"Why your two week trip to Haiti doesn't matter"

[haaaaaaaaaaveyoumetted]

http://almost.thedoctorschannel.com/14323-2/


I thought this was a very interesting read and hit on a lot of points I have encountered when discussing the issue of "service trips" with students at my school and with friends who go on these sorts of trips. I'm not sure whether this has been extensively discussed on SDN, but I have seen people who's "Clinical volunteering" category is two weeks of a trip they likely spent tons of money on, but was also likely ineffective at providing sustainable change, promoting the sustained health of the region, etc. Personally, I find volun-tourism disheartening and ineffective... For those of you that have gone on these trips, what are your thoughts on this piece?

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[lalex]

Yeah, it seems to be widely agreed on here that those do nothing for your app. I had a great experience during my trip, but probably will not include it on my app tbh. I did shadow doctors for a week, met amazing people, and saw amazing things. Something I probably wouldn't have experienced without the excuse of "it's for med school apps".

 

[Toutie]

Well that certainly made for a nice hours worth of reading. Some good links to other articles on the subject.

 

[Turkishking]

http://almost.thedoctorschannel.com/14323-2/


I thought this was a very interesting read and hit on a lot of points I have encountered when discussing the issue of "service trips" with students at my school and with friends who go on these sorts of trips. I'm not sure whether this has been extensively discussed on SDN, but I have seen people who's "Clinical volunteering" category is two weeks of a trip they likely spent tons of money on, but was also likely ineffective at providing sustainable change, promoting the sustained health of the region, etc. Personally, I find volun-tourism disheartening and ineffective... For those of you that have gone on these trips, what are your thoughts on this piece? Adcoms opinions on this type of thing on an app?

Promotes unethical practices..

 

[haaaaaaaaaaveyoumetted]

Yeah, it seems to be widely agreed on here that those do nothing for your app. I had a great experience during my trip, but probably will not include it on my app tbh. I did shadow doctors for a week, met amazing people, and saw amazing things. Something I probably wouldn't have experienced without the excuse of "it's for med school apps".

Did you have people there claiming that just being there was giving underprivileged people "hope" and making a difference? or was it pretty self-aware?

 

[piii]

I haven't done any of these trips. But there are trips that are in third world countries, or areas devastated by health disparities, where you work with a clinic for a week or so. I don't think it hurts your app to necessarily have an experience like this. But it is still a good experience for some people. If you combine it with serious and long term dedication to service work in the US, then it does contribute to your application package. Also if you are oriented towards global public health.

 

[honeydude]

I went on a medical brigade with MEDLife, and although I enjoyed the experience personally, I didn't think it would do a lot to improve my app. I mentioned it briefly in my PS since it tied in well with my overall theme. However, when I got to interviews I was shocked that this was probably the #1 thing that my interviewers wanted to know more details about.

 

[Dr Tony T. Chopper]

Jokes on you, my month abroad in DR changed my life and was the talking point of almost all of my interviews. Its what you make of it, not whether it is "good enough to put on your app".

 

[ditritium monoxide]

Adcoms like Goro and gyngyn tell us that they see no value in overseas service trips, but there might be other adcoms out there who do value them, so keep that in mind for whatever it's worth.

 

[piii]

Jokes on you, my month abroad in DR changed my life and was the talking point of almost all of my interviews. Its what you make of it, not whether it is "good enough to put on your app".

The people that really care that "your trip to Haiti doesn't matter" are envious that they are less adventurous than you and haven't gone on any trips themselves

 

[Mad Jack]

The people that really care that "your trip to Haiti doesn't matter" are envious that they are less adventurous than you and haven't gone on any trips themselves

Actually we're just going by what every adcom here has corroborated- most of these experiences amount to little more than poverty tourism and a feel-good experience you paid more than some of the villages you are visiting earn in a month to attend. Without a solid history of other volunteering, they are essentially meaningless. If you have a good amount of other volunteer work over the years, however, they can be viewed in a positive light as a natural extension of your other work.

 

[prettypinkbookworm]

While I understand many of the important criticisms of overseas trips, I don't quite understand the tendency I've seen on sdn to just dismiss them all.

I went on two of these trips, both to Spanish speaking countries in Central America. The organization we worked with had students come in the to the communities for clinics every three months, so there was consistency and followup. What's more, they used part of your fees to train local health workers, and eventually they actually left the cities they worked in once they had become self-sustaining. Because I spoke Spanish, I was able to have some very interesting conversations with the people I worked with. I asked them about their lives, their health problems, and their communities. The "jobs" I did were in no way outside of my skill level. I would do blood pressure and health history some days, and an educational station for kids another. The actual physicians were locals that we hired. Would it have been more efficient to just send my money over then fly down? Absolutely. We all knew that. But I was paying for the opportunity to see something new, and I don't know why that is considered a negative.

The experience showed me the developing world close up, and reaffirmed my desire to work there are some point. I used these trips as kind of a tester to see if I really wanted to go into global health. To me, they had a very real value.

I've spoken with several admissions committees about my trips, and none of them seem to look negatively on them. In fact, at several places I think they have really helped my application. For people considering such trips, I would really advise having a strong knowledge of the language of the country you are going to. Then I would say look for the similarities as much as the differences. What amazed me in Central America was that the medical resources were often there, but people just didn't have the ability to get to the cities were the doctors lived. The doctors didn't want to move to the countryside because there was nothing to do there. It wasn't so different from some of the poorer and more rural areas of the United States, and it put into broader perspectives the access problem in medicine.

 

[piii]

Actually we're just going by what every adcom here has corroborated- most of these experiences amount to little more than poverty tourism and a feel-good experience you paid more than some of the villages you are visiting earn in a month to attend. Without a solid history of other volunteering, they are essentially meaningless. If you have a good amount of other volunteer work over the years, however, they can be viewed in a nite positive light as a natural extension of your other work.

Which is exactly what I said in my first comment. And the one you quoted was just a joke.

 

[IlDestriero]

Not all trips are created equal, like everything, things aren't black and white. Having said that, you'd be better off managing a fund raiser to support a trip than attending as an unskilled warm body. Then you can spend the 2 weeks in Mexico during spring break instead, engaged in anatomy and physiology research.

 

[Lollygag]

Jokes on you, my month abroad in DR changed my life and was the talking point of almost all of my interviews. Its what you make of it, not whether it is "good enough to put on your app".

I think that is a little different though. Most of the service trips that my friends in college went on were 1-2 weeks. I personally think that spending an entire month displays another level of commitment and passion which would ultimately shed more meaningful experiences compared to the typical 1 week trip.

 

[hopefulERdoc251]

Medical trips as a premed where you're actually doing something rather than shadowing is unethical and dangerous (well unless you have a certification such as paramedic/RN/PA ect). You can service a third world country/poor area in so many other ways that are just as effective, and less hazardous to other individuals. I've volunteered with organizations like habitat for humanity ect where I was able to work in poor areas in my backyard and across the country. Sure I didn't do the clinical stuff but I still made a difference and I was able to talk about that at my interviews. Hell one interviewer told me that she's happy I did this rather than a medical mission trip. She said that she's had so many interviewees go on these trips and a majority of them can't really talk about WHAT THEY DID because they did nothing other than observe (because as I referenced earlier, if you don't have a license or certification, it's difficult to do even basic stuff).

 

[Planes2Doc]

When I was originally a pre-med, I wanted to go visit Brazil (I have family there) and do a medical mission trip. I thought this would be a golden ticket to medical school, and that this would have taken care of the "volunteering requirement" for medical school. I ended up pursuing business, and picked up the pre-med track a few years later... After that, I realized that medical mission trips aren't these hot golden tickets to medical school like some people might think.

I feel like people see these trips as killing two birds with one stone. You can check the volunteering check-box, all while visiting an exotic destination (surely more exciting than your local ED or free clinic)! But you know what? If you really want to have a fun time, then just take that insane amount of money you would spend on this trip, and instead put it toward an exotic vacation (because writing checks to an organization that helps the place you wanted to go to originally won't help your medical school application, duh!) to an even cooler destination. For instance, I looked at same random places, and I would much rather do a vacation package to the Maldives or Bali than Costa Rica (assuming a Central America mission trip). Also, you are technically helping the local population more (if you actually care, that is) by going on a regular trip because you are paying to stay at hotels that hire local workers, and will spend money on services and things that are also provided by locals. This will go farther than paying a boatload of money to an organization that capitalizes on pre-meds and other people who need to pad graduate/professional school applications.

I think that mission trips are similar to the epic failure of Kony 2012. I wrote about it in 2013, and if you're interested, check it out here: http://forums.studentdoctor.net/thr...oseph-kony-and-why-you-shouldnt-do-it.994079/

 

[makennacompton]

Did nothing but observe? I talked this week with my dental hygenist while in the chair and she described her recent church-sponsored trip to Ghana. After one day "assisting" the dentist, she was pulling teeth. Gentlemen: in the land of the blind, the one-eyed man is king. She knew her way around a mouth, so the dentist just told her to go at it. I expect had she stayed a month, she would be drilling and filling. Stay a couple more months, maybe root canals?

I believe that even volunteers can end up doing amazing things, as the whole "certification" thing goes out the window in the third world in the remote villages. They just don't care, and have no lawyers (frankly) who would sue. So the message is: go overseas, do one, see one, teach one!

 

[hopefulERdoc251]

Did nothing but observe? I talked this week with my dental hygenist while in the chair and she described her recent church-sponsored trip to Ghana. After one day "assisting" the dentist, she was pulling teeth. Gentlemen: in the land of the blind, the one-eyed man is king. She knew her way around a mouth, so the dentist just told her to go at it. I expect had she stayed a month, she would be drilling and filling. Stay a couple more months, maybe root canals?

I believe that even volunteers can end up doing amazing things, as the whole "certification" thing goes out the window in the third world in the remote villages. They just don't care, and have no lawyers (frankly) who would sue. So the message is: go overseas, do one, see one, teach one!

Ok well you can do that, but at the same time now what happens when you mess up or something goes horribly wrong and you end up causing more damage than good? If you have somebody not trained in sterile technique, or not trained in proper procedure, pull a tooth, and the area becomes horrifyingly infected and causes sepsis? This is obviously an extreme example but you can imagine scenarios when something less extreme occurs, and actually causes more harm than good.

 

[TBV]

Jokes on you, my month abroad in DR changed my life and was the talking point of almost all of my interviews. Its what you make of it, not whether it is "good enough to put on your app".

Which is fine but I had an interview where the majority of it we talked about college basketball (Never played organized basketball in my life) and I got in.

 

[gyngyn]

Which is fine but I had an interview where the majority of it we talked about college basketball (Never played organized basketball in my life) and I got in.

This is a good point.
The content of the interview is often the least important aspect.

 

[Mad Jack]

Did nothing but observe? I talked this week with my dental hygenist while in the chair and she described her recent church-sponsored trip to Ghana. After one day "assisting" the dentist, she was pulling teeth. Gentlemen: in the land of the blind, the one-eyed man is king. She knew her way around a mouth, so the dentist just told her to go at it. I expect had she stayed a month, she would be drilling and filling. Stay a couple more months, maybe root canals?

I believe that even volunteers can end up doing amazing things, as the whole "certification" thing goes out the window in the third world in the remote villages. They just don't care, and have no lawyers (frankly) who would sue. So the message is: go overseas, do one, see one, teach one!

That's a wonderful way to provide substandard, dangerous care to people who deserve better. If an adcom ever heard a student admit to such behavior during an interview, their app would go directly into the trash, because it shows blatant disregard for the principle of "first, do no harm." Sure, 9 out of 10 patients may be fine, but that 1 out of 10 that isn't, you've just harmed via your lack of training.

 

[Nietzschelover]

One school that seems to almost require these overseas experiences from applicants is Rochester.

 

[haaaaaaaaaaveyoumetted]

Did nothing but observe? I talked this week with my dental hygenist while in the chair and she described her recent church-sponsored trip to Ghana. After one day "assisting" the dentist, she was pulling teeth. Gentlemen: in the land of the blind, the one-eyed man is king. She knew her way around a mouth, so the dentist just told her to go at it. I expect had she stayed a month, she would be drilling and filling. Stay a couple more months, maybe root canals?

I believe that even volunteers can end up doing amazing things, as the whole "certification" thing goes out the window in the third world in the remote villages. They just don't care, and have no lawyers (frankly) who would sue. So the message is: go overseas, do one, see one, teach one!

See, I would feel very guilty to have someone like me (no medical degree, certification, etc) treating people just because they are in an underpriveleged country. Why should you be proud that the lack of access to the human right to healthcare means you get hands-on experience? That is scary and unethical to me. The last part of your post especially- "do one, see one" is probably the most dehumanizing way to talk about patients.

 

[haaaaaaaaaaveyoumetted]

Jokes on you, my month abroad in DR changed my life and was the talking point of almost all of my interviews. Its what you make of it, not whether it is "good enough to put on your app".

Traveling, seeing new cultures, experiencing new things are all positive and potentially life-changing things... but as long as you're admitting YOUR life is impacted more than the people constantly seeing underqualified college-aged students get off a bus and play soccer with them for a few weeks. The issue is treating people like a zoo, and in the idea that these short trips accomplish anything- I know the ones at my school were a week or two and did not involve any sort of living in solidarity with the communities they volun-toured in

 

[gyngyn]

Travel is transformative.
But medical "missions" for pre-meds take advantage of two vulnerable populations.

 

[Goro]

Bingo! I surmise that most of you who are pro-mission trip have never interviewed candidates for med school. Well I have, and when I probe the people who write about their "wonderful transformative" trip to Mexico etc, all they have to say is what they saw, and nothing about what they did, other than visit Dr Gonzalez in the clinic and watch him do his stuff....because they actually didn't do anything.

You could have done that at home.

Medical trips as a premed where you're actually doing something rather than shadowing is unethical and dangerous (well unless you have a certification such as paramedic/RN/PA ect). You can service a third world country/poor area in so many other ways that are just as effective, and less hazardous to other individuals. I've volunteered with organizations like habitat for humanity ect where I was able to work in poor areas in my backyard and across the country. Sure I didn't do the clinical stuff but I still made a difference and I was able to talk about that at my interviews. Hell one interviewer told me that she's happy I did this rather than a medical mission trip. She said that she's had so many interviewees go on these trips and a majority of them can't really talk about WHAT THEY DID because they did nothing other than observe (because as I referenced earlier, if you don't have a license or certification, it's difficult to do even basic stuff).

 

[sliceofbread136]

Travel is transformative.
But medical "missions" for pre-meds are taking advantage of two vulnerable populations.

There are plenty of things you can do on a medical mission without any formal training. You can take vitals, triage, do simple assisting of procedures etc. It doesn't have to be unethical.

Bingo! I surmise that most of you who are pro-mission trip have never interviewed candidates for med school. Well I have, and when I probe the people who write about their "wonderful transformative" trip to Mexico etc, all they have to say is what they saw, and nothing about what they did, other than visit Dr Gonzalez in the clinic and watch him do his stuff....because they actually didn't do anything.

You could have done that at home.

So you can get global medicine experience at home? Interesting

 

[gyngyn]

There are plenty of things you can do on a medical mission without any formal training. You can take vitals, triage, do simple assisting of procedures etc. It doesn't have to be unethical.

It usually isn't for the participant. It is for the companies that take advantage of vulnerable pre-meds and folks in desperate circumstances.

 

[gyngyn]

So you can get global medicine experience at home? Interesting

You can absolutely get relevant cross cultural experience with populations-in-need in the US.

 

[22031 Alum]

So you can get global medicine experience at home? Interesting

Don't be snotty. He meant that if you are just shadowing, then yes you can do that at home. Shadowing on foreign soil isn't automatically better just because of location. And don't tell me about seeing what a cultural differences, making do with a lack of resources, or the pathology that comes from lack of access to care is like- you can be exposed to that on US soil as well.

 

[sliceofbread136]

It usually isn't for the participant. It is for the companies that take advantage of vulnerable pre-meds.

Shrug, the trips at my undergrad were fairly economical and mostly done with fundraisers.

You can absolutely get relevant cross cultural experience with populations-in-need in the US.

Don't be snotty. He meant that if you are just shadowing, then yes you can do that at home. Shadowing on foreign soil isn't automatically better just because of location. And don't tell me about seeing what a cultural differences, making do with a lack of resources, or the pathology that comes from lack of access to care is like- you can be exposed to that on US soil as well.

Yes you can serve underserved communities in the US, but the experiences are not equivocal. You wouldn't say being a doctor for an underserved population in the US is the same as doing a doctors without borders program would you?

 

[hopefulERdoc251]

There are plenty of things you can do on a medical mission without any formal training. You can take vitals, triage, do simple assisting of procedures etc. It doesn't have to be unethical.



So you can get global medicine experience at home? Interesting

Well look at it from this angle. Yes having global overseas experience is interesting because it's a different area/country/lifestyle and yes it does enhance once's cultural competency. But the people you're seeing probably isn't the patient population you'd be practicing on. If you went to Mexico then yes maybe but if you're going to Africa/India/South America, the pathology that you might even see, or the cultural competency you obtain will not be significantly "useful" in America as a practicing physician. Sure it's eye opening to see the terrible living conditions abroad and it makes you appreciative of what you have now but once again, volunteering in your own back yard will give you the same results for 1/100th of the cost.

 

[Dr Tony T. Chopper]

On second thought, I concede that a large proportion of medical mission trips pander to the obsession of pre-meds to box check. I will say that worthwhile programs deserve a sense of intensity and tenacity like peace corp workers on 2+ year deployments on local living wage, solitude and only your village to rely on. Indeed the meat and potatoes of my time out of country dealt more with implementation, malpractice reform, writing protocols and other decidedly non clinical stuff.

 

[22031 Alum]

Yes you can serve underserved communities in the US, but the experiences are not equivocal. You wouldn't say being a doctor for an underserved population in the US is the same as doing a doctors without borders program would you?

Nope. But last I checked we weren't talking about physicians practicing in those two settings, were we?

 

[gyngyn]

Yes you can serve underserved communities in the US, but the experiences are not equivocal. You wouldn't say being a doctor for an underserved population in the US is the same as doing a doctors without borders program would you?

Pre-meds are not doctors. Serving the vulnerable is admirable, but pre-medical "missions" are designed to benefit the missionary.

 

[haaaaaaaaaaveyoumetted]

Shrug, the trips at my undergrad were fairly economical and mostly done with fundraisers.

Yes you can serve underserved communities in the US, but the experiences are not equivocal. You wouldn't say being a doctor for an underserved population in the US is the same as doing a doctors without borders program would you?

Those two examples are actual physicians practicing in different populations. As pre-meds, we should not be allowed to treat patients, especially just because they are in a more disadvantaged country with less strict guidelines for care. In the US, you have plenty of opportunities to actually have a sustainable impact on the underserved populations in your backyard. Abroad, you make no difference in your two weeks and the next eager load of pre-med kids are sent through after you.


I will also add that traveling and trying to learn from people from all over the world is admirable and an experience worth getting. But too many trips like this encourage the mentality of "I had never seen such extreme poverty" "I was exposed to such terrible conditions" despite the experience being rather superficial.

 

[makennacompton]

Agree with opinions above. My hygienist clearly should have refused. Patient safety and associated ethics trump immediate emergencies.

 

[DubVille]

Agree with opinions above. My hygienist clearly should have refused. Patient safety and associated ethics trump immediate emergencies.

To add: a hygienest pulling teeth is not the same as a premed trying to treat patients or even triaging. Premeds now essentially nothing about the practice of medicine. A hygienist has specialized training in oral care and experience (not saying they are equivalent to dentists at all).

 

[WingedOx]

and behold we have a wonderful example of what's wrong with pre-meds and med students.

They grow up in places like the Philly Main Line or Chicago North Shore then have mommy and daddy pay for trips to impoverished 3rd world hellholes for "cultural experiences"

...yet ask them to be able to communicate with someone from a lower middle class family from DelCo or Will County, and they basically drool on themselves.

 

[22031 Alum]

Agree with opinions above. My hygienist clearly should have refused. Patient safety and associated ethics trump immediate emergencies.

If it truly was an emergency situation, you wouldn't have described it as "getting to" do more than she was qualified for because the patients were too poor to have any other say. Disgusting.

 

[MrChance2]

Didn't read the article. Premeds don't know medicine. They thus are not really going to help people medically. Most can't even really take a history. You learn how to do these things better while on these trips though. I always thought it was nuts these cost so much money to "help people" but as a premed you are likely to get more out of it than you contribute.

I've only been on one of these trips and it was during medical school but there was just a few premeds on it. If I was the one interviewing them for med school I would definitely think it was significant that they have done this. It is the best thing for learning basic clinical skills and it is pretty much the closest thing a premed can get to having first hand experience in medicine.

 

[sliceofbread136]

Nope. But last I checked we weren't talking about physicians practicing in those two settings, were we?

Then why is it so outlandish that the two experiences are different as a premed?

 

[sliceofbread136]

Those two examples are actual physicians practicing in different populations. As pre-meds, we should not be allowed to treat patients, especially just because they are in a more disadvantaged country with less strict guidelines for care. In the US, you have plenty of opportunities to actually have a sustainable impact on the underserved populations in your backyard. Abroad, you make no difference in your two weeks and the next eager load of pre-med kids are sent through after you.


I will also add that traveling and trying to learn from people from all over the world is admirable and an experience worth getting. But too many trips like this encourage the mentality of "I had never seen such extreme poverty" "I was exposed to such terrible conditions" despite the experience being rather superficial.

As above, if practicing is different then you would expect the entire experience to be different. You can't equate volunteering in a clinic in El Paso with volunteering in a clinic in Guatamala (I say from personal experience). If you are interested in global medicine I can't see any reason why actually experiencing global medicine would not be a valuable experience.

And as I said earlier, there are plenty unskilled tasks a premed can help out with.

 

[Planes2Doc]

I feel like people are unfortunately too harsh on pre-meds that go on these trips in hopes of getting hands-on experience. Now, I know you hear about LizzyM's advice "if you can smell the patient, it's clinical experience" all the time. But how often do people actually follow it?

For example, my clinical experience consisted of volunteering in an ED for 4 hours once a week plus scattered shadowing that amounted to around 30 hours. I followed LizzyM's advice pretty closely I must say. But what about people that volunteered at free clinics? Or how about those that did paid entry-level clinical jobs like scribing, EMT, CNA, phlebotomist, etc...

As you can see, there is a trend toward doing more hands-on stuff. The more the better, or so they think. You'll learn lots of skills (many being irrelevant for physicians) doing these entry-level clinical jobs. These come with the job, and no one will look at this in any negative light. But what about volunteering? The general consensus on this site is free clinic volunteering is superior to hospital emergency department volunteering. Now why is that? I don't think it's because these free clinic volunteers have always been passionate about helping the homeless or very poor people. I think it's because the general consensus is you get to "do more" in a free clinic. When I was in the hospital, the most I ever touched a patient was shaking one's hand. I never took vitals, did a finger stick, or anything else. People claim to be able to do these things at free clinics all the time.

So I'm sure that if someone said they were able to help with suturing or something like that in a free clinic, people on SDN would high-five them on an awesome clinical experience. Now, if they claimed to have done the same thing on an overseas mission trip, they would be blasted and told to keep their mouths shut because what they did is unethical. Even if someone says that they want to do the basic things overseas that pre-meds routinely do here in free clinics, it would make others feel uneasy.

I don't think that these pre-professional school students going on mission trips are psychopaths that wake up one morning and say: "I feel like traveling across the globe and hurting people." I think the same motivations drive these people to do mission trips that drive those to volunteer in a free clinic instead of an ED, or to pick up an entry-level clinical job instead of volunteering. It's the pressure cooker environment of the pre-med process, where everyone tries to one-up one another, and do more "hands-on" stuff versus just smelling the patient. These medical mission trips, however, are held to a double-standard when compared to free clinics.

Now let me be non-PC for a moment, and I apologize in advance if I upset anyone. But in my opinion, what draws pre-meds to mission trips and free clinics is the general idea of being able to practice on the poor. I haven't heard anyone on this site recommend doing a free clinic because you provide services to the needy, but always because you can "do more" and it's somehow "superior" (because of doing more) compared to a hospital emergency department. As terrible as it sounds, people might see the poor as guinea pigs. But when you practice these things overseas, people will rip you a new one. If you do them in our metaphorical backyard, you'll be viewed as a hero. Just think about it before you judge someone on a mission trip.

 

[Goro]

The problem is, Planes, is that the majority of people who say they went on a medical mission are outright lying or embellishing.

I feel like people are unfortunately too harsh on pre-meds that go on these trips in hopes of getting hands-on experience. Now, I know you hear about LizzyM's advice "if you can smell the patient, it's clinical experience" all the time. But how often do people actually follow it?

For example, my clinical experience consisted of volunteering in an ED for 4 hours once a week plus scattered shadowing that amounted to around 30 hours. I followed LizzyM's advice pretty closely I must say. But what about people that volunteered at free clinics? Or how about those that did paid entry-level clinical jobs like scribing, EMT, CNA, phlebotomist, etc...

As you can see, there is a trend toward doing more hands-on stuff. The more the better, or so they think. You'll learn lots of skills (many being irrelevant for physicians) doing these entry-level clinical jobs. These come with the job, and no one will look at this in any negative light. But what about volunteering? The general consensus on this site is free clinic volunteering is superior to hospital emergency department volunteering. Now why is that? I don't think it's because these free clinic volunteers have always been passionate about helping the homeless or very poor people. I think it's because the general consensus is you get to "do more" in a free clinic. When I was in the hospital, the most I ever touched a patient was shaking one's hand. I never took vitals, did a finger stick, or anything else. People claim to be able to do these things at free clinics all the time.

So I'm sure that if someone said they were able to help with suturing or something like that in a free clinic, people on SDN would high-five them on an awesome clinical experience. Now, if they claimed to have done the same thing on an overseas mission trip, they would be blasted and told to keep their mouths shut because what they did is unethical. Even if someone says that they want to do the basic things overseas that pre-meds routinely do here in free clinics, it would make others feel uneasy.

I don't think that these pre-professional school students going on mission trips are psychopaths that wake up one morning and say: "I feel like traveling across the globe and hurting people." I think the same motivations drive these people to do mission trips that drive those to volunteer in a free clinic instead of an ED, or to pick up an entry-level clinical job instead of volunteering. It's the pressure cooker environment of the pre-med process, where everyone tries to one-up one another, and do more "hands-on" stuff versus just smelling the patient. These medical mission trips, however, are held to a double-standard when compared to free clinics.

Now let me be non-PC for a moment, and I apologize in advance if I upset anyone. But in my opinion, what draws pre-meds to mission trips and free clinics is the general idea of being able to practice on the poor. I haven't heard anyone on this site recommend doing a free clinic because you provide services to the needy, but always because you can "do more" and it's somehow "superior" (because of doing more) compared to a hospital emergency department. As terrible as it sounds, people might see the poor as guinea pigs. But when you practice these things overseas, people will rip you a new one. If you do them in our metaphorical backyard, you'll be viewed as a hero. Just think about it before you judge someone on a mission trip.

 

[Planes2Doc]

I think you have a rather inaccurate idea of what happens when pre-meds volunteer in free clinics. I'm not saying what you describe NEVER happens, but I haven't seen anything like it in the several years I've been working, interning, and volunteering in various free clinics and low-resource settings. (Side note: believe it or not, I am actually passionate about helping the homeless and poor people. I did it before I was pre-med and continue to do it in med school when it has little, if any, benefit to my career prospects. A few of us actually exist.)

When I was in free clinics, I was mostly helping with paperwork/logistics and some health education and outreach events. I was able to do basic vital signs (blood pressure, blood glucose, etc.) - but only because I was a certified EMT. I did some HIV testing and education - but only after receiving training and certification for that role. I also did some vision screening - but again, only after becoming a certified screener with my state Prevent Blindness affiliate (they also train teachers to do these screens in their classrooms). The 3 clinics I worked at don't let you just walk off the street and do that stuff. I certainly NEVER came even close to counseling patients about their health problems, diagnosing, treating, doing procedures, suturing, etc. I never did any of that abroad either. I knew I wasn't qualified to do that stuff, so I never wanted to. I also think you'll find that many of the people who spend their lives working in free clinics actually care about the people they're serving and wouldn't allow somebody unqualified to "practice" on these patients either.

Fair enough. But there is still something that attracts people to free clinics over hospital emergency departments, and you'll see free clinics being touted as a "superior" experience on SDN. I think this might have to do with the perception of being able to do more, whether you will actually be able to or not. That's dependent on each individual clinic. I have seen a few posts here and there where pre-meds are complaining about their free clinic volunteer experiences, where they spend the majority of time taking care of administrative tasks. So yes, it can definitely vary. I'm glad that you are having a good experience with yours!

 

[samac]

http://www.bootsnall.com/articles/15-03/short-term-missions-trips.html
I like this article. It breaks down how much you pay vs how much you could help by Using the money in their local economy.
I remember an interview with a woman who ran an orphanage where she said if the group of volunteers sent them the money instead that their 1 week trip could run the orphanage for 3 months. It's always resonated with me.

My medical school does a mission trip and I'm in a very small minority not supporting it. For one, it's a school supported mission trip with a Christian undertone, which I don't think should be a school run thing for a university.
For 2, as medical students we can't do anything other than take vitals and count pills. Part of the fee goes toward bringing meds. How much more could they send to these people if they just raised all the money for medications?

 

[makennacompton]

Given the 'disgusting' vitriol embraced by 'Alum' in its reply to me, I will take the advice to heart and (1) dissuade anyone from performing a Heimlich or (2) performing CPR on anyone unless they convince all bystanders of their medical certificates. After all, who really can tell what a real emergency situation is, really? Glad for this advice. The assumption that my hygienist or the attending dentist were just playing games with patients should be set against the very real examples in YOUR backyard where med students - who are not MDs and no better distinguished than my hygienist to 'treat' patients -- in clinical rotations get to write orders for patients. Guess you might find that 'disgusting' as well? The analogy holds.

 

[ZedsDed]

Given the 'disgusting' vitriol embraced by 'Alum' in its reply to me, I will take the advice to heart and (1) dissuade anyone from performing a Heimlich or (2) performing CPR on anyone unless they convince all bystanders of their medical certificates. After all, who really can tell what a real emergency situation is, really? Glad for this advice. The assumption that my hygienist or the attending dentist were just playing games with patients should be set against the very real examples in YOUR backyard where med students - who are not MDs and no better distinguished than my hygienist to 'treat' patients -- in clinical rotations get to write orders for patients. Guess you might find that 'disgusting' as well? The analogy holds.

If you are going to take shots at @22031 Alum , you should at least have the courage to quote or tag him/her.