Pre-Med :: Clinical Experience and Jobs – Part 1

Every Pre-Med student knows if they want to get into medical school, they should have some type of clinical experience on that nice padded resume of theirs.  But what type of clinic experience should one pursue?  So many choices are available – shadow doctors, EMT, nursing assistant, dietary, phlebotomy, volunteering, medical research, or others I’m probably forgetting or never even knew about.  

So what should you do? There’s a couple questions you should ask yourself.  What sounds interesting?  What type of person are you?  What are you looking for in a clinical experience?  Do you have any friends or family in the healthcare field?  Think about these questions as you continue on with this post.  

EMT (Emergency Medical Technician) – These are the people who work in the fire departments or ambulances and come to the rescue when you dial 911.  If you are considering becoming an EMT, first think about what kind of area you live in.  Are you in an urban area or out in the middle of nowhere?  In the city, being an EMT will be more like a part-time or full-time job.  Ambulance companies and fire stations are numerous and since I don’t have any knowledge in that area, you should probably ask someone some questions about whether or not it’s feasible to become an EMT in that area.  If you live in the rural country like me, then we’re always looking for EMTs.  Volunteer fire departments can never have too many EMTs hanging around.  This field is a great area to gain some clinical experience.  First off, it’s has a lot of autonomy.  When you’re the EMT out in the field and a person is hurt, you are the one calling the shots.  Should we stay and put in an IV and push drugs or should we load and go?  Also, you get to work with patients from all walks of life.  The young kid who fell and broke his leg riding his bike, the drunk 20-year-old in the bar fight, the middle age woman with chest pain, and the old lady who just isn’t feeling right, may all be calling you for that special care you provide.  What you see out in the field is raw and sometimes dangerous.  It’s an adrenaline rush and this job is not for the faint hearted, but it will definitely help you decide quick, do you like medicine? But this job is far from perfect.  Being an EMT requires taking at least a basic level class (about one semester long – if you take it full-time).  So if you want or need to get started right away, this is not the best route.  Also, EMTs are up all hours of the day.  In the bigger cities I imagine you work shifts, but on a volunteer service you could be on call for a few days or even a week at a time.  When you have something planned the next morning and a combative puking drunk fell at hit his head at 2am, it’s not fun but you have to get up and go.  

Pros: Great patient interaction, autonomy, work with all types of patients
Cons: Bad hours, class time required, not for the faint hearted

CNA (Certified Nursing Assistant) – Ever been in the hospital visiting a patient or been a patient yourself?  You should be familiar with the nursing aide then.  If you hit that call light, the person you see will most likely be the nursing aide.  Being a nursing aide is great.  First off, there is no 120 hour national standardized curriculum.  Usually, just a couple hour class or workshop can get you setup to become a nursing aide.  Most nursing homes will hire people with no previous clinical experience and train them.  Nursing aides help patients with the activities of daily living.  That’s a fancy way of saying that they do things for sick people.  Kind of like, if you stay home with a sick family member and help them out with their day.  That’s what being a nursing aide is like times 100.  The great thing about this job is the interaction with patients.  This is probably the best pre-med job to work for getting to know patients.  Nursing aides are the people who probably spend the most time with patients (and RNs).  There is plenty of time to learn people’s life stories, learn about their families, hobbies, worries, and everything else.  If you’re looking for relationships with patients (you know the kind of relationships I mean), then look no further than the nursing aide.  But being a nursing aide isn’t all rainbows and roses.  While they may have regular hours, nursing aides are the person that will be cleaning the vomit and the stool.  Also, as a nursing aide, you probably only work in a select area of the hospital or nursing home.  So, you’ll be seeing the same types of patients every day (unless you’re an aide in the ER or a float aide).  There is some autonomy with this job but it’s depends on where you work, and how nice your nurses are.  On the flip side, you do work a lot closer with different medical workers (RNs, Techs, even Docs).  

Pros: Best job for patient relationships, not much training required, work closely with other medical professionals
Cons: Cleaning puke and poop, pretty much the bottom of the totem pole, not much variety in patients

Phlebotomist (Lab Tech) – This is the special person in the hospital who is in charge of gathering blood samples.  No, not just going around and picking them up, but actually sticking needles in people to get their blood.  It’s not as bad as it sounds (unless you’re scared of needles).  This is a great job for the pre-med student.  First it introduces you to the types of labs doctors order.  Second, phlebotomists travel all around the hospital, so they see a variety of patients.  Some hospitals will train people with no previous experience (depending on how the phlebotomist job market is in your area).  If you are lucky enough to get trained by a hospital, in my case it only required one week of safety training on the computer and 2-3 weeks of hands on blood draw training.  This job is perfect for those who like a little technical element required out of their job.  But as you’ve seen so far, every job has it’s downside.  Phleb
otomists probably work the worst hours for any tech or aide in the hospital.  Shifts in my local hospitals started at 4am and went to noon.  The evening shifts go from noon to 8.  This really messes up your day.  Working a half day ahead or behind everyone else makes it extremely difficult to make any plans.  Also, patients hate you.  The love of the patient goes to the food service, the nursing aide, the RN, even the doctor.  But never the phlebotomist.  Imagine walking into someone’s room at 4am (after they probably had the worst sleep of their lives – hospitals are noisy), and saying “Good morning, I’m from the lab and need to get a blood sample. I’m going to flip on this bright light ok?”  How many patients do you think want to strangle you at the moment?  

Pros: Technically satisfying, variety of patients
Cons: Messed up hours, hated by patients

Shadowing Doctors – This is probably the worst choice for the pre-med student for clinical experience.  Now shadowing a doctor you know (or a friend knows), or a specialty that you have some interest in, a couple times is a good thing.  But if this is a majority of your clinical experience, I personally think that it’s not a good choice.  First off, you may see what the doctor does but you don’t have any reference on how or why they are doing it (unless you were previously another medical professional – RN, PT, etc).  Second, patients and staff act different around doctors (in most wards).  You will not get the full raw patient experience that you will be experiencing as a medical student, intern, or resident.  You will not have any autonomy (won’t learn to make your own choices about patient treatment), no relationship with the patients (you’re just a shadow after all), no responsibility, and it’s not really that fun just following around someone all day. To sum up, I recommend pre-med students shadow doctors but not as the primary means of clinical experience.  

Pros: Learn what a doctor does
Cons: No patient relationships, no autonomy, no responsibility, not a real clinical experience 

To be continued… [Part 2] and [Part 3]

Dreaming of the Clinic

Today after talking to a couple MS3s and an MS4, I started to get that feeling again.  I feel like I belong with patients, in the clinic, working.  Since the start of my clinical experience, just passing food trays to hospital patients, I knew I wanted to work in a hospital.  Through the years working as a certified nursing aid, a phlebotomist, and an EMT has helped me keep my eye on the prize and help me stay connected to patients.  With the older medical students talking about their day in the clinic and their future aspirations in certain specialties, I couldn’t help but long to be back on the wards.

Throughout my time in medical school, the school workload has only grown.  The only job I’ve had time for is taking call shifts as an EMT here in Vermillion.  But with licensing boards and finals lingering over me, and my certification about to lapse, I’ve had to slowly discontinue my volunteer work with the ambulance department.

This lack of patient interaction has made me miserable.  I feel like it is a part of who I am, as I’ve had some interaction with patients since I was 15 years old.  On the way to school today, I daydreamed that I would see an accident on the interstate.  Then I’d be able to stop and help out, even if that meant just holding someone’s C-spine until an ambulance arrived.  I felt like an EMT rookie again, wishing (yet at the same time not wishing) for an accident to happen.

I really can’t wait for third year.  I realize it’s not all exciting life-saving work, but the school work is bogging me down.  I feel unhappy, and the only thing getting me through the day is that in a few short months I will be in the clinics.  Sure, there will be a lot of waiting around, running small errands, standing in the corner, holding retractors, and doing redundant paper-work, but that sure beats sitting in class any day of the week in my opinion.

Well back to studying…