Types of Clinical Experiences

[Rearanged-351235]

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Hello,

I have been a paid EMT-Basic for about a year and a half and have approximately 1000+ hours. As you may know, EMTs do not interact with physicians very often, since we are primarily in the field.

Some people have told me that I should also pursue a clinical position where I interact more with physicians/doctors (such as an ER Tech, Medical Assistant, etc.).

What is the consensus on this? Or will my EMT experience suffice?

 

[LizzyM]

For me, the point of clinical experience is to interact with patients and the point of shadowing is to interact with physicians. You are interacting with patients just as applicants who spend their time entertaining children in a pediatric ward interact with patients but rarely see physicians, and applicants in hospice settings interact with patients but would almost never see a physician.

Your EMT experience suffices. Just be sure to have at least 50 hours of shadowing, with at least some of that in primary care setting ("out-patient clinic")

 

[Goro]

The whole point of clinical experience is to interact with patients. You need to show admissions committees that you know what you're getting into, and that you really want to spend a lifetime caring for the sick and suffering.

You can interact with doctors by shadowing.

 

[Rearanged-351235]

Thanks for the reply, guys. That makes a lot of sense. Would it necessarily be beneficial if I chose to take on a, say, ER Tech position? Would it make a substantial difference, or would I be better off investing my time in other aspects of my app?

 

[Heyigotnoclue]

This is a very good question. I recently had a meeting with director of admissions at a school that I was waitlisted at and was told my application lacked interaction with physicians. I have thousands of hours of direct patient interaction and about 50 hours shadowing physicians. I was told, that as an EMT, if I roll a patient into the ER and do not directly interact with a physician, then the school (I will not say which one) does not consider it a clinical experience. I think this is rubbish, and that they were simply looking for an excuse. Or are raising the bar again, and we, as applicants have yet another hoop to jump through. How many EMT's actually speak to a physician in the ER? Isn't it usually the PA/NP or charge nurse?

 

[polymerization]

This is a very good question. I recently had a meeting with director of admissions at a school that I was waitlisted at and was told that my application lacked interaction with physicians. I have thousands of hours of direct patient interaction and about 50 hours shadowing physicians. I was told, that as an EMT, if I roll a patient into the ER and do not directly interact with a physician, then the school (I will not say which one) does not consider it a clinical experience. I really do think this is rubbish, and that they were simply looking for an excuse. Or is that they are simply raising the bar again, and we, as applicants have yet another hoop to jump through. How many EMT's actually speak to a physician in the ER? Isn't it usually the PA/NP or charge nurse?

I would push back (only theoretically in my own head) on this by saying that even if you did provide report to the charge nurse/physician on duty, it likely still would not be sufficient for this particular individual's own definition of a clinical experience.

Their definition relies on the idea that you are actively observing, participating within, and reacting to the practice of a physician—which you wouldn't be doing as an EMT in any meaningful way given the typical EMT's practice setting.

Just saying "hey, we picked up so-and-so AMS from Golden Years Nursing Home, vitals stable but only AOx1" is going to give you some kind of magic wisdom you wouldn't have otherwise.

The physician in ~70% of cases finds these reports generally pointless anyway because first responders and hospital staff have wildly different levels of clinical reasoning. There will always be the frustration that the EMT didn't even look at the nursing home facesheet and realize that the note itself is effectively blank and tells us nothing about the patient's baseline, which means we don't know how aggressively we should monitor the patient, what they are capable of, or (most importantly) how we can dispo them back to the nursing home without knowing what "normal" is for them.

I can understand why you would think that is a form of moving the goal posts... but you won't understand why the standard was created until you see what the workup looks like after you drop the patient off.

 

[LizzyM]

This is a very good question. I recently had a meeting with director of admissions at a school that I was waitlisted at and was told that my application lacked interaction with physicians. I have thousands of hours of direct patient interaction and about 50 hours shadowing physicians. I was told, that as an EMT, if I roll a patient into the ER and do not directly interact with a physician, then the school (I will not say which one) does not consider it a clinical experience. I really do think this is rubbish, and that they were simply looking for an excuse. Or is that they are simply raising the bar again, and we, as applicants have yet another hoop to jump through. How many EMT's actually speak to a physician in the ER? Isn't it usually the PA/NP or charge nurse?

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