Why Premed Students Need Shadowing Experience for Medical School
Updated: May 17, 2022
Most premed students are familiar with shadowing as a common feature of the journey to medical school, alongside other activities like research or volunteering. However, many students wonder whether shadowing is truly mandatory. One of these students, Rafael, told us recently:
“I’ve heard mixed things about shadowing. Some people say it's something you have to do, while others say it's suggested but not required.”
What is physician shadowing?
Physician shadowing involves observing physicians in action as they provide care and treatment to patients.
How important is physician shadowing to medical schools?
Answer: Shadowing is so important that some schools won't consider you if you haven't shadowed in some way
The medical school at Loma Linda states that “applicants are required to obtain physician shadowing experience and direct patient care exposure to better inform their decision for a career in medicine.”
Let me emphasize here that schools are specifically seeking shadowing experience. Clinical research or clerical work in a physician's office does not count.
In fact, the University of Washington School of Medicine notes that “volunteering with patients conducting clinical research or working as an office assistant or insurance coordinator in an office are all great ways to develop a broader understanding of the field of medicine. However, they are not the same as shadowing.”
Can you get into medical school without shadowing?
For some schools, the answer is yes. One example is the University of Pittsburgh School of Medicine, where 78% of accepted applicants reported physician shadowing or clinical observation. Conversely, that means over 20% of accepted applicants did not report physician shadowing.
Having said that, I'm pretty sure that those who did not report physician shadowing were able to demonstrate an understanding of the medical profession through other activities.
While shadowing is not absolutely necessary, it will improve your chances at a broader range of medical schools
Shadowing may not be absolutely necessary, but it will maximize your chances of being seriously considered at a broad range of medical schools. Remember that many schools will simply not consider your application if there is no evidence of shadowing. And it makes sense to appeal to as many medical schools as possible.
Keep in mind that even if a particular school doesn't have a blanket policy, certain members of the admissions committee may have very specific and sometimes very strong opinions about shadowing.
I've heard colleagues say, “This applicant hasn't shadowed. How would she know that this is the right profession for her?”
Shadowing experience on a resume:
Why medical schools value it
At a basic level, applicants who make the decision to go to medical school should understand what the medical profession is all about and what it's like to be a doctor. Schools are looking for applicants who have made an informed decision.
One way to show schools that you have explored (and gained an understanding of) the profession is by shadowing physicians.
Since you'll be including it on your medical school application, it's important to track all of your different shadowing experiences as well as the hours spent with each experience.
How many hours should you spend shadowing?
As you might expect, the number of hours required or recommended varies from school to school.
The University of Washington School of Medicine recommends that applicants shadow for at least 40 hours.
The University of Utah states that competitive applicants will have shadowed a variety of physicians for at least 24 hours.
Please note that these are minimum requirements.
In fact, some applicants will accrue well over 100 hours of shadowing experience.
I've encountered applicants with over 200 or even 300 hours of shadowing experience.
Note that many schools will indicate that shadowing is important, but leave it up to the applicant to decide how much time to spend.
Per the words of the Morehouse School of Medicine:
“It is imperative that applicants have the experience of shadowing a physician. There is no set designation of time, but having a good understanding of the roles and responsibilities of a physician is extremely important.”
Note the last part of that statement from Morehouse: a good understanding of the roles and responsibilities of a physician is extremely important.
Medical schools will be looking for evidence of that in your application-- and shadowing is an important way to demonstrate that.
How to describe shadowing experience
During the application process, you'll be asked to describe your shadowing experience.
You will have to describe the clinical setting, the physician, and the hours spent
In essays and interviews, you may also be asked to describe the impact of this experience. How did this experience impact you?
How did your shadowing experience influence you?
What can you learn from shadowing? You can learn about multiple areas related to the practice of medicine, including...
The varied concerns that bring patients to the office or hospital, and how physicians respond to them
The ways in which physicians establish rapport with patients during difficult times in their lives
The importance of knowledge and problem-solving in medical practice
The importance of noncognitive qualities such as warmth, compassion, respect, and empathy in quality medical care
The stories and health journeys of the many different patients that you encounter while shadowing
Medical school applications and interviews will often ask you about your shadowing experiences. Specifically, how did the experience impact you? It's important to be reflect upon and be able to describe the impact of the experience on you and on your understanding of medicine.
As you consider shadowing a physician, it's always important to consider the patient perspective
We had a patient reach out to us with an important comment after reading one of our posts. She commented that shadowing has effects on patients, and we as physicians and future physicians need to consider that.
As a student who is shadowing, you may have no pre-existing relationship with a patient--but you may then be present when a patient receives a challenging diagnosis. There may also be concerns on the part of patients with providing a full and transparent medical history when others are present.
As you shadow physicians, you will notice that they or their staff will first ask patients for their permission to have a shadowing student in the room during the encounter. (And if they do not first ask permission, recognize that this represents a gap in proper patient care.) Some (or many) patients will decline, and as a student it's important to respect and understand this issue from the patient perspective.
Sometimes, you'll be witness to amazing experiences
You may see a patient with colon cancer who credits the physician with saving his life, because the cancer was caught early.
You may see a patient who suffered a stroke but made a full recovery thanks to life-saving clot-busting therapy.
These are incredible moments and reminders of the impact that physicians have on the lives of patients and their families.
As uplifting as those moments are, there will be times when the prognosis is poor
You may see a patient whose cancer has returned. You may see a diabetic patient who is losing his vision.
These are difficult conversations for both patients and physicians. Sometimes these conversations are filled with intense emotions, and you'll be able to see how doctors handle these situations.
You'll see the many responsibilities of a physician, and quickly realize that high quality care is not a solo effort
Shadowing should allow you to see what happens before and after the patient encounter so that you can develop a fuller understanding of the provision of healthcare.
Collaboration and cooperation are essential in the physician's daily work, and you'll observe the way physicians must rely on a team of other healthcare professionals to be effective.
What if you can’t find shadowing opportunities in the specialty you’re interested in?
This is a common question. For example, if you’re interested in surgery, you might have a hard time finding opportunities to actually shadow in the operating room.
In general, I recommend that you not worry too much about a particular specialty if you’re not able to locate those opportunities.
Certainly, if you’re interested in pediatrics and you’re able to find an opportunity to shadow in that specialty, that’s wonderful, because it will provide a good look at what the day of a pediatrician looks like.
However, if the only shadowing opportunity you’re able to locate is within family practice, that’s fine.
Medical schools don't expect that premed students will have decided on their field this early in their medical career. In fact, we recommend against a firm decision on your medical career this early on since you just haven’t been exposed to enough fields.
The most important thing about shadowing experiences is not the specialty, but that you have participated in them.
Does shadowing really give you that understanding of the roles and responsibilities of a physician?
For many students, the answer is yes.
To give you an idea of how enlightening shadowing experiences can be, let me share with you the results of a study of premedical students. These were students who completed surveys before and after their shadowing experiences.
Before the experience, only 46% agreed with the following statement: “I understand how physicians interact with patients in clinical settings.”
After the experience, 85% agreed with that statement.
Before the experience, only 33% agreed with the following statement: “I am familiar with what a physician does to fulfill his or her responsibilities.”
After the experience, 70% agreed with that statement.
Finally, I would like to leave you with the words of Ashley Peterson, a student at the Philadelphia College of Osteopathic Medicine who had this to say about her shadowing experience.
“Shadowing helped me see how adaptive physicians are. The physicians I followed chose well-researched diagnosis plans for their patients, worked well within a team, and were health care leaders. From watching these doctors, I began to understand which skills I needed to develop before applying to medical school. I learned more about medicine and being a physician from 100 hours of shadowing than years of researching what a doctor does.”
That's the type of experience I hope you have while shadowing.
Now that you have a better understanding of the importance of physician shadowing, how do you go about identifying and arranging such experiences?
It can be challenging to locate and secure shadowing opportunities. That's why we've written and spoken about this topic.
If you'd like to learn our 7 expert strategies for locating shadowing opportunities please see this post.
If you’d prefer to listen, here's our podcast episode on this topic.
Dr. Rajani Katta is the creator of Medical School Interviewing 101, the course that teaches students how to ace their interviews. She is also the author of the Multiple Mini Interview: Winning Strategies from Admissions Faculty, the Casper Test Prep Guide, and The Medical School Interview. Dr. Katta is a practicing dermatologist and served as a Professor of Dermatology at the Baylor College of Medicine for over 17 years.
Dr. Samir Desai is the author of The Clinician's Guide to Laboratory Medicine, The Medical School Interview, and Multiple Mini Interview: Winning Strategies from Admissions Faculty. He is an Internist, on faculty at the Baylor College of Medicine, and has served on the medical school admissions and residency selection committees at the Baylor College of Medicine and Northwestern University Feinberg School of Medicine.