Voluntourism and adcomm cognitive dissonance

[begoood95]

Here is a quote by @Goro that I have heard here many times, on a post talking about volunteering abroad:

I consider them as such...unless it has to do with the Peace Corps, the US military, or an NGO like MSF.

How do medical schools square that opinion with the fact that many have a "global health" program? You say, and many other adcomms say, that pre-med students going abroad is voluntourism--yet medical schools clearly value their global health initiatives.

Why, on the one hand, would adcomms view this negatively, while simultaneously being part of an institution that suggests--some strongly--involvement in a global health component? Not to be rude in any way, but that seems somewhat hypocritical, or misguided.

I understand that "you could've donated that money," or "you could've done the same thing that is much needed at home." However, students oftentimes go on these "trips" because they offer not just exposures in medicine, but one that is within the context of foreign ideas, foreign cultures and people, people of a different socioeconomic status oftentimes, and exposure to the difficulty of communication with those holding completely different paradigms than you--among many other, I would think, valid reasons. How do adcomms, at least those on SDN, view such activities in such a black and white manner, when, in fact, the experience has the potential to be enriching in a number of different ways? Sure, they can be expensive, and the money could have probably been spent elsewhere more efficiently--but that could be said about many, many other things as well; that critique doesn't seem to hold much water.

edit: There's also the suggestion that pre-meds are taking advantage of the situation, i.e., we do things we're normally not allowed to do in the US. However, I also think this is an incorrect assumption, for students are normally not allowed to perform invasive operations, and at most, they would be allowed to take blood pressure, heart rate, and etc. Furthermore, these experiences are situated within a unique context with different ethical and moral dimensions. Presumably, these people lack access to such basic medical procedures; should we just let them suffer? Again, I know "you could've just donated the money," but is that what we, as future physicians, should be learning to do--just throwing money at problems? I think not. I would think this is an important practice in recognizing unique ethical dimensions, understanding one's scope of practice, and working within a unique environment--all of which may be found here at home, "in the real world." Should we be doing this in the US, as many adcomms suggest, where access is usually (not always) better, where physicians are much more readily available? We would surely be out of our scope of practice in the US, but outside of the US, in different contexts within different socioeconomic environments, the issue seems more complex.

@gyngyn @LizzyM might also be interested in responding.

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[efle]

Best guess: Because taking a bunch of teens out to the third world to displace some local labor for a couple weeks isn't a global health initiative

 

[Lucca]

Some points:

1. Organizations like the Peace Corps, the U.S military and Medecins Sans Frontiers offer long-term, often multi-year commitments which, while not always offering opportunities involving direct patient contact, are appropriate to your level of training and education. These are very serious service commitments and the people that do these things are typically not just doing it to improve their application. In addition to that, they are not-for-profit and large, international operations often associated with the U.S. or other foreign governments, giving them an implicit stamp of approval for service-in-good-faith and "officiality".

2. "Voluntourism" organizations tend to be for-profit (though many are not) and fall into one of two camps (in my experience): Basically shadowing but somewhere else (think Atlantis project) or delivering medical care absolutely inappropriate to your level of training and expertise (think prescribing antibiotics and starting IVs in Peru -- I know people who have actually done these things as pre-meds). The programs these orgs offer also tend to be short term and pay-to-play, and applicants pay thousands of dollars to spend anywhere from a week to a summer doing one or both of the activities formerly described.

3. Being interested in 'global health' and being ready to contribute to 'global health' are very different things. There is something to be said for going abroad, learning about the great need for better medical education and healthcare services, and then wanting to commit your career to those problems. It is an entirely different thing to spend a week in Peru in a luxury hotel with a total of 10 hours of actual patient-contact time and then suddenly have 'come to the realization' that the world is filled with 'masses of wretched sick' who are in great need of your help as only you can provide (and also you read the school's mission statement during your junior year and realized you hadn't done a single thing with 'underserved populations'). If you meet someone who was suddenly enlightened as to how hard life is when you cannot find any food and several factions in your country are trying to kill each other but doesn't seem to understand how children two zip-codes from their hometown might be seriously malnourished or actively poisoned by their drinking water, then you are not going to take their interest in "global health" very seriously. See "Mbuto, pass me another baby".

Together, these factors make it so that separating Voluntourism from global health is entirely comprehensible.

 

[LizzyM]

See "Mbuto, pass me another baby".

https://forums.studentdoctor.net/threads/my-personal-statement-and-i-got-accepted.285834/

please recognize that this essay is satire. However, it is a 4.0 of the genre.

 

[sliceofbread136]

Some points:

1. Organizations like the Peace Corps, the U.S military and Medecins Sans Frontiers offer long-term, often multi-year commitments which, while not always offering opportunities involving direct patient contact, are appropriate to your level of training and education. These are very serious service commitments and the people that do these things are typically not just doing it to improve their application. In addition to that, they are not-for-profit and large, international operations often associated with the U.S. or other foreign governments, giving them an implicit stamp of approval for service-in-good-faith and "officiality".

2. "Voluntourism" organizations tend to be for-profit (though many are not) and fall into one of two camps (in my experience): Basically shadowing but somewhere else (think Atlantis project) or delivering medical care absolutely inappropriate to your level of training and expertise (think prescribing antibiotics and starting IVs in Peru -- I know people who have actually done these things as pre-meds). The programs these orgs offer also tend to be short term and pay-to-play, and applicants pay thousands of dollars to spend anywhere from a week to a summer doing one or both of the activities formerly described.

3. Being interested in 'global health' and being ready to contribute to 'global health' are very different things. There is something to be said for going abroad, learning about the great need for better medical education and healthcare services, and then wanting to commit your career to those problems. It is an entirely different thing to spend a week in Peru in a luxury hotel with a total of 10 hours of actual patient-contact time and then suddenly have 'come to the realization' that the world is filled with 'masses of wretched sick' who are in great need of your help as only you can provide (and also you read the school's mission statement during your junior year and realized you hadn't done a single thing with 'underserved populations'). If you meet someone who was suddenly enlightened as to how hard life is when you cannot find any food and several factions in your country are trying to kill each other but doesn't seem to understand how children two zip-codes from their hometown might be seriously malnourished or actively poisoned by their drinking water, then you are not going to take their interest in "global health" very seriously. See "Mbuto, pass me another baby".

Together, these factors make it so that separating Voluntourism from global health is entirely comprehensible.

1. I agree that w/e you do should be within the scope of practice that would normally be allowed and that the program as a whole should be long term. However, the commitment of the volunteer does not need to be long term to do some good. A premed helping out for a week could actually make a nice difference.

2. Don't see a problem with starting an iv, that is something you learn adequately well in a few tries. I guess hard stick kids would be an exception. Distributing vitamins and meds that you would give to anyone is fine. No medical decisions or complicated procedures should be allowed

3. I see zero reason why being exposed to global health as a premed would be a bad thing, just like any other field of medicine.

As a whole I would view global health volunteering in a long term environment that has an ethical scope of practice for a premed to be a positive. It's just currently the cool thing to hate on the past few years

 

[sliceofbread136]

I don't think adcoms would disagree with you...provided the program is sustainable, not harming the community it tries to serve, and nobody is outside their scope of practice, I think many adcoms would look favorably on this type of experience. The problem is that many programs/students do not follow these guidelines - that's what I often hear being "hated on."

However many programs do follow them. They still get auto hated on by many people on this board, which I think is silly.

 

[LizzyM]

There are opportunities to live abroad or travel abroad without making it a volunteer thing. You can learn language and culture by taking your backpack and a guidebook and traveling as cheaply as possible, shopping locally, staying in simple lodging or going to language immersion and staying with a host family. I did a combination of those when I was still a teen and it was eye-opening without being exploitative of local unmet need for medical care. (of course, I was not pre-med).

 

[Seldon]

https://forums.studentdoctor.net/threads/my-personal-statement-and-i-got-accepted.285834/

please recognize that this essay is satire. However, it is a 4.0 of the genre.

Have you ever seen an actual successful satirical PS come through your doors before?

 

[efle]

I see zero reason why being exposed to global health as a premed would be a bad thing

many programs do follow them. They still get auto hated on

I think there's a little bit of nuance around this point though. The knee-jerk reaction I've seen is against a short international experience being good evidence of altruism. Someone that was talking about their trip as essentially a brief shadowing experience that got them interested in learning more about a global health career I don't think would get auto hated on

 

[Matthew9Thirtyfive]

There are many posts on how a bunch of college students going to a third world country to displace the local labor force and do shoddy work that needs to be redone when they leave is not experience they want to see.

When we (the military) go to a foreign country to provide aid, it is for months or years, and the people going have been trained and are qualified to successfully perform the tasks they are going there to perform. When we go to clear the shipping lanes or rebuild hospitals and homes or provide medical care, we aren't using a bunch of voluntourists. We're using professionals.

 

[LizzyM]

Have you ever seen an actual successful satirical PS come through your doors before?

No, not satire.

The memory is faded but there was a successful applicant about 20 years ago who submitted a numbered list of facts about himself. I wouldn't recommend it but it worked for that applicant.

 

[JoaoMoutinho]

When we (the military) go to a foreign country to provide aid, it is for months or years, and the people going have been trained and are qualified to successfully perform the tasks they are going there to perform. When we go to clear the shipping lanes or rebuild hospitals and homes or provide medical care, we aren't using a bunch of voluntourists. We're using professionals.

MEDCAPs FTW

 

[gyngyn]

There is significant concern among members of the admissions community regarding these experiences.
Some of them were recently published here: https://www.aamc.org/download/474346/data/clinicalexperiencesshadowingsurvey.pdf

 

[efle]

There is significant concern among members of the admissions community regarding these experiences.
Some of them were recently published here: https://www.aamc.org/download/474346/data/clinicalexperiencesshadowingsurvey.pdf

It blows my mind that 50% of surveyed admissions people didn't see an issue with unsupervised invasive procedures

 

[Goro]

There are some good response to your post so I have no wish to be redundant.

But another thing about these mission trips is that they are all about the applicants, and NOT about the patients. When you're medical student on a Global Health trip, it IS about the patients, and your education comes second.

And then there are the people who merely go back tot he old country and visit Nana/Abuela/Ajima and maybe say hi to the local doctor, and then call it a "medical mission".

Whenever I interview people who take these trips, the only thing we get out of them is their recognition that medical care in the Third World is close to non-existent. Well, no ****, Sherlock.

And then you have the people whose only experience with patients from these mission trips. We want them to understand what it's like to deal with patients in the USA first, because that's where they'll be practicing.

Here is a quote by @Goro that I have heard here many times, on a post talking about volunteering abroad:


How do medical schools square that opinion with the fact that many have a "global health" program? You say, and many other adcomms say, that pre-med students going abroad is voluntourism--yet medical schools clearly value their global health initiatives.

Why, on the one hand, would adcomms view this negatively, while simultaneously being part of an institution that suggests--some strongly--involvement in a global health component? Not to be rude in any way, but that seems somewhat hypocritical, or misguided.

I understand that "you could've donated that money," or "you could've done the same thing that is much needed at home." However, students oftentimes go on these "trips" because they offer not just exposures in medicine, but one that is within the context of foreign ideas, foreign cultures and people, people of a different socioeconomic status oftentimes, and exposure to the difficulty of communication with those holding completely different paradigms than you--among many other, I would think, valid reasons. How do adcomms, at least those on SDN, view such activities in such a black and white manner, when, in fact, the experience has the potential to be enriching in a number of different ways? Sure, they can be expensive, and the money could have probably been spent elsewhere more efficiently--but that could be said about many, many other things as well; that critique doesn't seem to hold much water.

edit: There's also the suggestion that pre-meds are taking advantage of the situation, i.e., we do things we're normally not allowed to do in the US. However, I also think this is an incorrect assumption, for students are normally not allowed to perform invasive operations, and at most, they would be allowed to take blood pressure, heart rate, and etc. Furthermore, these experiences are situated within a unique context with different ethical and moral dimensions. Presumably, these people lack access to such basic medical procedures; should we just let them suffer? Again, I know "you could've just donated the money," but is that what we, as future physicians, should be learning to do--just throwing money at problems? I think not. I would think this is an important practice in recognizing unique ethical dimensions, understanding one's scope of practice, and working within a unique environment--all of which may be found here at home, "in the real world." Should we be doing this in the US, as many adcomms suggest, where access is usually (not always) better, where physicians are much more readily available? We would surely be out of our scope of practice in the US, but outside of the US, in different contexts within different socioeconomic environments, the issue seems more complex.

@gyngyn @LizzyM might also be interested in responding.

 

[tantacles]

I think my issue with this kind of trip is not so much the trip itself, provided that you've avoided the pitfalls listed by the admissions committee members above, but rather the expense required to take the trip. These trips really can only be taken by people of means, and honestly, people of means are already well represented in medical school. I would also hate to create an unspoken expectation that any experience that requires payment is at all necessary for medical school, and so I'm inclined to disregard these kinds of experiences rather than treat them negatively. If the experience is valuable to you, I say go ahead and do it, but it's just not something that I'm looking for in a medical school applicant.

Sadly, a college education also falls into the category of things most poor people cannot afford, so it's unfortunate that we may miss out on some who might be fantastic doctors because they have to spend their time to work and feed their families, but there has to be some academic marker of fitness given the rigor of medical school.

 

[begoood95]

Best guess: Because taking a bunch of teens out to the third world to displace some local labor for a couple weeks isn't a global health initiative

This is a good summary of the rest of the post, and the quotes are of such length that I'm not going to respond to them individually, but I think I can speak to the general opinions voiced so far. I'm sure you're aware, @efle, but I'd say that is a pretty large oversimplification of the issue. Good thing you're not an adcomm

I guess my first response is that--at least, according to many critics--I'm surprised so many pre-medical students are allowed to perform invasive procedures. Delivering babies? Suturing wounds? Are you kidding me!? Of course, that seems like a terrible overreach in our scope of knowledge. In my post, I was, in a sense, arguing that it seems as though some members on here are too quick to dismiss these activities abroad. If someone were to tout their experience abroad as the single, conclusive evidence of their altruism, of course that is unwise. I further agree that if a student were to diagnose and suggest treatment for an individual, it would be a breach of scope. Thought that's not what I'm saying.

I'm saying this: assume the applicant is a "rockstar." This applicant has shadowing experience in the US, and has volunteered in the US within medicine and non-medical environments. In other words, they're not using the time spent abroad as the only evidence of anything. To me, it seems that to write off all volunteering abroad as inconsequential/negative/etc., is short-sighted, and too dismissive.

There is significant concern among members of the admissions community regarding these experiences.
Some of them were recently published here: https://www.aamc.org/download/474346/data/clinicalexperiencesshadowingsurvey.pdf

Then, from at least the data in that survey which is presumably a bit more representative than SDN, there exists a variety of opinions on the subject, which I guess isn't too much of a surprise. (It is surprising that ~50% don't think invasive procedures are problematic, though!)

For some context, if you couldn't tell already, I participated in one of these experiences. Without giving away too much information, there were about 20 MS1/2 students, 10 graduate anthropology students, and I was one of four undergraduates. It lasted one month, and given that I had worked as an COA for two years, I was allowed to conduct various eye examinations--in addition to triage. There was also a "pharmacy" station, where the medicine prescribed by the four attending physicians was handed out. The undergraduate students and graduate anthropology students never performed invasive procedures, nor did they diagnose. We did, however, have the opportunity to conduct a patient history--in the presence of the physician, after which s/he conducted another round. The whole experience was a combined medical/anthropology expedition, so in addition to the clinics we arranged, we lived/studied/interacted with monks in the region we were located in.

I would guess this anecdotal experience wasn't too bad.

Everyone does point out many good reasons as to be weary of these for-profit, short-term volunteering abroad experiences, and I don't disagree with them!

There are opportunities to live abroad or travel abroad without making it a volunteer thing. You can learn language and culture by taking your backpack and a guidebook and traveling as cheaply as possible, shopping locally, staying in simple lodging or going to language immersion and staying with a host family. I did a combination of those when I was still a teen and it was eye-opening without being exploitative of local unmet need for medical care. (of course, I was not pre-med).

That was my initial plan, but it fell through

 

[begoood95]

...Sadly, a college education also falls into the category of things most poor people cannot afford, so it's unfortunate that we may miss out on some who might be fantastic doctors because they have to spend their time to work and feed their families, but there has to be some academic marker of fitness given the rigor of medical school.

Unfortunate indeed.

 

[efle]

I'd say that is a pretty large oversimplification of the issue. Good thing you're not an adcomm

Eh, this is a pretty weak dismissal. You asked very generally about how global health emphasis can be reconciled with a negative view of these kinds of programs, and I think one line of text is about all you need to point out that these two things are not comparable.

Don't take this thread's tone as a criticism of your EC choices dude. If your program was the exception (not fluff and did not have you doing more than you should've), I don't think it will cause you issues. This is, after all, a very common EC that was on the AMCAS of one in three matriculants:

 

[ScottTenorman54]

I would guess this anecdotal experience wasn't too bad.

Doesn't seem bad. How you frame it makes a difference too, which tends to be a problem with people when they describe these kinds of premed experiences. Learning/different experiences/anthropology etc vs "as I extended an arm out to the poor, hobbling native to give him some much needed aspirin, it suddenly dawned on me how people in Port-au-Prince have such limited access to healthcare. His gratefulness was humbling but at the same time filled me with energy to continue my work."

 

[begoood95]

Eh, this is a pretty weak dismissal. You asked very generally about how global health emphasis can be reconciled with a negative view of these kinds of programs, and I think one line of text is about all you need to point out that these two things are not comparable.

Don't take this thread's tone as a criticism of your EC choices dude. If your program was the exception (not fluff and did not have you doing more than you should've), I don't think it will cause you issues. This is, after all, a very common EC that was on the AMCAS of one in three matriculants:

Haha I wasn't, though of course being that I've been on one, I took things one step too personal! And I may have miscommunicated, because I didn't mean to equate medical schools' global health programs and voluntouristic activities--because I agree, they're very different. I guess I was getting a bit tired of people's gut-reflexive responses to every person's post on here, rather than giving it just one second more of thought, so I just wanted to have a thread that discussed things in a bit more detail.

 

[LutGholein]

I think my issue with this kind of trip is not so much the trip itself, provided that you've avoided the pitfalls listed by the admissions committee members above, but rather the expense required to take the trip. These trips really can only be taken by people of means, and honestly, people of means are already well represented in medical school. I would also hate to create an unspoken expectation that any experience that requires payment is at all necessary for medical school, and so I'm inclined to disregard these kinds of experiences rather than treat them negatively. If the experience is valuable to you, I say go ahead and do it, but it's just not something that I'm looking for in a medical school applicant.

Sadly, a college education also falls into the category of things most poor people cannot afford, so it's unfortunate that we may miss out on some who might be fantastic doctors because they have to spend their time to work and feed their families, but there has to be some academic marker of fitness given the rigor of medical school.

This hits the nail on the board. If you're from a working class background you can forget about international trips--it's an uphill battle and I'm glad to see that many others can see why this shouldn't put those from working class backgrounds at a disadvantage.

Side note: you would be very surprised at what some "premeds" can get away with in these trips---had a friend tell me they assisted in an invasive surgery/operation working on some islanders from XYZ island. They included this info in their AMCAS app too -_-

 

[ciestar]

This hits the nail on the board. If you're from a working class background you can forget about international trips--it's an uphill battle and I'm glad to see that many others can see why this shouldn't put those from working class backgrounds at a disadvantage.

Side note: you would be very surprised at what some "premeds" can get away with in these trips---had a friend tell me they assisted in an invasive surgery/operation working on some islanders from XYZ island. They included this info in their AMCAS app too -_-

I had a friend try and convince me before I even applied I'd never be accepted without one of these trips. I came to discover this trip cost my friend more than $10,000 to go on... i was making $14k a year... I also learned that of the week spent on the trip, maybe 40 hours were spent with patients and like three days were spent being a tourist in Paris with said organization.

Meanwhile, I received FAP and was actually told by an adcom member at my current school that my status would have actually been called into question had I gone on one of these trips.

But I agree, these trips should never put any one applicant over another simply because they have the financial means to do so. Us poor people already have an uphill battle to climb.

 

[freak7]

Eh, this is a pretty weak dismissal. You asked very generally about how global health emphasis can be reconciled with a negative view of these kinds of programs, and I think one line of text is about all you need to point out that these two things are not comparable.

Don't take this thread's tone as a criticism of your EC choices dude. If your program was the exception (not fluff and did not have you doing more than you should've), I don't think it will cause you issues. This is, after all, a very common EC that was on the AMCAS of one in three matriculants:

People put MCAT prep on their AMCAS? That doesn't seem right. Are you sure this data isn't from the AAMC survey/not aggregated from AMCAS?

 

[efle]

People put MCAT prep on their AMCAS? That doesn't seem right. Are you sure this data isn't from the AAMC survey/not aggregated from AMCAS?

It's from the matriculant survey

I'm assuming the people who did it and reported it in the survey also listed it as one of the 15 AMCAS activities

 

[Danbo1957]

He who makes any positive difference in another person's life is a better man than those who just walk by...

 

[LizzyM]

He who makes any positive difference in another person's life is a better man than those who just walk by...

Injecting cash into the local economy by showing up, staying in a local hotel, eating a meal, buying a locally produced item makes a positive difference in a community.

 

[begoood95]

I had a friend try and convince me before I even applied I'd never be accepted without one of these trips. I came to discover this trip cost my friend more than $10,000 to go on... i was making $14k a year... I also learned that of the week spent on the trip, maybe 40 hours were spent with patients and like three days were spent being a tourist in Paris with said organization...

$10,000?! Holy ****. My experience wasn't near as much, but you're right: had I not been privileged to have parents that are willing to pay for such an experience, I would have never been able to go. I don't think that experience should put me over any other applicant.

Injecting cash into the local economy by showing up, staying in a local hotel, eating a meal, buying a locally produced item makes a positive difference in a community.

And doing that prepares me for medical school...how? Again, you're voicing criticism in this economic/moral way, such that I'm better off throwing money at an issue than attempting--to any extent, which I know may be limited--to alleviate it personally. From the perspective of the future physician, it makes no sense, really, to throw money at an issue, if I'm indeed trying to enrich the lives of others, and by extension myself, because that's not what physicians do.

Again, I get what you're saying, but it's just too dismissive to be taken seriously. Let's all just throw money at underdeveloped nations, instead of going to help (whether that be through training locals or providing free healthcare)--that'll teach us pre-meds! /s

 

[LizzyM]

$10,000?! Holy ****. My experience wasn't near as much, but you're right: had I not been privileged to have parents that are willing to pay for such an experience, I would have never been able to go. I don't think that experience should put me over any other applicant.

And doing that prepares me for medical school...how? Again, you're voicing criticism in this economic/moral way, such that I'm better off throwing money at an issue than attempting--to any extent, which I know may be limited--to alleviate it personally. From the perspective of the future physician, it makes no sense, really, to throw money at an issue, if I'm indeed trying to enrich the lives of others, and by extension myself, because that's not what physicians do.

Again, I get what you're saying, but it's just too dismissive to be taken seriously. Let's all just throw money at underdeveloped nations, instead of going to help (whether that be through training locals or providing free healthcare)--that'll teach us pre-meds! /s

If you are going to take a vacation, you are helping the people of the local area where you vacation. When you eat a meal, buy a handicraft, stay in a hotel you make it possible for people in that area to be employed. Now they can buy the items they need in the pharmacy rather than waiting for some do-gooder to come along and give them a bottle of NSAIDs at no charge. In turn, the local drugstore remains in business, the pharmacists can afford to send their children to school, the school teachers have the means to feed their children, the local food shop has more local customers, and so forth. That's not "throwing money". It is choosing to direct your discretionary spending toward communities that need your tourism dollars more than they need your handouts and that cash remains in the community and circulates many times.

I don't believe that any short-term volunteer experience overseas prepares anyone for medical school in the US.

 

[Danbo1957]

.............

 

[Matthew9Thirtyfive]

Here's the essay I was thinking of earlier. It makes some good points. There are a number like it about not just medical voluntourism, but any kind really.

VOLUNTOURISM IS ULTIMATELY ABOUT the fulfillment of the volunteers themselves, not necessarily what they bring to the communities they visit. In fact, medical volunteerism often breaks down existing local health systems. In Ghana, I realized that local people weren’t purchasing health insurance, since they knew there would be free foreign health care and medications available every few months. This left them vulnerable in the intervening times, not to mention when the organization would leave the community.

https://psmag.com/instagrammingafrica-the-narcissism-of-global-voluntourism-e5001bf57fdf#.aj23n0no2

 

[gyngyn]

Here's the essay I was thinking of earlier. It makes some good points. There are a number like it about not just medical voluntourism, but any kind really.



https://psmag.com/instagrammingafrica-the-narcissism-of-global-voluntourism-e5001bf57fdf#.aj23n0no2

Some applicants actually send pictures of themselves with starving children...

 

[Matthew9Thirtyfive]

Some applicants actually send pictures of themselves with starving children...

Wow. Just...wow.

 

[freak7]

Some applicants actually send pictures of themselves with starving children...

Wow. Just...wow.

The thing is that at least once they had to consider the question: "is this in good taste?" And decided the answer was "yes"

*shudders*

 

[Goro]

Some applicants actually send pictures of themselves with starving children...

 

[JoaoMoutinho]

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...................................,

 

[BlessUp]

Personal anecdote relevant to this thread: I am part of a small organization that provides free medical care (8-10 doctors per trip) in a little town in a third world country on a yearly basis. A certain MD school also goes at a different time of year to the same village. It is well known among our organization that the group of students sees a fraction of the patients that our docs do, and that this trip is more of an educational experience for the students than anything else. So yes, IMO there is some cognitive dissonance going on.
With that said, I realize that I myself (as a pre-med) am unskilled labor and not necessarily vital to the mission work of our group. However I am also heavily involved in the year-round efforts of the org, including fundraising. I don't see it as a problem to show an ongoing commitment to a cause that involves some mission work.
I absolutely agree that volunteers should always be cognizant of the impact of their work, and of the broad social and economic forces at play. For anyone interested, there is a great video/book series called "Helping Without Hurting" on this topic. However, I also think that people should be careful about criticizing the volunteer work of others and making sweeping generalizations like the adcoms on this site tend to make- "All abroad volunteer work by premeds is bad".

 

[BlessUp]

That is not the consensus of adcoms on this site. That's not even the consensus of adcoms in this thread. They are criticizing a very specific type/model of volunteering abroad. If that model doesn't describe what you did, then it's fine.

Yeah, I disagree with you. I have seen over and over on this site adcoms and others criticizing volunteering abroad on the basis that premeds are unskilled labor and thus are taking away potential employment from natives. This is not a "very specific type/model of volunteering abroad", but rather all volunteering abroad by premeds because by definition, premeds are unskilled labor in these situations (except for the rare non-trad nurse who is premed or something of the like).

 

[fball22]

I had a friend try and convince me before I even applied I'd never be accepted without one of these trips. I came to discover this trip cost my friend more than $10,000 to go on... i was making $14k a year... I also learned that of the week spent on the trip, maybe 40 hours were spent with patients and like three days were spent being a tourist in Paris with said organization.

Meanwhile, I received FAP and was actually told by an adcom member at my current school that my status would have actually been called into question had I gone on one of these trips.

But I agree, these trips should never put any one applicant over another simply because they have the financial means to do so. Us poor people already have an uphill battle to climb.

FAP recipient here. Went on a trip with an organization similar to the one in the personal anectdote earlier in the thread (npo that goes to the same villages on a quarterly basis with physicians, pharmacists and nurses. Continuity of care is super important to the organization.) the system is set up 100% to benefit the patients, the only reason I was there, along with a few other undergrads, is because we could contribute to patient care as an interpreters.

Because I was an interpreter my expenses were covered while there, all I had to do was get there (500$ plane ticket) which I raised money for and went.

While I don't think it is necessary to go on a trip, you can most definitely be poor and do so. It's all part of the climb.

Edit: if my expenses hadn't been covered for the ~10 days, it would have been 800$, which is what the physicians, nurses, and pharmacists pay.

 

[begoood95]

You said it yourself...exposure to "foreign ideas, foreign cultures and people, people of a different socioeconomic status oftentimes, and exposure to the difficulty of communication with those holding completely different paradigms than you." You can do all of that without taking blood pressures all week.

If you are going to take a vacation, you are helping the people of the local area where you vacation. When you eat a meal, buy a handicraft, stay in a hotel you make it possible for people in that area to be employed. Now they can buy the items they need in the pharmacy rather than waiting for some do-gooder to come along and give them a bottle of NSAIDs at no charge. In turn, the local drugstore remains in business, the pharmacists can afford to send their children to school, the school teachers have the means to feed their children, the local food shop has more local customers, and so forth. That's not "throwing money". It is choosing to direct your discretionary spending toward communities that need your tourism dollars more than they need your handouts and that cash remains in the community and circulates many times.

I don't believe that any short-term volunteer experience overseas prepares anyone for medical school in the US.

I misread @LizzyM's post, thinking they said that I ought to just donate money. Of course, going there on a quasi-vacation, whether it be backpacking or just a literal trip is going to expose me to such ideas. At the same time, do you honestly believe that the extent to which I'm (or anyone else is) going to be exposed to things that are conducive to growth is going to be the same if I'm on a vacation with mommy and daddy versus on a global health program? Not only will the program provide experiences that afford opportunities to experience foreign ideas and etc., but furthermore, the premed will be interacting with MS1/2 students and physicians who are more knowledgeable than I am within such a context. To completely deny and dismiss the value of that is wrongheaded, I think, because of the following.

There is a difference between going on vacation and "direct[ing] your discretionary spending toward communities that need your tourism dollars," and going on a global health initiative. Moreover, it's myopic to think that tourism is the most efficient way to economically benefit a community, and I don't think I need to point you to literature that provides evidence as such; briefly, tourism may in fact negatively impact a number of communities for, once established, the culture in which the tourism takes hold is oftentimes overrun by multinational corporations, the goals of which are not the betterment of said country, but rather, increased revenue. They're goals as a corporation are different than--antipodal to--the physician's goal. I'm not saying it's completely and without a question negative, but your scenario--while nice and comforting--@LizzyM, is a bit of an oversimplification, and is probably not the norm.

I agree, that "any short-term volunteer experience overseas [does not] prepare anyone for medical school in the US." That's not really the point of these experiences, anyways, as many have alluded to above.

I think we can all agree that it's a complicated issue, and that both sides have valid points.

 

[begoood95]

Also, whoever the hell includes pictures of themselves with starving children is just idiotic. My god what goes through their minds?!

 

[LizzyM]

I misread @LizzyM's post, thinking they said that I ought to just donate money. Of course, going there on a quasi-vacation, whether it be backpacking or just a literal trip is going to expose me to such ideas. At the same time, do you honestly believe that the extent to which I'm (or anyone else is) going to be exposed to things that are conducive to growth is going to be the same if I'm on a vacation with mommy and daddy versus on a global health program?

I was not picturing a vacation with Mommy and Daddy. I'm saying go into the back country, stay at locally owned hotels, eat at local places, etc. I think that you can have an adventure and meet local people and interact with them without taking their blood pressure.

Moreover, it's myopic to think that tourism is the most efficient way to economically benefit a community, and I don't think I need to point you to literature that provides evidence as such; briefly, tourism may in fact negatively impact a number of communities for, once established, the culture in which the tourism takes hold is oftentimes overrun by multinational corporations,.

Maybe it is my own experience that I look back on but if you go off the beaten path, you will not find multi-national corporations but locally owned and operated lodging, restaurants and markets. Even corporate lodging can benefit the local population given that you just can't out-source housekeeping and security and thus it employees local people. I'm not talking about places where tourism is the major source of income but places that benefit from having you "passing through" just as much as if you settled in for a week and did a "medical mission".

 

[Goro]

Our best interviewees, and the ones who get the highest scores after interviews, are the ones who radiate passion about their volunteering, and what they took away from it.

A common theme I have noticed amongst SDNers who have been accepted into Harvard/Stanford class schools, is that that they have tons of volunteer experience, particularly benefitting those in need.

The pre-med that you see are box-checkers. They are not successful. The successful ones love they do, and do what they love.

Thank you for contributing so much, I have learned a lot simply by looking through your posts.

Honest question: Does any sort of volunteering, short-term or otherwise, prepare you for medical school? It just seems like an arms race to get the highest number of hours. I rarely see any compassion from the people volunteering around me, and it's almost always from the non-premeds.

 

[Danbo1957]

Volunteerism is valuable to those who receive it, and volunteering does not have to end after the personal statement is written. "And what goes around, comes around..."

 

[begoood95]

Speculation: With gap years becoming more common than traditional matriculation, masters degrees will become the new norm to set yourself apart.

I don't think this is going to become the new norm simply because I don't think a majority of the people willing to become a physician want to add even more years to their plate.

Also, if getting a masters becomes the new norm to set yourself apart—it by definition no longer sets anyone apart! We're all doomed. We're all the same. A pre-med is a pre-med is a pre-med.

(/s)


Sent from my SAMSUNG-SM-G920A using SDN mobile

 

[Matthew9Thirtyfive]

Volunteerism is valuable to those who receive it, and volunteering does not have to end after the personal statement is written. "And what goes around, comes around..."

Agreed. I'm already thinking of ways I can volunteer when I'm in med school and beyond. It just feels good, and there is no shortage of people who need it.

 

[Saifa]

Some applicants actually send pictures of themselves with starving children...

According to my social media this is the absolute pinnacle pre-PA milestone.

 

[gyngyn]

According to my social media this is the absolute pinnacle pre-PA milestone.

I'm sorry to hear that.