Clinical Disconnect: Why Are Pre-Health Students Struggling?

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PMY 552: Clinical Disconnect: Why Are Pre-Health Students Struggling?

Session 552

Today, we speak with Dr. Deborah Gutman and R.T. Arnold about the struggle premeds have with finding clinical experience.

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

Deb and R.T.’s Backgrounds

Deb Gutman is a physician who realized she wanted to be a doctor after working as an EMT during college. She went to Brown University and worked as an EMT there, which helped seal her decision to become an emergency physician.

R.T. Arnold is the founder and CEO of CAPYear, a company that supports pre-health students in finding gap year opportunities to gain clinical experience. He did not have a clinical background himself but was inspired to start CAPYear after talking to his wife, who is a vascular surgeon. Realizing there was a disconnect between pre-health students seeking clinical experience and healthcare employers looking to fill entry-level positions, he founded CAPYear.

Barriers Between Students and Clinical Opportunities

Recognizing Transferable Skills and Overcoming Resume Limitations

Deb highlights the existence of several barriers that hinder the connection between pre-health students seeking clinical experience and healthcare employers offering entry-level positions.

One prominent challenge is that human resources departments at larger healthcare systems often fail to recognize the valuable transferable skills possessed by students who may not have formal clinical experience on their resumes. This oversight can lead to missed opportunities for students with immense potential.

Reevaluating Certifications and Understanding Gap Years

Another barrier lies in job descriptions that frequently require specific certifications, which clinics find challenging to modify for individual candidates. This rigid requirement can exclude talented students who may not possess the exact certifications stated but possess a significant aptitude for the role. By reevaluating the necessity of certain certifications, clinics can open doors for students to gain valuable clinical experience.

“There is a little bit of a barrier with certification and hospital-wide system saying they require certification.”

Moreover, clinics exhibit hesitancy in investing substantial training time into students who may only be available for a short period. They perceive gap years as lasting only a few months. This misconception about the duration and purpose of gap years contributes to a general lack of understanding among employers. A deeper appreciation of what a gap year entails and the potential timeframe availability of students can help bridge this disconnect.

Overall, these barriers have created significant challenges for students in their search for clinical opportunities. And those have hindered clinics from recognizing pre-health students as viable candidates.

Reasons Students are Choosing Gap Years

There are several factors contributing to more students electing to take gap years between undergraduate studies and medical or PA school.

R.T. emphasized that a gap year is not mandatory to get into medical or PA school, though it is becoming more common. Some students simply want to slow the pace after years of continuous schooling. Many want to slow down their timeline in order to fully concentrate on completing prerequisite courses and gaining diverse clinical experiences.

The COVID-19 pandemic significantly impacted students’ ability to gain clinical experiences unless they had an employee role. This tipped more students toward taking a gap year.

Some students utilize a gap year to improve their grades if their GPA did not initially meet medical or PA program standards. Additionally, gap years allow time to explore different interests temporarily before fully committing to an expensive degree program in healthcare.

“Medicine has changed substantially over the last 10 years in terms of the team in terms of whether you’re an independent employee, or you’re working for a hospital.”

Maximizing Your Gap Years

When considering how to fill a gap year, R.T. recommends clinical positions over other options. This allows students to gain exposure to physicians and patients to help determine their career path. However, he notes there are also other valid reasons for a gap year like improving grades or pursuing different interests temporarily. Ultimately, he encourages students to thoroughly explore their options before committing to an expensive medical or PA school program.

Many employers don’t realize gap years can last 18-24 months for application timing purposes. Conveying the accurate length of availability is important to convince them to invest in training. Six weeks to three months is typically how long it takes to fully train a student with no prior clinical experience. Employers need advocates willing to provide that training.

Finally, part-time clinical work in the spring/summer before matriculation can help students secure full-time jobs starting in the gap year and get initial onboarding out of the way.

Ways to Get Clinical Experiences

There are several common avenues that pre-health students pursue to gain their initial clinical experiences. Working as an Emergency Medical Technician (EMT) through college ambulance services, as Deb did, is a popular option as it provides direct patient care experience.

Other certification opportunities involve becoming a Certified Nursing Assistant (CNA) under the supervision of nurses or a Medical Assistant typically working with physicians and PAs in outpatient settings.

For students seeking experience but lacking certification, volunteering in clinical environments is also an option. A newer role mentioned was Community Health Workers, which focuses on assisting patients with social needs. Deb emphasized that certification in one area like CNA should not preclude applying to medical assistant roles, as the skills overlap between the positions.

Experience as an EMT also demonstrates transferable clinical skills. Overall, any safe, supervised opportunity through paid employment, certification programs, or volunteering can help pre-health students start gaining the clinical exposure required for medical or PA school admissions.

The Importance of Professionalism for Students with Weak Clinical Experiences

One of the biggest mistakes a student can make that would prevent them from getting a clinical job is a lack of demonstrated professionalism, even if they have weak clinical experiences on their resume.

Many employers are willing to train students without experience. But they want employees who will treat the role seriously and deliver a positive experience for patients, not just view it as “just a job.” Students need to convey their excitement for the opportunity through their interview answers and follow-through.

Simply focusing on certification alone is not enough. Students should seek out roles like resident advising or campus leadership to build skills in communication, responsibility and representing an organization professionally to complement their academic qualifications.

Balancing Professional Commitment and Employee Rights in Healthcare Careers

Deb agrees that working in healthcare requires more than just viewing it as “a job.” Caring for patients’ health and lives demands a level of commitment beyond simply punching a clock. She acknowledges the challenges of the current healthcare structure where most physicians are employees rather than independent practitioners. She respects that younger generations are pushing back on being indoctrinated to work tirelessly for low pay during training.

Setting boundaries as employees is important. At the same time, no matter the work environment, directly caring for patients necessitates putting their needs above just receiving a paycheck. The depth of knowledge and responsibility required of clinical roles means one cannot engage in them half-heartedly.

“If you’re caring for patients, you have to be in it for more than the paycheck.”

Deb supports future physicians thinking critically about balancing a professional identity and independence within employment. Prior generations may not have advocated for themselves sufficiently in that regard. But delivering compassionate, competent care will always demand more than minimal effort.

Consequences of Unprofessionalism for Medical Assistants and Pre-Health Students

R.T. notes there could be negative ramifications at both the patient and workplace level if a medical assistant or pre-health student fails to demonstrate professionalism.

From a patient perspective, lacking professionalism in interactions and care delivery could create a poor overall experience when people are already anxious and unwell. 

Clinicians want team members who are as dedicated to patient care as themselves. At the workplace, unprofessional conduct could lead to being fired since medical assistants are on the frontlines of first impressions and a large part of the care team experience.

Not treating the role seriously or with respect for patients could damage the reputation of the practice among clients. It is important for career aspirants to understand how their conduct impacts both individual health outcomes and team/office dynamics from the start of clinical roles.

How CAPYear Can Help You During Your Gap Years

CAPYear is an organization that supports pre-health students in finding gap year opportunities to gain clinical experience and bolster their medical or PA school applications. It operates an online job board where students can search and apply for clinical positions like medical assistant roles that are appropriate for gap year experience.

CAPYear does not directly hire students but helps connect them with healthcare employers. Students are employees of the facilities, not CAPYear. It works to establish relationships with engaged employers who are prepared to hire students through CAPYear rather than traditional application methods.

CAPYear provides students with educational resources on gap year planning, clinical job preparation, and application tips based on employer perspectives. Using CAPYear’s job board and resources allows students access to opportunities that may be difficult to find through standard job searches or HR filters at large healthcare systems.

Final Words of Wisdom

For students struggling on their journey, Deb encourages keeping an open mind about different paths. She emphasizes that everyone’s route is unique – there is no single right way or linear path. If students follow their interests genuinely, they will gain experiences that strengthen their candidacy over time.

Deb reassures listeners that medical and PA schools understand life is not always straightforward. Most applicants’ journeys involve unexpected detours rather than a perfectly straight track.

Her final piece of advice is to pursue passions, trust the process, and remember comparable candidates are accepted from diverse backgrounds every year. With dedication and flexibility, students’ interests will guide them where they need to go.


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