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Clinical Experience for Pre-Med Post-Bacc Students: Volunteer or Shadow?

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Clinical experience is a critical element of post-baccalaureate programs. In addition to strengthening your resume and medical school applications, clinical experience helps you engage with the reality of becoming a physician and helps shape your perspective on what type of medicine you want to pursue. You can explore specialties that interest you, interact with different patient populations—for example, children, the elderly, or neo-natal patients—and begin to imagine where your talents and interests match within the broader field of medicine. You may even discover you’re more interested in an entirely different, but related field, such as addiction counseling, psychology, occupational therapy, or advanced practice nursing.

For pre-med students, there are two primary clinical experience options: shadowing and volunteering. In this article, we compare both options and explain how each has something uniquely valuable to offer your preparation for your future as a medical professional.

What’s the Difference Between Shadowing and Volunteering?

Shadowing is an entirely observational process—you follow a physician throughout his or her workday and see how he or she treats patients, solves problems, and collaborates with other professionals. Clinical shadowing can be a one-day experience or occur over a period of weeks. Often, shadowing experiences are arranged through informal channels—a relative, an advisor, or your own family physician. If you do not have physicians in your professional or personal network, make sure to inquire about shadowing opportunities when deciding on which post-bacc program to attend.

Volunteering combines observation with service. During volunteering, you carry out tasks under the direction of a practitioner. Usually, these tasks are very limited in terms of direct clinical treatment, but you will play an important role as part of a health care team. That is one of the primary purposes of volunteering—to help you understand how collaborative a process healthcare really is, and to gain direct experience seeing how care teams work. There are many formal volunteering programs which actively seek pre-medical students.

Why Do Shadowing and Volunteering Matter to Medical Admissions Committees?

When considering your application to medical school, admissions committees don’t just want to see evidence of scholastic evidence. They want to see dedication to patient care and a genuine interest and desire to work in the medical field. They also want to see evidence that you’ve taken time to deeply consider what being a physician might look like for you.

Shadowing and volunteering offer strong evidence in both these areas, so if you can, do your best to undertake a mix of these activities during your pre-med post-bacc years.

What Will I Do When I Shadow (or Volunteer)?

First, always remember that the patient’s well-being matters more than your desire for clinical experience. Don’t feel put out if a patient doesn’t want you observing an exam while you’re shadowing his or her doctor, or if a medical professional says you can’t perform certain types of direct care during your volunteering experience.

Shadowing: Observation and Questioning

In a shadowing experience, you follow a physician during his or her workday. If the patient gives permission, you can observe exams and treatment procedures. You can also follow the practitioner you’re shadowing to meetings, rounds, minor procedures, and other daily duties. While shadowing, you can make notes about your observations, but note that the Association of American Medical Colleges (AAMC) recommends you do this between patients, not in front of them.i Additionally, shadowing gives you the opportunity to ask questions of the physician you’re shadowing, or of other practitioners working with him or her, such as registered nurses or technicians.

Volunteering: Collaborating and Interacting (and Observing Some More)

In a volunteering experience, your role is a little more active, although learning by observation is still key. You may do any of a variety of things depending on the clinical environment you’re working in, but you will always do it under the supervision of a qualified practitioner (a physician, an RN, an NP, etc.).

Unlike a shadowing experience, volunteering often involves some level of direct patient contact. This contact can vary from helping someone complete paperwork to providing very basic care, such as changing a dressing on a minor wound. You may also weigh and measure babies at a well-baby clinic, take vital signs, or ask questions about a patient’s eating habits—it all depends on what organization you’re volunteering with.

No matter where you volunteer, remember that your primary purpose is still observation, not treatment. Volunteering is a valuable opportunity to take part in the collaborative process of healthcare, and to understand the roles of other professionals, including nurses, technicians, and others who make a physician’s job possible.

Just as importantly, volunteering offers you the opportunity to learn to relate to patients. To succeed as a physician, you will need to develop and demonstrate cultural competence, not just clinical competence. Whether you’re volunteering with elderly people of a background similar to yours, or with people from an entirely different country and cultural context, professionalism, empathy, and respect matter.

How to Get Started with Clinical Shadowing or Volunteering

The primary difference between shadowing and volunteering is that the former is more informal while the latter is often a formalized process. If you’re in a pre-med post-bacc program, your institution may have an advisor or team who can help you find opportunities.

Finding Clinical Shadowing Opportunities

Shadowing opportunities usually come about through someone you know, whether you are fortunate enough to have a relative who’s a physician, or connect to one through a professor, your family doctor, or your student health center. If you are reaching out to a potential shadowing practitioner you don’t know well, don’t be shy! According to the American Medical Student Association, “The vast majority of physicians are more than welcoming to pre-med students and would be excited to share their ideas and experience with you.”ii

You may have to sign agreements related to patient safety and confidentiality before your experience begins—remember, the patient’s well-being is always the highest priority. If possible, try to arrange multiple shadowing experiences with different practitioners in different clinical contexts. If you can’t find one, don’t panic: the AAMC says that “in a 2016 survey of medical school admissions officers… 87% of respondents indicated that they accept an alternate activity instead of clinical shadowing.”iii

Finding Clinical Volunteering Opportunities

There are numerous medical volunteering programs operated by local, national, and international organizations. As a pre-med post-bacc student, you should have plenty of contacts who can put you on the right track. Contact a pre-med society, talk to an instructor, or even visit a local hospital’s website to learn more.

Volunteering is usually a longer-term commitment than shadowing. They can be fixed-term—say, a summer program, or for the duration of a specific free clinic—or an open-ended opportunity. Consider making a longer-term commitment if you can. Organizations genuinely do need your help—whatever you do, however minor, can help free up practitioners’ time and energy to do more for patients.

Additionally, sustained commitment can be more attractive to medical school admissions committees. The AAMC says of volunteering that “it’s important to show you’ve cultivated specific interests and are able to commit to an activity over a sustained period. You’re more likely to gain significant responsibilities or leadership roles if you volunteer with an organization regularly.”iv

There are a wide variety of volunteering opportunities at home and abroad—in fact, many students hurry to apply to medical volunteering programs abroad. However, 2011 AAMC guidelines on medical and pre-medical student volunteering notes that “There are many opportunities to help the disadvantaged and other underserved groups in the U.S. … Also, be mindful that while appropriate experience in other countries can be valuable and may be viewed as complementary, if you plan to practice in the U.S, it is particularly important to understand U.S. healthcare.” v


i https://students-residents.aamc.org/applying-medical-school/article/shadowing-doctor/

ii https://www.amsa.org/2017/12/19/pre-med-tips-shadowing-physician/

iii https://students-residents.aamc.org/applying-medical-school/article/shadowing-doctor/

iv https://students-residents.aamc.org/applying-medical-school/article/finding-health-care-related-volunteer-opportunitie/

v https://www.aamc.org/download/181690/data/guidelinesforstudentsprovidingpatientcare.pdf

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