Clinical hours but no volunteering or shadowing?

[juiscurious]

I was wondering if it was okay to only have paid clinical hours? I’m a CNA and I work full time while also being full time pre-med in college so when i’m not working or going to class i’m studying/doing work which means I don’t have time to shadow or volunteer. Will this affect me when I apply?

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[juiscurious]

I’m also going on a medical brigade with global brigades to guatemala, so that’s unpaid. Do I need non clinical volunteer hours?

 

[LizzyM]

You don't need clinical volunteer hours and the medical brigade is not likely to impress adcoms (there are ethical issues involved in these types of short-term service projects).

You do need shadowing, but only 50 hours or so that you can spread over a year or more. If you are interested in medicine because of the aspect of helping people, some adcoms will want to see that you spend some of your free time (maybe a half day a month, about 50 hours/yr) helping people in your community using skills you already have.

Being a full-time student and a full-time employee (in a role that doesn't really allow studying while on the job as is the case with some desk jobs) is a tough row to hoe so you might want to think about ways that you can decrease your responsibilities on one side or the other... or figure on needing to take a gap year (or two) during which you might be working but not going to school so that you'd free up many hours for shadowing and volunteering.

 

[juiscurious]

Do you think I shouldn’t put the brigade when I apply? I didn’t know there was issues with it.

 

[candbgirl]

Do you think I shouldn’t put the brigade when I apply? I didn’t know there was issues with it.

You can search on here for lots of threads on this subject. It’s referred to as voluntourism. You need the nonclinical volunteering to be in the US focusing on the unserved/underserved. The brigade won’t help you but it’s up to you what you put on your application.

 

[cj_cregg]

Whether or not you have any nonclinical volunteering is another key piece of the answer to this question. I would shoot for a couple hundred hours of volunteering total, ideally working directly with underserved populations. You need adequate clinical experience and volunteering, those do not need to overlap.

Global health can be done well but is often not. I will say Global Brigades is a more commonly used organization and though not perfect, probably tends a bit more towards the ethical end of the spectrum in my limited knowledge about it (edit: I take this back after reading about what OP's responsibilities will entail lol, I was not aware they were having students do things they are not trained to do). But generally these types of trips do not impress me unless it is in the context of a well-documented interest in caring for the underserved and/or global health and done the right way.

Some things to think about before your trip: are you being educated on local culture, language, and health issues before you go? are you going to be doing things that you would also be allowed to do in the US, or are you being asked to do things outside the scope of what's reasonable for your level of training? Is there appropriate follow up care for these patients? Are you partnering with local organizations and care providers? are you taking away work opportunities from locals (e.g. building homes or schools when you could instead be paying local construction workers to do what will probably be a better quality job anyway)? is your group helping to support long-term development of healthcare resources in the communities you visit or just handing out baggies of tylenol and leaving? are you going to engage in advocacy and education based on your experience when you return home? An applicant who shows that they have really wrestled with these questions and are working towards a more ethical approach to global health can be impressive.

 

[juiscurious]

We’ll be doing teeth cleaning, eye exams, and ultrasounds ect. nothing really invasive but it will all be supervised by the health professionals there.

 

[cj_cregg]

Instead of guessing, 2016 survey of medical schools done by the AAMC can give clear guidance and warnings on the issue


Executive Summary of GSA Committee on Admissions Survey regarding Clinical Experiences

• Member schools expressed significant concern with regards to premedical students engaging in unsupervised clinical activities in international settings. In particular, 45- 50% of those schools completing the survey described applicant involvement in invasive procedures in international settings as either harmful to, or of no value to, their application. Examples of such invasive procedures include giving vaccinations, suturing an injury, pulling teeth, and delivering a baby. This concern of admissions officers persisted, albeit at lower levels (35-40% of respondents), when the students were supervised by a health professional while performing such invasive procedures in international settings

Not disagreeing with this obviously, but I would just add to be attentive to the bolded phrases - they're not saying all global health is bad, but global health experiences where the student is doing something outside of their normal scope of practice for their training level is definitely bad.

We’ll be doing teeth cleaning, eye exams, and ultrasounds ect. nothing really invasive but it will all be supervised by the health professionals there.

If the health professionals are supervising YOU doing those procedures, assuming you are not somebody who has worked/trained as a dental hygienist, ophthalmic technician, or ultrasound technician in the US - this is not okay. I would say it falls into the category described in the last sentence of the quote gonnif posted. Things that would be okay for you to do personally would be the same things you do in your work as a CNA, e.g. checking vitals, charting certain aspects of patient care, etc.

 

[Mr.Smile12]

We’ll be doing teeth cleaning, eye exams, and ultrasounds ect. nothing really invasive but it will all be supervised by the health professionals there.

DANGER! DANGER!

Teeth cleaning or prophylaxis is invasive and requires bona fide training. Ultrasound and Xray operation requires certification for it to be done properly. I'm sure even simple eye exams require some training.

You can do simple histories but no physicals. Show people how to brush and floss. Help people try on glasses that fit. Unless you have specific training, one should not touch patients.

Faculty have designated applicant files for denial or rejection if the candidates did what you said on these mission trips.

 

[cj_cregg]

And this is a problem of guilt by association, perception, and risk. If some of these programs have activities for the students that the med schools dislike then there becomes a negative perception About these programs overall. Add to this the already widespread perception many of these are Volunteer tourism, And overall the social programs are pretty widespread negative perception. Since applying to medical school is as much as push in the positive aspects of your record it is also reducing risk in that record. The overseas activity here Is wholly under the prospective applicants control and therefore the risk can be reduced by not participating in the activity.

Historically mission trips have been about building schools/churches, assisting in education, water and sewage projects, and similar. I Have in your blanket statement for my advisees: If an overseas volunteering trip has any health or medical activities, You should avoid those trips. Only people with qualifications, such as nurses, ER techs, And similar who are working in that capacity, either with a well-known group in the field, or an ad hoc group particularly for crisis aftermath (war zone, hurricane, floods) should be on those sorts of trips

I don't think you make an unreasonable point here by any means but there are adcoms/app reviewers (myself included) who disagree. I think global health activities CAN BE (rarely are, but can be) a useful part of an application under specific circumstances. For instance if an applicant has a history of service to Latino populations in the US, speaks Spanish, demonstrates an interest in public health and global health through coursework or advocacy, and then does a global health trip in Guatemala working with a reputable organization, alongside locals, not working outside the scope of their training (maybe just documenting vitals or filling out intake paperwork or walking patients station to station) - that is fine for me and can be an asset to their app. I absolutely acknowledge that this makes up a minority of applicants but that's why I don't give a blanket "don't do it."

I actually think the building schools/churches, assisting in education, water/sewage projects can sometimes be just as problematic as the medical missions. Surely there are qualified and more experienced construction workers in those regions, why are a bunch of untrained teenagers building a school for free that locals could do better and get paid for? Don't get me started on the ones where people go and play with traumatized, attachment-disordered kids at an orphanage for 5 days and then leave and never see them again lol.

 

[PuzzlesMD]

I’m also going on a medical brigade with global brigades to guatemala, so that’s unpaid. Do I need non clinical volunteer hours?

can you get a refund? $1200+ could go along way towards application costs. Heck, buy supplies and setup a food drive with that money; buy and distribute supplies for the homeless population in your area; pay for a reviewer to look over every single secondary essay; etc.

 

[cj_cregg]

I think the reason I harp on this, as well as other points in the process, is the psychologically of premeds, which I find almost bipolar. On one hand, they are either very optimistic, seeing everything through rose-colored glasses, particularly how something on their record will be viewed in only the most positive, favorable way by an adcom or they see things very pessimistic, in the most neurotic manner possible, particularly on the all the points in the actual application process and the waiting. There are few who see the nuances of it all. So if some starry-eyed premed sees that someone wrote a long post detailing pros and cons of an overseas volunteer experience, all they take away from it "overseas good." Perhaps their should be a premedical corollary to murphy's law: "premed applicants will only view their record in the most positive way possible." I always tell premeds what I want they to use for their application, use your judgement.

I agree with all of this. Yeah I think it's truly a tiny minority of applicants that global health experiences actually help. Most, it either is neutral or hurts.

 

[Goro]

I was wondering if it was okay to only have paid clinical hours? I’m a CNA and I work full time while also being full time pre-med in college so when i’m not working or going to class i’m studying/doing work which means I don’t have time to shadow or volunteer. Will this affect me when I apply?

Totally fine. The idea is to have patient contact experience, whether paid or volunteer. We want people who know what they're getting into and really want to be around sick and injured people for the next 30-40 years