High School Students Shadowing?

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goofball

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This article by a physician/bioethicist has been making the rounds. She makes thinly-veiled complaints that high school students are shadowing doctors and seeing patients.

Personally, 5 years ago, I was a high school student who shadowed doctors as well. I think it was invaluable in giving me a realistic look at the profession, in contrast to what you see on Grey's Anatomy.

Also, I don't understand where the "privacy" concerns are coming from. Even being allowed to shadow is a bureaucratic nightmare, and you'll pretty much only get the position if you've already volunteered there and been trained in HIPAA and various other sets of rules.

Hell, you won't be seeing ANY invasive procedures for a while, at least in my experience. Forget the patients, my attending would kick me out of the room whenever she had to do a pelvic exam or look at a penis.




Finally, you pretty much have to shadow as a high schooler if you want any shot at a BA/MD program.








I really think that Dr. Kitsis' piece doesn't give an accurate portrayal of what shadowing is vis-a-vis the students. What do you think?

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I don't think it's necessary for a high school student to shadow a physician. Remove the student doctor introduction and replace it with "this is a high school student" and I'd be willing to bet that there would at least be a slight increase in refusals to observe. I know my mother and her friends and family would refuse.

What business does a teenager (who is not a student doctor) have observing a private examination? In my opinion, a shadow only becomes believable as a 'student doctor' once they've passed their freshman year of college.

It's possible that the author is just keen or privacy, or like me, takes issue with calling a high schooler a student doctor. I know the name is probably just to comfort patients by making their believe that the observer/shadow is at least somewhat qualified to watch, but...

I don't know. If a high schooler wants an 'accurate' look at the life of a physician, they should read some autobiographies or wait until they're actively on the pre-medical path and doing well.

In regards to your attending: You have an attending in M1/senior year? Or are you talking about the doctor you shadowed? I think I'm misunderstanding this part of your post...

(Obviously I don't plan to shadow this year or freshman year of college.)
 
This article by a physician/bioethicist has been making the rounds. She makes thinly-veiled complaints that high school students are shadowing doctors and seeing patients.

Personally, 5 years ago, I was a high school student who shadowed doctors as well. I think it was invaluable in giving me a realistic look at the profession, in contrast to what you see on Grey's Anatomy.

Also, I don't understand where the "privacy" concerns are coming from. Even being allowed to shadow is a bureaucratic nightmare, and you'll pretty much only get the position if you've already volunteered there and been trained in HIPAA and various other sets of rules.

Hell, you won't be seeing ANY invasive procedures for a while, at least in my experience. Forget the patients, my attending would kick me out of the room whenever she had to do a pelvic exam or look at a penis.




Finally, you pretty much have to shadow as a high schooler if you want any shot at a BA/MD program.








I really think that Dr. Kitsis' piece doesn't give an accurate portrayal of what shadowing is vis-a-vis the students. What do you think?

IMO, She seems to look at shadowing in a short sided way. I've done some shadowing before, and I think it is a great opportunity to get exposed to the Medical field. When I was with the doctor, none of the patients seemed to mind. I'm sure they knew i was a highschooler anyway, since i look pretty young. Even though the doctor i was with asked the patients if it was okay for me to be in there while she performed her tasks (In which 9 times out of 10 they said it was okay). Some were even delighted to know that my career focus was in the medical field and had conversations with me about it.

What's interesting for me to read was: "Of course, ​there are other ways to find out what it is like to have a career in medicine." Sure you can research it online, but, as a high schooler and maybe even a college student, It's tough (at least as a high schooler) to experience the medical field first hand. Shadowing actually helped me decide that i wanted to be a doctor.

I do agree with the part in which she says a code of conduct is needed. Especially for a high schooler. These kids could get into a lot of trouble without Guidelines. Though most hospitals do have guidelines for shadowing, there should be a universal code of conduct for all shadowing programs. Then again, shadowing is usually set up by the guest.

But, long story short, Shadowing is far from a "shady" practice.
 
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I don't think it's necessary for a high school student to shadow a physician. Remove the student doctor introduction and replace it with "this is a high school student" and I'd be willing to bet that there would at least be a slight increase in refusals to observe. I know my mother and her friends and family would refuse.

Yep. Language is a powerful thing. :)

What business does a teenager (who is not a student doctor) have observing a private examination? In my opinion, a shadow only becomes believable as a 'student doctor' once they've passed their freshman year of college.

Actually they ARE student doctors. The term "Student Doctor" refers to everyone in all stages of the medical training process, from high school to fellowship. That's why this site, the "Student Doctor Network," has a forum for high schoolers.

And you won't be seeing any invasive procedures for a while. The attending will kick you out of the room before the patients will, trust me.

It's possible that the author is just keen or privacy, or like me, takes issue with calling a high schooler a student doctor. I know the name is probably just to comfort patients by making their believe that the observer/shadow is at least somewhat qualified to watch, but...

But they ARE qualified to watch. You aren't allowed (by the hospital bureaucrats) to shadow unless you've volunteered for hundreds of hours and been trained in HIPAA and all that crap.


I don't know. If a high schooler wants an 'accurate' look at the life of a physician, they should read some autobiographies or wait until they're actively on the pre-medical path and doing well.

Difference between reading and seeing. Also, if you're applying to BA/MD programs, shadowing looks a lot better than saying you read a book.


In regards to your attending: You have an attending in M1/senior year? Or are you talking about the doctor you shadowed? I think I'm misunderstanding this part of your post...

(Obviously I don't plan to shadow this year or freshman year of college.)

Sorry, "the attending I shadowed."
 
I think there's ups and downs to both sides. I mean, even I wanted to shadow physicians (with no luck). When I was a junior my class went on clinicals and observed doctors and nurses. I thought it was really not that helpful, and many of our students weren't interested in many of the fields. I know this won't be the case for many of the kids REQUESTING to shadow, but that was my experience.

To my surprise, I actually agree with her to some point. I think that if the info is sensitive like "rectal bleeding," a patient might not mention it. I mean c'mon, it's hard to admit it in the first place, let alone in front of a 16 year old who might burst out in laughter if he hears it.

I think for BS/MD programs, it may be a necessary evil because they might really require it for the college, but for students going into college the traditional way, it causes me to think twice.
 
Actually they ARE student doctors. The term "Student Doctor" refers to everyone in all stages of the medical training process, from high school to fellowship. That's why this site, the "Student Doctor Network," has a forum for high schoolers.
I define student doctors pretty rigidly. I don't consider myself a student doctor, nor do I consider the pre-meds student doctors (They're student student doctors!) I do see where you're coming from though.

But they ARE qualified to watch. You aren't allowed (by the hospital bureaucrats) to shadow unless you've volunteered for hundreds of hours and been trained in HIPAA and all that crap.

Yes, when you put it that way, you're right. I volunteer at the hospital and went through the HIPAA agreements. I just tend to see it as "What is the purpose of them being here? Do they even understand what's going on?" Still, I guess there's not much to be learned in relation to medicine though, so there's really no need to be a completely educated student doctor in order to shadow. That's what rotations and things are for, right?

I do agree that shadowing is great for getting into a BS/MD program, but if you're going the normal route, reading books is just as good (to me).
...Then again, I'm a shy quasi-bookworm who would like to avoid patients and doctors as much as possible.

(Man, I'm the most self-defeating debater.. haha.)
 
It depends on the person. Some high schoolers are immature and not fit to shadow. Others are as mature as college students. Doctors should at least know the maturity level of the high schooler before letting them shadow. The patient privacy thing is irrelevant. High schoolers have to go through the exact same HIPAA procedures as college students. I think anyone who wants to shadow should be able to. As long as they have a decent maturity level and are fairly responsible. Maybe there could be some sort of teacher recommendation system.
 
Actually they ARE student doctors. The term "Student Doctor" refers to everyone in all stages of the medical training process, from high school to fellowship. That's why this site, the "Student Doctor Network," has a forum for high schoolers

I would disagree with this to some degree.
Within a hospital system there is a semantic understanding when it comes to titles.
"Doctor" means physician, and "Student Doctor" means medical student. It's what helps to avoid confusion.
We don't refer to PhD's as "Doctor" in the hospital because it engenders confusion amongst staff and patients. Not that they don't deserve the title, but it could lead to additional problems.

I had a patient's family member who had a PhD in history, who told a nurse that he was a doctor and that the nurse needed to do certain things for his parent. I had to step in and nip that in the bud real quick.
 
I would disagree with this to some degree.
Within a hospital system there is a semantic understanding when it comes to titles.
"Doctor" means physician, and "Student Doctor" means medical student. It's what helps to avoid confusion.
We don't refer to PhD's as "Doctor" in the hospital because it engenders confusion amongst staff and patients. Not that they don't deserve the title, but it could lead to additional problems.

I had a patient's family member who had a PhD in history, who told a nurse that he was a doctor and that the nurse needed to do certain things for his parent. I had to step in and nip that in the bud real quick.

I stand corrected.

Still, it's a matter of semantics, and as far as the patient is concerned, it doesn't matter. The high schooler isn't putting in a central line. He's standing around watching people talk until the attending does something invasive, then the attending kicks him out into the hall.

Forcing people to say "high school/college student interested in medicine" would reflect badly on the student, the attending, AND the hospital. It's easier and better to say "student doctor."

The technical definition of "student doctor" is important when deciding who does what in a hospital. But in shadowing, there is no question on who is doing what. By definition, one person stands around and watches. So there is no harm done by euphemistically referring to people as "student doctors."
 
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Actually they ARE student doctors. The term "Student Doctor" refers to everyone in all stages of the medical training process, from high school to fellowship. That's why this site, the "Student Doctor Network," has a forum for high schoolers.

And you won't be seeing any invasive procedures for a while. The attending will kick you out of the room before the patients will, trust me.

As stated above, student doctor does not refer to college or high school students. It is a formal, legal definition which requires an individual to be formally enrolled in a MD or DO track program and is covered by the licenses and insurance of the institution/physicians. Further, the problem is many times high school students AREN'T kicked out during invasive procedures. This isn't the high school student's fault, but it is a problem.

I stand corrected.

The technical definition of "student doctor" is important when deciding who does what in a hospital. But in shadowing, there is no question on who is doing what. By definition, one person stands around and watches. So there is no harm done by euphemistically referring to people as "student doctors."

This is not true. By falsely referring to a high school student as a "student doctor", you are impinging on the autonomy of the patient by assuming that they are equally comfortable with an untrained individual being privy to their medical care as a person who has passed the requirements to be admitted into medical school and has gone through thorough ethical training and screening. Most high school students who shadow don't end up as physicians, I would wager. Further, a couple hours of HIPAA training does not somehow make an individual worthy of the inherent trust required to tell someone about their medical problems.
 
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This is not true. By falsely referring to a high school student as a "student doctor", you are impinging on the autonomy of the patient by assuming that they are equally comfortable with an untrained individual being privy to their medical care as a person who has passed the requirements to be admitted into medical school and has gone through thorough ethical training and screening. Most high school students who shadow don't end up as physicians, I would wager. Further, a couple hours of HIPAA training does not somehow make an individual worthy of the inherent trust required to tell someone about their medical problems.

Then I guess I had a fairly atypical shadowing experience as a high school student. I asked to shadow at a few places and was turned down at all but one. At that institution, I was only allowed to shadow because I had volunteered there for a few hundred hours, and because the physician was a close friend of my family and thus he could personally vouch for me.

It was easier to find shadowing opportunities in college, fortunately.


But getting back to your point: we need to weigh the concerns for the patient's autonomy (that I still disagree with) against the benefits for the student and nonmaleficence vis-a-vis the attending and the institution. The fact remains that if you're a high schooler interested in a BA/MD, you're not getting in without shadowing. Period. Until that changes, shadowing will be a sad necessity for assiduous high school students interested in medicine.

Regarding the attending and the hospital, well, imagine if they had to introduce students as "high school student interested in medicine." That would put down the student, first of all, but that doesn't matter. It would also reflect badly on the Attending, who is apparently letting high school students tag along. And finally, it would reflect badly on the hospital, which also lets high school kids follow physicians around. Why should we harm everyone just for the sake of a few words?

And anyways, I still disagree that we're impinging on the patient's autonomy, we're just taking a looser definition of a word "student doctor" (whose legal definition most patients won't even know). The term "student doctor" can have a legal definition as well as a colloquial definition. The legal definition is undoubtedly crucial as far as patient care is concerned. But with regards to the high school student, patient care doesn't matter, because he's certainly not involved in it. Basically, I don't see how the legal definition of the phrase is applicable in a situation that doesn't involve patient care for the "student doctor."

Finally, if the term "student doctor" is problematic just because it already has a legal definition and is thus ambiguous, why not refer to them as "doctor in training," "doctor-to-be," "future physician," "studying to become a doctor," or whatever. As far as the patient is concerned, what does it matter? If the patient ever feels uncomfortable, they can say "get out" at any time (and they do!) and the student has to leave.



Most high school students who shadow don't end up as physicians, I would wager.

90+% of college premeds don't make it to med school either. I'd wager that kids who shadow physicians in high school are more likely to get into medicine, just because very few of them do it, and self-selection is huge there.
 
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I've shadowed Physicians and Surgeons, including Podiatrists, Internists, and an orthopedist and i'm about to shadow a dentist when I get there.

Currently i'm shadowing a Pharmacist, of whom I see about 2 times a week. He likes the company, and i'm happy he let me shadow him because I was denied by other Pharmacists who work at chains.
 
As far as the patient is concerned, what does it matter? If the patient ever feels uncomfortable, they can say "get out" at any time (and they do!) and the student has to leave.

This is what I personally disagree with. I think that many patients may feel uncomfortable/withhold sensitive information when a high schooler is around. I mean cmon, psych patients do it all the time with their real psychologists/psychiatrists, so I think to believe a high schooler wouldn't effect them is just downright naive. And also, I think there are MANY people who would not ask the student to leave, whether it be to be respectful to the student, doctor, ect.
 
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Then I guess I had a fairly atypical shadowing experience as a high school student. I asked to shadow at a few places and was turned down at all but one. At that institution, I was only allowed to shadow because I had volunteered there for a few hundred hours, and because the physician was a close friend of my family and thus he could personally vouch for me.

It was easier to find shadowing opportunities in college, fortunately.
I think there should be restrictions on college shadowing too. Patients should know who is listening in/watching.

But getting back to your point: we need to weigh the concerns for the patient's autonomy (that I still disagree with) against the benefits for the student and nonmaleficence vis-a-vis the attending and the institution. The fact remains that if you're a high schooler interested in a BA/MD, you're not getting in without shadowing. Period. Until that changes, shadowing will be a sad necessity for assiduous high school students interested in medicine.

Patient autonomy when the patient has capacity is always the first priority, non-maleficence is not an excuse to impinge on autonomy except in very specific circumstances (and I disagree, this is not maleficence, see below). More importantly, physicians are healers first and educators second. Once you are in medical school you will rapidly appreciate this, as there are many situations when the care of the patient will and should take precedence. We are here to serve first and teach second. However, that is not the key point. The point is that lying to patients about who an individual is is never appropriate on the grounds of education, be it letting a pre-med listen into a sensitive conversation on the grounds that he is a "student doctor', or convincing a patient to let a medical student perform an gynecological exam because he is a "student doctor". I have no problem with people shadowing, I believe in the educational experience entirely, my point is that there are certain things about shadowing that I strongly disagree with. I don't intend to say that these are necessarily the student's fault, but they are not appropriate.

1) Calling a pre-med a student doctor, because it is misinterpreting the situation and biasing a patient towards your will, not their own. Even as a medical student I still get kicked out of rooms. You can't tell me that not a single additional patient would dispute a pre-med (and I have seen this done to pre-meds when I was allowed in the room as a medical student). This is maleficence, on the grounds that they are being deceived to serve your purposes not theirs, which is not healthy for the relationship, and they are also unknowing placing themselves at a higher risk of having their confidentiality compromised. You have no idea how many admissions essays I read on SDN that have the patient's REAL NAME and information in it. I don't deny that medical students and physicians do it to, but the accountability is far less and the understanding of what is compromising is also much less.
2) Pre-meds wearing white coats while shadowing because it, again, misconstrues their role and thus the potential level of trust a patient may have.
3) Pre-meds in the operating room prior to draping and covering. There is NO reason why a pre-med should watch a patient being undressed, having a foley placed, etc. This is not a learning experience and it is an unnecessary exposure of the patient's privacy to outside eyes..
4) Pre-meds in the OR at all without patient consent. Again, unnecessary exposure of the patient's privacy and concerns about the correlation of number of people coming and going in the OR and risk of post-op infection.
5) Pre-meds witnessing genital, breast, and rectal exams. Again no real learning experience (these are really things you have to "feel" to really benefit from) and major exposure of the patient's privacy and dignity.
6)Pre-meds doing the genital, breast, and rectal exams. Nuff said
7) Pre-med shadows participating in any patient care or procedures without patient consent. I don't even have that much of a problem with it, unlike some, but the patient should know who is suturing their arm or whatever. There are other ways to teach "cool" skills like suturing than using unaware patients as an advertisement for our profession. Get a banana peel or a piece of raw chicken.

Regarding the attending and the hospital, well, imagine if they had to introduce students as "high school student interested in medicine." That would put down the student, first of all, but that doesn't matter. It would also reflect badly on the Attending, who is apparently letting high school students tag along. And finally, it would reflect badly on the hospital, which also lets high school kids follow physicians around. Why should we harm everyone just for the sake of a few words?

How does this put down the student? It is TRUE, if you are offended by such a comment then that your choice, but their is no disrespect intended. We were all high school students once and many of us were interested in medicine. An interest in medicine at any level shouldn't win you some special award.... How does it make the attending look back by encouraging early interest in the field? How does this make the hospital look bad? By allowing interest in medicine in a patient protective way? I'm sorry, but these suggestions just don't reflect the reality of my experiences in medicine. Do you know what really looks bad, when news breaks that a hospital and their physicians have been lying to patients. Looking bad is not a justification for lying.

And anyways, I still disagree that we're impinging on the patient's autonomy, we're just taking a looser definition of a word "student doctor" (whose legal definition most patients won't even know). The term "student doctor" can have a legal definition as well as a colloquial definition. The legal definition is undoubtedly crucial as far as patient care is concerned. But with regards to the high school student, patient care doesn't matter, because he's certainly not involved in it. Basically, I don't see how the legal definition of the phrase is applicable in a situation that doesn't involve patient care for the "student doctor."

I'm sure the CEOs before the crash also felt they were just loosening definitions. The absence of a patient's knowledge of the legal definition does not give us the right to exploit their lack of knowledge. You know who else exploited a lack of patient knowledge? The people at Tuskegee. Not the same degree of inappropriateness, but on the same spectrum. Privacy and informed consent are PART of patient care, thus it matters. This doesn't even get into the fact that it places the institution and physician liable if privacy is exposed and the patient was told that a pre-med was a medical student.

Finally, if the term "student doctor" is problematic just because it already has a legal definition and is thus ambiguous, why not refer to them as "doctor in training," "doctor-to-be," "future physician," "studying to become a doctor," or whatever. As far as the patient is concerned, what does it matter? If the patient ever feels uncomfortable, they can say "get out" at any time (and they do!) and the student has to leave.

High school students aren't necessarily doctors to be and future physicians, for one. And again, studying to become a doctor is ambiguous enough to misconstrue the relationship. It matters because it is their decision to make and it matters because their privacy is at risk.

90+% of college premeds don't make it to med school either. I'd wager that kids who shadow physicians in high school are more likely to get into medicine, just because very few of them do it, and self-selection is huge there.

All of what I said applies to pre-meds regardless of age.
 
sorry to derail this thread, but I never really understood how hospital volunteering helps to prepare a premedical student for a career in medicine...most of the student hospital volunteers i see end up running food around to places or candy striping...
 
sorry to derail this thread, but I never really understood how hospital volunteering helps to prepare a premedical student for a career in medicine...most of the student hospital volunteers i see end up running food around to places or candy striping...

Hospital volunteering is just a hoop you have to jump through. It doesn't help prepare you for anything.

Shadowing can give you a good look at how medicine actually works, but it also is a hoop to jump through to some extent.
 
Hospital volunteering is just a hoop you have to jump through. It doesn't help prepare you for anything.

Shadowing can give you a good look at how medicine actually works, but it also is a hoop to jump through to some extent.

Well said. If I were in medical school admissions I wouldn't accept someone who didn't have proper exposure unless they were a nobel laureate.
 
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