Pre-medical Access to Clinical Experience (PACE)

Pre-medical students sometimes lack clinical training that allows them patient contact medical experiences. In contrast, other pre-health care students (i.e. nursing students) complete many clinical rotations during undergraduate studies. Pre-medical students should ha e opportunities to gain similar experience. !"#ecti e$ %his guide pro ides pre-medical students with methods to access training, #o"s and programs that allow growth in clinical health care experience. %his resource, in turn, is meant to narrow pre-medical students& career goals, create competiti e applicants, and 'acilitate a success'ul medical experience 'or 'uture medical students and their patients. Admissions directors re eal what they&re really looking 'or ( Appendix A )i''erent paths to similar opportunities ("elow) In order to 'ind the most direct and economical path to your desired experience, research opportunities a aila"le to you at a local and national le el$ hospitals medical schools certi'ications internships

HOSPITALS *ospitals may o''er training programs, such as technician or assistant trainings, which would integrate trainees right into that hospital&s system. )epending on the si+e and policies o' local hospitals, patient care technician (PC%), itals or similar trainings may "e o''ered on the #o". ,earch #o" openings and their -uali'ications on hospital we"sites. I' you mention that you are a pre-medical student, many hospital employees will "e more willing to 'oster clinical growth. .ote that smaller hospitals with more o' a sta''ing shortage may o''er more on-the-#o" training and opportunities 'or growth. And although teaching hospitals o'ten ha e more health care pro'essionals and may want to see a certi'ication "e'ore hiring a pre-med student into a clinical position, the teaching atmosphere o' the hospital is meant to 'oster growth in health care pro'essions and that mindset will likely carry o er to your super isors& management techni-ues. /ut don&t 'orget to network with co-workers, and e en peers, "uilding trust that will lead to more experience. *ospitals may also "e looking 'or participants in medical studies at their 'acilities. %hese studies are o'ten looking 'or healthy young adults o' all kinds and pay participants potentially large amounts o' money. /ut most importantly, participation allows clinical and research o"ser ation and 'irst hand experience0a good way to learn patient empathy. 1our campus pre-med ad ising department may ha e their own physician-shadowing olunteer or internship programs. !'ten hospitals will ha e separate olunteer ser ices or physician mentoring programs (i.e. appointment "uddy). Either one o' these programs usually allow participants to work their way up to positions with more clinical, medical and patient-contact

opportunities. !therwise, use the Internet to search 'or specialty organi+ations (i.e. American Academy o' Pediatrics), to 'ind a physician who may "e interested in supporting a pre-medical shadow. 2emem"er that you will only get as much out o' the shadowing or olunteer program as you put in. I' you 'urther research what you discuss with your physician mentor or super isors, you are more likely to gain their respect and trust. Although hospital experience is important, do not discount local clinics or practices as potential sites to gain more personal attention and understand a di''erent atmosphere o' medicine. 3or instance, i' you are interested in eating disorders or pediatric nutrition, try to 'ind a clinic 'ocused on treating patients with anorexia or "ulimia, or 'ind a local 4omen, In'ants, Children (4IC) go ernment nutrition program, respecti ely. 5ost importantly, don&t "e a'raid to call, e-mail or use campus and peer connections to get in touch with local hospitals or health care 'acilities. MEDICAL SCHOOLS 5any medical schools create pre-medical programs to support local students interested in pursuing a career in medicine. 3or instance, 6ni ersity o' 7ansas ,chool o' 5edicine o''ers a pre-medical student primary care workshop, and 6ni ersity o' Connecticut ,chool o' 5edicine is piloting a program teaching students the "asics o' taking a medical history. Also, consider contacting medical students or schools to 'ind medical student mentors who might "e willing to connect you with medical school or clinical opportunities. CERTIFICATIONS 2e iew the Certi'ications )ata"ase that lists applications and possi"le training organi+ations 'or many short-term certi'ications a aila"le to pre-medical students. 7eep in mind that these certi'ications, although sometimes expensi e, make it more likely to 'ind a position that will pay you to gain medical or clinical experience.
.ote that the list o' certi'ications does not include in'ormation a"out pricing and training locations "ecause they ary so much 'rom state to state. %he gi en certi'ication descriptions and their utility may ary as well. Certification Ad anced Cardio ascular 8i'e ,upport (AC8,) AE) Assistant Certi'ied .ursing Assistant Utility expansion on /C8,, designed to address adult cardiopulmonary emergencies re-uired 'or almost all clinical health care positions "ut is sometimes included in more ad anced certi'ication programs possi"le assistant certi'ications$ ser ice monitoring, dental, eterinary allows growth in many units as a Patient Care %echnician (PC%), .urse9s Assistant or )irect Care ,ta''er /C8, le el re-uired 'or almost all clinical health care positions "ut is sometimes included in more ad anced certi'ication programs

CP2

Emergency 5edical %echnician (E5%) 3irst Aid 5edication Administration programs 5assage %herapy Phle"otomy

%echnician

usually allows participation in community health promoting, am"ulatory ser ice, E2 units ( aries "y state) re-uired 'or almost all clinical health care positions "ut is sometimes included in more ad anced certi'ication programs allows medication administration and assistance among people who are not capa"le o' administering their own medications hospital massage therapist drawing "lood possi"le technician certi'ications$ "one density, cardiac, anesthesiology:critical care, operating room, pharmacy, x-ray, nedical la"oratory

Certification location options$ American 2ed Cross, American *eart Association, uni ersities:colleges, career schools, hospitals i.e. American *eart Association course options i.e. American 2ed Cross course options (search also local 2ed Cross course o''erings)

I' you are looking 'or osteopathic training, your "est resource is your own local osteopathic school. ;isit American Association o' Colleges o' !steopathic 5edicine (http$::www.aacom.org:Pages:de'ault.aspx ) 'or a list o' osteopathic schools and 'urther osteopathic in'ormation. Additionally, "y third and 'ourth year medical school rotations, a student with phle"otomy training and general clinical experience will ha e less trou"le integrating into clinical settings (i.e. working with I;s, drawing "lood) and will "e more use'ul, and perhaps more impressi e, to hospital sta'' and patients compared to a person who has only read a"out phle"otomy in text"ooks. 4hen choosing a certi'ication, take into consideration what you want 'rom the experience. I' you want opportunity 'or growth, choosing Certi'ied .ursing Assistant can lead to on-the-#o" mentoring and "asic medical techni-ue training (i.e. phle"otomy and E7<), especially when your superiors know you are a pre-medical student. Phle"otomy training, on the other hand, can "e somewhat more restricti e in terms o' intra-hospital #o" mo ement. In contrast, i' you are interested in a speci'ic area o' health care, choose a technician position 'or that hospital unit, which o'ten allows 'or on-the-#o" training. Also 'eel 'ree to call a local hospital to ask i' they need a technician in your unit o' interest, e en i' the position is not listed. .ote that the list o' certi'ications does not include in'ormation a"out pricing and training locations "ecause they ary so much 'rom state to state. %he gi en certi'ication descriptions and their utility may ary as well. Check out the 'ollowing we"sites 'or more in'ormation on certi'ications and #o" opportunities, or search 'or allied health pro'essions in'ormation$ Explore*ealthCareers.org http$::www.explorehealthcareers.org:en:3ield.=.aspx

American 5edical Association (A5A) *ealth Pro'essions http$::www.ama-assn.org:ama:pu":category:=>?@A.html

INTERNSHIPS In general, contact any local organi+ations whose mission may "e o' interest to you and consider taking a 'ull time, or at least part time, position at their 'acility in order to gain more experience (perhaps take a semester o'' and take classes during the summer i' the position is normally much more competiti e during the summer). 3acilities to consider include nutrition centers, hospitals, research centers, go ernment:non-go ernmental organi+ations (.<!s), la"s or insurance companies. ,et goals with your super isor 'or what you would like to accomplish and learn. 5ost importantly, "e sure to 'ind a super isor who will encourage growth in the medical 'ield. 4ashington, ).C. is a great place to 'ind internships with the )epartment o' *ealth and *uman ,er ices and the )epartment o' Pu"lic *ealth, and many other go ernment and nongo ernment organi+ations that may 'it your medical and research interests. A5,A, with its main o''ice located #ust outside the 4ashington, ).C. area, o''ers internships 'or medical and premedical students interested in areas o' medicine such as health policy, community and pu"lic health, glo"al health and student li'e. Also, some study and:or olunteer a"road programs, short or long term, o''er clinical or shadowing experiences 'or pre-medical students. 6ndergraduate students, especially those with any kind o' clinical experience already, can sometimes take part in more medical and clinical experiences a"road than in the 6.,. Check out these examples o' shadowing and international programs$ International 3ederation o' 5edical ,tudent Associations& (I35,A http$::www.i'msa.org: ) or ECE8A (http$::www.ecela.com:ser icesBmedical.php ), a ,panish school "ased in ,outh American, or consult your campus international or community ser ice opportunities o''ices. Also, do not discount research opportunities. %hey can in ol e clinical and medical exposure and open up pu"lication opportunities.

Acknowledgements American *eart Association American 2ed Cross A5,A national leadership )eirdre Cordan, Assistant Cooperati e Education Coordinator, /ou e College o' *ealth ,ciences 7athy /arrow, 5.). 6ni ersity o' Ari+ona College o' 5edicine 6ni ersity o' Connecticut ,chool o' 5edicine 6ni ersity o' 7ansas ,chool o' 5edicine 6ni ersity o' 5iami 5iller ,chool o' 5edicine

%he !hio ,tate 6ni ersity 5edical Center 6ni ersity o' ;irginia ,chool o' 5edicine 6ni ersity o' 4ashington ,chool o' 5edicine 6ni ersity o' 4isconsin ,chool o' 5edicine and Pu"lic *ealth 4est ;irginia ,chool o' 5edicine

Appendix A$

The Scoop fro

the A! issions Directors$

5edical school admissions directors across the 6.,. ad ise what experiences will make your application stand out.
.ote$ %he 'ollowing three experiences are highlighted consistently "y admissions directors across the country as "ene'icial on medical school applications$ Physician shadowing, or experience that re'lects your knowledge o' a physician&s li'estyle Patient contact, especially with underser ed populations <rowth in clinical knowledge /elow are -uotes 'rom medical school admissions directors, re ealing what they look 'or in premedical clinical experience. BBBBB D!ur goal is to select the most capa"le students to attend our medical school and to ha e a "alance!# "$t hetero%eneo$s %ro$p that &ill e'cel in "oth the art an! science of e!icine. 4e recogni+e that a di erse student "ody promotes an atmosphere o' creati ity, experimentation and discussion that is conduci e to learning. Exposure to a ariety o' perspecti es and experiences prepares students to care 'or patients 'rom all walks o' li'e and 'rom e ery segment o' society. Physician ,hadowing ( Applicants should spend enough time with a physician(s) to understand the challenges, demands and li'estyle o' a doctor. ,hadowing a physician o' any specialty through all the acti ities o' an a erage day o er a period o' time will help de elop your knowledge o' the medical 'ield. Patient Exposure ( It is important that the applicant "e com'orta"le working with and around people who are ill. %he patient exposure experience can "e gained in a ariety o' ways. 5any applicants olunteer or work in hospitals, emergency rooms, homeless clinics or extended care 'acilities and are acti ely in ol ed in patient contact. 8eadership A"ility ( De!ication# !eter ination# a"ility to a(e !ecisions an! a &illin%ness to contri"$te to the &elfare of others are in!icators of one)s a"ility to s$ccee! in e!icine. Indi iduals with these characteristics readily accept positions o' leadership and are an asset to their community and pro'ession. 8eadership capacity can "e demonstrated in a ariety o' ways such as positions in employment, church, community and school organi+ations including coaching, tutoring and mentoring.

Extracurricular Acti ities ( %he Admissions Committee is interested in ho& applicants !eal &ith the !e an!s of their li*es o$tsi!e of the classroo . %his is a strong indicator o' how well they handle responsi"ilities and deal with stress'ul situations. It also predicts how well they will handle the di''icult demands o' medical school. Community:;olunteer ,er ice ( %he medical pro'ession is strongly oriented to ser ice in the community. Applicants sho$l! !e onstrate a co it ent to the co $nity "y in*ol*in% the sel*es in ser*ice an! *ol$nteer acti*ities. 4ork per'ormed in ser ice learning courses and community ser ice per'ormed as part o' employment is a good starting point. 2esearch ( 2esearch is the 'oundation o' medical knowledge. 4e consider participation in research acti ities to "e an important part o' the preparation 'or medical school. Physicians depend on medical literature to remain current in their 'ields. 5ost physicians participate in research at some point in their careers. 2esearch experience may "e in any discipline and per'ormed at any site. Applicants sho$l! "e a"le to !escri"e their pro+ect# the ,$estions "ein% as(e! an! their role in the con!$ct of the research. 2esearch per'ormed as part o' a course re-uirement or a senior thesis pro#ect is accepta"le. 5ore research experience is expected o' 5):Ph) applicants.E FPresenting a Competitive Application, Preparing for Medical School at Ohio State, %he !hio ,tate 6ni ersity 5edical Center, recommended "y 8orna 7enyon, )irector, Admissions and 2ecords, %he !hio ,tate 6ni ersity College o' 5edicine BBBBB D%he 6ni ersity o' 4ashington ,chool o' 5edicine is always impressed "y applicants who ha e worked with under ser ed populations, 'or instance in a 'ree clinic.E FPatricia 3ero, )irector, !''ice o' Admissions, 6ni ersity o' 4ashington ,chool o' 5edicine BBBBB D%he 6ni ersity o' Ari+ona Admissions Committee re iews applicant 'iles 'or relati*e clinical e'perience that s$pport the o*erall %oal for a career in e!icine. I' students are interested in medical research, the Committee re iews the 'iles 'or relati e research experience. Clinical experiences that stand are ones with direct patient contact. 3or example, Clinica Amistad ser es uninsured and disad antaged clients and clinical exposure is pro ided through patient assessment, medical procedures, and counseling. The Co ittee re*ie&s for len%th of ser*ice an! ti e co itte! to the e'perience. %hrough our pre-health o''ice, e erything 'rom counseling to we"-"ased courses to clinical experience re'errals are a aila"le.E F%anisha .. Cohnson, 5.Ed., )irector o' Admissions, 6ni ersity o' Ari+ona College o' 5edicine BBBBB D,ince &e loo( to accept a !i*erse class into e!ical school# the a! issions co ittee *al$es any !ifferent e'periences- Health care e'periences# co $nity ser*ice# an! research are the top three areas of interest. %hey speak to the heart o' what it means to "e a doctor. *owe er, the committee also alues leadership, scholarship, international experiences, #ournalism, li"eral arts, and athletics (to name a 'ew). 6sually committee mem"ers place more importance on ,$ality o*er ,$antity. 4e ask oursel es, what does the experience actually tell

us a"out the candidateG 3or example, sha!o&in% !octors for a fe& ho$rs a &ee( o*er the co$rse of a year is note!# "$t !oesn)t carry a lot of &ei%ht- It really !oesn)t say $ch a"o$t the st$!ent- Participatin% in a e!ical ission to Haiti for t&o &ee(s i%ht "e ore fa*ora"ly recei*e! an! &o$l! say ore a"o$t the can!i!ate an! his . her co passion for others- Creatin% an or%ani/ation that raises oney an! sponsors international e!ical issions to Haiti# an! or%ani/in% an! participatin% in se*eral issions &o$l! "e consi!ere! a 0ho e r$n-1 Not only &o$l! it !e onstrate co passion# "$t also a host of other o$tstan!in% ,$alities# incl$!in% co it ent# lea!ership an! or%ani/ational s(ills. !ur undergraduate school has special programs a aila"le to pre-med students who wish to participate in clinical and research acti ities. %he medical school o''ers se eral mentoring programs 'or pre-medical students, including an am"itious program run "y one o' our medical student organi+ations, the 655,5 Academic ,ocieties. 4e also ha e an !''ice o' Pro'essional )e elopment and Career <uidance that helps pre-medical students 'ind intra- and extramural research opportunities.E F2o"ert *ernande+, 5.)., ,enior Associate )ean 'or 5edical ,tudent Administration, 6ni ersity o' 5iami 5iller ,chool o' 5edicine BBBBB DI think the "est e'pos$re that pre2 e!s can %et in ter s of han!s2on trainin% is si ilar to that for &hich &e $se o$r e!ical assistants- 3y this I ean !oin% patient inta(es &ith "loo! press$res# e!ications.aller%ies# "rief histories# an! assistance &ith settin% $p tests an! fee!"ac( calls "et&een *isits. !" iously, attaining skills use'ul to an urgent care setting or E) would also "e ery important, and we put a lot o' stock in those candidates who ha e had E5% certi'ication. A patient contact experience I rate highly is assa%e therapy. ,tudents ha e direct contact with the patient, help assess their pain needs, and some anatomy thrown in. I also 'eel interpretation ser ices gi es direct patient interaction and exposure to clinical medicine. O$r co ittee# an! the e!ical school# !oesn4t ta(e an isolate! ite "$t rather loo(s at the "o!y of acti*ities$ I' the applicant is in "and:athletics, s:he might not ha e as much time 'or research I' the applicant does research, "asic or clinical, they may not ha e as much clinical medical exposure. I' the applicant has to work to support him:her sel', that may limit other acti ities. ,ome medical exposure is important "ut that can take many 'orms0one demonstration o' altruism or compassion. <et to know someone, a pro'essor:mentor, etc., that can write a really good letter. Is drawing "lood HIx a day 'or whate er time a "etter prere-uisite 'or a career in medicine than working in a homeless shelter or waitressingG %his aspect o' medical school admissions is up 'or de"ate.E Fresponses compiled "y 8ucy 4all, Assistant )ean 'or Admissions, 6ni ersity o' 4isconsin ,chool o' 5edicine and Pu"lic *ealth BBBBB D4e o''er a college 'ellowship program that pro ides each student with some shadowing

experience. 4e are piloting a mini course designed to introduce students to taking the history.E F7eat ,an'ord, 6ni ersity o' Connecticut ,chool o' 5edicine BBBBB

e!ical

D!ur Committee does look to see whether applicants ha e demonstrated experience and exposure to the clinical practice o' medicine (hospital olunteer work, shadowing physicians, etc.), and aside 'rom any "ene'it to one9s application, we think it ad isa"le 'or applicants to ha e clinical experience as a means o' determining whether the medical pro'ession is indeed their ocation o' choice. 4e seek di ersity in our matriculating class each year, and part o' that is enrolling a class with a wide ariety o' experiences. 4e seek to gi e credit 'or the myriad accomplishments one may ha e$ clinical experience and exposure can "e accomplished in a ariety o' ways, such as "y shadowing physicians, olunteering in hospitals, emergency rooms or clinics, or "y E5% olunteer work. 4e do, howe er, tend to place the highest alue on experiences in which the student was a"le to work directly with a physician or physicians.E F8esley 8. %homas, C.)., )irector o' Admissions, 6ni ersity o' ;irginia ,chool o' 5edicine BBBBB D4e particularly like a *ariety of physician sha!o&in% e'periences and anything hands on that has to deal with patients. 5e are not a "i% research school# so altho$%h research is *al$e!# &e appreciate clinical e'periences $ch ore (unless someone is going into the 5)-Ph) program). Also, as a personal opinion, those who ha e had paying #o"s ser ing the pu"lic (such as camp counseling or wait sta'' in restaurants) seem to ha e an edge "ecause they ha e learned "etter how to communicate and deal with people. People &ho ha*e &or(e! in n$rsin% ho es or on oncolo%y &ar!s are $s$ally ,$ite i pressi*e in "ein% a"le to artic$late their e'periences. E5% and si ilar certifications are nice 2 "$t only if they ha*e act$ally $se! it. It allows some more physician and acute care experiences.E F<. Anne Cather, 5), Associate )ean o' ,tudent ,er ices and Pro'essional )e elopment, Pro'essor o' 3amily 5edicine, 4est ;irginia ,chool o' 5edicine