Do I Apply Earlier or Gain Clinical Experience?

Session 297

Today’s nontrad has some shadowing hours but little-to-no clinical experience. Are they better off waiting a year to gain that experience?

Questions answered here on the podcast are taken directly from the Nontrad Premed Forum over at premedforums.com. Please go ahead and register for an account, ask your question, and have fun with the community.

Also, please be sure to check out all our other podcasts on Meded Media as we try to bring you as many resources as you need on this journey.

Listen to this podcast episode with the player above, or keep reading for the highlights and takeaway points.

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[02:32] OldPreMeds Question of the Week

“I am planning to apply this next cycle and am a nontrad premed. I have ten years of working in my formal career in business accounting, several years before that in the restaurant industry, and a variety of volunteer activities, caregiving activities, shadowing hours, etc.

The one thing I am lacking is direct clinical experience. I live in a somewhat rural area where COVID is still not well controlled. I feel lucky to have gotten shadowing hours even. A lot of the volunteer activities I do are related to health care – ICU volunteering, hospice volunteering, but are non-patient-facing.

I realize that clinical experience is very important and I have tried to get direct clinical experience but it simply has not worked out based on my schedule and demographics. I work a 9-5 M-F and am not in a position financially to quit my job. The whole goal has been to prepare financially for med school so I am able to quit my job at that point.

I’ve looked into patient-facing hospice, phlebotomy, scribing, medical assisting, volunteer EMT, care companions, etc. The sense I get is that it is too much liability for companies to have volunteers be patient-facing given the pandemic. But if they were to employ you, they expect 20 hours +/wk and that simply doesn’t fit into my schedule.

However, despite all this, I feel like I have gained a strong understanding of what clinical work would be like, and have a desire for it. In part, I believe this comes with being a non-trad student and being in the workforce for several years.

Non-Client Facing Roles

I’ve spent significant time working at a desk in non-client-facing roles – I know I really dislike this. I’ve also spent significant time in fast-paced work where I am on my feet and working with customers (some of whom are unhappy) and I really enjoyed this type of work.

Caregiving Experience

Furthermore, I have acted as a caregiver to multiple relatives and loved ones on a long-term basis and I was not turned off by this type of work and what it entailed. The most recent experience I have in this area was this past fall, taking care of my elderly grandmother for about a month on evenings and weekends. Otherwise, I am far removed from my other experiences. I have volunteered at many flu clinics, checking people in, answering their questions, etc. and I really liked this interaction.

Hospice Experience

My time with hospice, while not client-facing, has been so important. I have learned that while I not only like the type of work that would entail being a physician, I have recognized that issues of medicine and age and related ailments are something that is very important to me and I have a heart for.

Volunteer Work in the ICU

Lastly, my volunteer time in the ICU, while not client-facing, has me regularly interacting with the nurses and staff, and often comforting very distraught family members. And I realize that is another component of care that is significant.

While I am not in a role where I am checking in patients and taking their vitals and history each day, I feel like I understand what is involved with work in medicine based on my various experiences. And I want to be a part of all of it.

Lack of Actual Knowledge

The one thing I recognize I am lacking is the actual knowledge that would come with being in such a job – knowing acronyms, recognizing standard medications, etc. But medical school teaches you all of this. My shortcoming might simply be that I’m not starting on the same page as some of my peers, but I have confidence in myself that I will rise to the occasion.

So, all of that being said, do you think it is possible to express this to medical schools when I apply? Or do you think I will be shooting myself in the foot to apply without direct clinical experience?

The Edge of Nontrads

I do feel like there is knowledge and wisdom that comes with being a nontrad and being in the workforce that I know I didn’t have as a trad student. I simply wouldn’t have had the insight and experience to place myself in those roles mentally and know if I would like them or not. I would have had to go out and actually get a job in a clinic, because how was I to know if I really enjoyed working with people that might come in miserable because they feel really sick? I hadn’t worked much at all at that point and had very little experience or run-ins with unhappy people in a professional situation (just to give an example).

My other option is to wait a year to apply; I will be in a better position to quit my FT job by the fall of 2022 and could apply for a clinical position. But I’m also hesitant to do this because I recognize that time is not on my side – I want to maximize my time as a physician, and seeing as I am older, time is already not on my side.”

[08:35]

Ultimately, this question comes down to whether medical schools are going to believe this student knows what they’re getting themselves into.

The goal of clinical experience is to prove to yourself that you like clinical experience and that you like taking care of patients. And then you prove to the medical schools that you like it through your writing, your storytelling, your interviewing, etc. Have you done enough to prove to yourself that this is what you want?

Just because you don’t have direct clinical experience doesn’t mean you don’t know what it’s like and so you shouldn’t apply to medical school. But it’s a risk.

'One of the biggest reasons students don't get into medical school is a lack of clinical experience.'Click To Tweet

[10:09] Clinical Experience: Direct vs. Indirect?

The student puts it as direct clinical experience but I don’t separate direct and indirect, because clinical experience is direct. You’re interacting with patients.

Maybe a lot of the things the student is doing is clinical experience, but maybe they just don’t think it’s good enough. And so, they’re discounting it. Otherwise, find something else because your time is limited. There’s always somebody out there who will take you as a volunteer to do something. People are getting shadowing again as things are getting better.

Focus on the things that you know are an issue, and in this situation, the student’s issue is clinical experience.

[12:47] Should You Apply?

Unfortunately, that’s the ultimate question I can’t answer. At the end of the day, this student understands that if you apply to medical school without clinical experience, it will be hard to convince the medical schools that you have enough experience. It can be difficult to prove that you want to be a physician.

You have to be able to show your story in your personal statement and through your activities so that you understand what it’s like to be a physician and why you want to be one. Obviously, COVID has impacted everyone’s ability to get experiences. At least from March 2020 to where we’re at now, things are opening back up.

Caregiving is a clinical experience so that can go on the application. That may not be enough to help the medical schools understand the journey that you’ve been on.

At the end of the day, the only one who can answer “should I apply or should I not” is you. You can apply, knowing that your weakness is clinical experience. Then after you submit your application, you can cut back your hours with your full-time job. Then send updates to schools. Tell them what when you applied, your only clinical experience was caregiving then show them what you’ve been doing since applying in 2022. And if the update letters don’t work, you can apply again in 2023.

[15:26] Taking a Year Off

It doesn’t have to be an all or none. Obviously, time and money are a big part of this. It’s going to cost money to apply to medical school, knowing that your application probably is less strong, because of that lack of clinical experience. And if you’re okay applying in 2022, knowing that you may have to reapply in 2023, then go ahead.

In figuring out the right steps to take, think about what you’re comfortable with and what risk you are comfortable with.

Finally, I am very conservative when it comes to telling students, you’re good to apply. I would probably tell the student to take a year off and get clinical experience. I just believe in clinical experience that much.

Shadowing is also another big one. And so even if you’ve done shadowing in the beginning, make sure it’s recent. Ultimately, the answer only can come from you.

'Are you willing to apply with a less than perfect application, knowing that perfect applications typically don't exist anyway?'Click To Tweet

Finally, the lack of clinical experience usually comes through in how the student writes their reflection on their personal statement. And so, it’s easy for schools to reject applications knowing that the student doesn’t have enough experience to understand what they’re getting themselves into.