terrorist attack, etc. You are correct that it is good training to have, but it is of a totally different nature than what you will be learning in medical school, so confidence in the skills you have is a moot point, and I don't know many basic EMT's who "understand the patient", simply because of the extremely lacking manner of education of EMT's. Take a look at a EMT textbook, in the physiology section and compare that to a A&P textbook and tell me that a EMT-B course is going to be any improvement for someone who has studied anatomy and physiology, because it is simply not.

And one more point, it is not the education that makes you confident, it is the experience- which is great in showing one how little they really know and driving them to learn more- and as I said before, real experience as a BLS level provider is hard to come by because of the types of assignments they tend to be handed at work.

 

[bruinfan32]

I will say that while city/urban EMS tends to disfavor a good learning experience for the basic level provider (EMT-B), a rural volunteer experience can be the exact opposite. I run with a rural EMS agency, where the duty crew (which can number anywhere from myself plus a driver to numerous advanced life support providers) is responsible for covering the entire county. What this often means is that if numerous calls are coming in at once, simply due to staffing, I as a basic provider may be managing a serious trauma or medical emergency by myself (at least until I can intercept a medic) providing amazing experience. Also, with a rural agency, you are more likely to be working with an advanced provider as an "ALS assist", which would allow you to help put patients on the moniter, set up IV's, and generally observe and assist on the "bad calls" where the real learning and experience occurs.

 

[DropkickMurphy]

I agree Bruinfan, well said, but I still do not believe EMS is really the best way to gain medical experience for a premed.

 

[45408]

I agree Bruinfan, well said, but I still do not believe EMS is really the best way to gain medical experience for a premed.

the job situation can also play into this - some places are easy to get jobs, and others are never hiring. See if you can get a job in your field before you waste your time in the training. Some places will hire you as an ER tech if you're an EMT/CNA, which is going to be more interesting than phlebotomy. Praetorian makes some good points, but I'm an EMT, and I love my job, clinical experience or no clinical experience. Basically, your mileage will vary.

 

[themitz]

where most of us live, you are not going to see any situation where you are challenged by your patient. Most BLS providers wind up doing non-emergent transfers and never see a critical or even serious patient unless there is something really major going on- i.e. plane crash, terrorist attack, etc.

It definitely depends where you live.

For example - Suffolk County of Long Island is almost strictly volunteer for 911, so even as a EMT-B you'll be going to the cardiac arrests, massive traumas, and many other serious calls that will give you a wealth of experience.

As for city/urban EMT's...it also depends who your partner is. I found that while working in a city with another Basic (2 basics on one rig), 90% of the time you get general transportant non emergent patients. However, if you make sure your partner is a Medic, you'll see quite a few critical patients on a daily basis.

Basically...the one bit of real advice I can give is that if you're going to spend the time to become an EMT...make sure you actually <b>use</b> it. An EMT certification with no experience means absolutely nothing.

I agree Bruinfan, well said, but I still do not believe EMS is really the best way to gain medical experience for a premed.

In regards to that... it depends how you use your certification and what experience you get. As an EMT (and a premed obviously), I've performed CPR more times than I can count, dealt with some amazing medical problems, and have really learned a good bed side manner (aka: how to treat a patient and keep them calm, while still getting your job done well).

 

[McPoyle]

I must disagree with EMS not being a good place to start getting clinical experience. This is especially true at the Paramedic level. Being in EMS allows us to begin getting comfortable speaking with pt.s, teaches us how to formulate an assessment, develop a basic tx. plan. Depending what we plan to specialize in, our experience can be very valuable.
As far as EMS being dangerous, this varies greatly on where you are working. The job carries an inherent level of danger with being out on MVCs on the freeway, dealing with violent pt.s, lifting heavy pt.s, operating the vehicle etc. all present an oportunity for injury.
I love what I do, I've been a paramedic for about two years and couldn't imagine doing anything else right now, however I can't do it forever, and as was previously stated wouldn't get into the job just to gain experience for med school. Paramedic school averages about two years which is long time if you really don't have an interest in the field.
EMT class is only one semester and many four year schools offer this as a course. EMT's are used not only prehospital but also in the ED. This is probably a great choice if your school offers the class, especially if you have an interest in emergency medicine.

Eric

 

[DropkickMurphy]

I've been in the field for 8 years, five as a supervisor (both paid and volunteer) and an instructor, and I agree that ALS level practice is a good experience, but to say that EMT-B is a good choice simply to pad your app is not a good idea. That we really do need to keep in mind that honestly medical schools could care less about our little stint as an EMT during college- part of this being the ease with which one can become an EMT.

But as I said, if you have an honest interest in EMS, go for it. We need good EMT's and medics, but we also need people who will eventually become the next generation of medical directors and advocates for improved prehospital care. But please, please, please only do it if your heart is in it. That is all I am asking.

 

[McPoyle]

I've been in the field for 8 years, five as a supervisor (both paid and volunteer) and an instructor, and I agree that ALS level practice is a good experience, but to say that EMT-B is a good choice simply to pad your app is not a good idea. That we really do need to keep in mind that honestly medical schools could care less about our little stint as an EMT during college- part of this being the ease with which one can become an EMT.

But as I said, if you have an honest interest in EMS, go for it. We need good EMT's and medics, but we also need people who will eventually become the next generation of medical directors and advocates for improved prehospital care. But please, please, please only do it if your heart is in it. That is all I am asking.

for sure, I doubt that many med schools even consider it, I just thought the hands on stuff at any level would be beneficial once you are there. I totally agree, please only do it if you truly want to, not just for experience.

 

[MollyMalone]

I've got to weigh in and discuss the oft-maligned CNA. Sure, if you get a CNA just to work in a nursing home, you're not going to see much. But, at least where I live (Wisconsin, other areas of the country may vary, I have no idea), if you become a CNA you've got a decent shot at working in a hospital, where you can see much cooler things. As a pre-med, you also have a very decent shot at becoming a critical care tech (especially if you can give a summer up to the experience), and this position enables you to see/assist in a mad variety of things. In my hospital, critical care techs can expect to see the following:

codes
thoracentesis
chest tube insertion/removal
craniotomy for ICP monitoring
as many line placements as you want to watch
echocardiograms (transthoracic and transesophageal)
cardioversions
EGD/colonoscopy
various guided biopsies
lots of other stuff

Plus learn about critical care including:
ventilators
ABGs
hemodialysis (regular/continuous)
balloon pumps
Swan-Ganz caths
any line/tube/drain you care to name
post-op care for a vast variety of surgeries
end-of-life issues
and much, much more

Also, if you are having trouble finding a doc to shadow, you won't have any difficulty once you're working in the hospital... you will pretty much be able to see anything you have an interest in.

This route obviously isn't for everyone, but if you have a desire to work hard, earn OK cash, get your hands dirty, and really feel what it's like to be a part of a hospital team, I recommend it. Especially if you think you might want to be a hospitalist or a critical care physician.

 

[45408]

That we really do need to keep in mind that honestly medical schools could care less about our little stint as an EMT during college- part of this being the ease with which one can become an EMT.

I'm pretty sure med schools are fully aware that they're only looking at less than three years of most applicants' lives. There can only be so much in their applications. By the time I submitted the AMCAS, I had almost nothing in my app over a year and a half long.

In all, med schools just want to see if you actually know what you're getting into. You don't need to do lots of cool stuff before med school - you're going to be an MD for gosh sake!

Anyways, last night, I worked for 11 hours and went on one call. Got paid to sleep and study the rest of the time. Beat that.

 

[odrade1]

I got a volunteer job at the hospital, transporting patients. Sometimes it is interesting. Other times it is less so. If you pay attention to what you, your patients, and the nurses/doctors are doing, and give it some thought, you can learn a lot just being an escort. I was able to use this job successfully when discussing my medical experiences with the interviewers. You won't be a doctor until after med school, so don't fixate on trying to get glamorous medical jobs. Even a non-glamorous job looks good if you learned the right things from it.

The coolest thing I got to do was follow med students around on rounds with their attending one day. Talk about an eyefull! Definitely the best medical experience I got to partake in. Try asking friends who are residents or MS3/MS4s to speak to their attending. I got a no from the ER but a yes from the internal med department (about shadowing the attendings on rounds). Definitely *not* something many of my friends got to do....

 

[bostonguy]

EMT is the best hands down, only ifr you work in rural area for a cool company. I have helped deliver a baby, worked with med flights, done cpr two times by myself (as the highest emt there, no medics), and done a code on a 21 year old. Plus, its fun to be in the ER in flirt with nurses in between trying to read their handwriting, haha.

If you want to know anything else about it, send me a PM.

 

[Camillekc]

So I strongly suggest NOT doing this for the pre-med experience, but if you are actually interested, I work/volunteer as a rape crisis/domestic violence advocate in the emergency room, and it's a great experience. You'll definitely see the dirty side of medicine, learn a great bedside manner, and it's really rewarding if you're good at it. If you have a strong interest in learning about this side of medicine, check out if your hospital has a SAFE or other such program.

Hope this helps.

Edit: the training is extensive, but not nearly as long as EMT

 

[dz88]

wow, thank you guys for so many ideas, I have already volunteered as a patient escort, and it seems tedious, so I'm looking for something else. I guess the consensus is that the EMT option takes too long and requires tremendous dedication.

 

[Med01]

I have another suggestion: volunteer in a Free clinic for the uninsured. This was recommended to me by an advisor. It was really fun, I learned a lot from the nurses, and got to do stuff (like take histories, give flu shots, take blood glucose tests), and you feel like you're doing something useful for people who can't afford care. The nurses and staff who volunteered were really very generous people and great to learn from.

 

[tacrum43]

I've been in the field for 8 years, five as a supervisor (both paid and volunteer) and an instructor, and I agree that ALS level practice is a good experience, but to say that EMT-B is a good choice simply to pad your app is not a good idea. That we really do need to keep in mind that honestly medical schools could care less about our little stint as an EMT during college- part of this being the ease with which one can become an EMT.

I disagree. I got my EMT certification as part of my high school senior project, and since then it has been important in several of my EC's, although I didn't work as an actual EMT. While I was shadowing the ER, they let me do more stuff since I had the EMT cert. (and the healthcare provider level CPR that goes with it) and it was also a requirement for the summer camp job that I had. I think it is a good starting point to gain medical experience.

As to whether medical schools care about EMT experience: I think they do, so long as you have a meaningful experience. True I haven't gotten in anywhere yet, but at one of my interviews they seemed very interested in my experiences (which I couldn't have had without my EMT cert.) and commented about the EMT cert. in a positive way.

I do agree though that if you're doing it only for padding, then it's not a good idea. They will see right through it. My point is just that an EMT cert. can help you to gain valuable clinical experience, and not just in working as an EMT with an ambulance company or fire department.

 

[DropkickMurphy]

I guess part of the problem I have with it is that I have seen entire classes where there was not a single person who actually was interested in being an EMT just because they wanted to be a prehospital provider. Everyone was using it as a stepping stone to either nursing (a profession that REALLY doesn't care about EMS experience) or medical school. It kind of saddens me that's all.....

And by the way, the reason I said med schools generally take a non-chalant approach to EMS certs is because I've had members of three ADCOM's tell me that it is such a common thing that it borders on redundant. As one put it, "....it is just conversation fodder with no real weight unless someone comes in with truly in-depth and prolonged involvement, such as leadership." Another made a comment regarding originality and that kind of short term "I'm an EMT, isn't that cool" approach to things giving the appearance that persons are only interested in the flashy and exciting side of medicine. Just passing along what I was told.

 

[N1DERL&]

I have another suggestion: volunteer in a Free clinic for the uninsured. This was recommended to me by an advisor. It was really fun, I learned a lot from the nurses, and got to do stuff (like take histories, give flu shots, take blood glucose tests), and you feel like you're doing something useful for people who can't afford care. The nurses and staff who volunteered were really very generous people and great to learn from.

Med01, how'd you find your clinic? I'm interested in volunteering at a clinic but have been unable to find one. Any tips?

 

[Med01]

Med01, how'd you find your clinic? I'm interested in volunteering at a clinic but have been unable to find one. Any tips?

Local hospitals are often affiliated with them, call around b/c it saves them emergency room fees. I volunteered with Rotacare.
http://www.rotacare.org/default.htm

However, like any situation, it depends on having a couple of great people around you. The doctors were quite standoffish, but the nurse practitioners (with Masters) were really competent and great people, willing to show me stuff. They also could see patients alone.

 

[N1DERL&]

Thanks for the link med01. Much appreciated.

Does anyone know of any clinics in southern california, like in orange county??

 

[stupibname]

"I'm an EMT, isn't that cool" approach to things giving the appearance that persons are only interested in the flashy and exciting side of medicine. Just passing along what I was told.

wait.. so we can't just be in it for the glamour?

 

[DropkickMurphy]

No, because there is actually very little glamour in it. But your sense of sarcasm is appreciated