Should I scribe at a teaching hospital or a non-teaching hospital?

[702599]

So I recently got offered positions for ER scribe at two different locations. My main goal in scribing is to get back into clinical work, learn all I can about medicine/ER before medical school, and build strong relationships with professionals who can potentially write a letter on behalf of my application. The pros/cons for each location are pretty balanced for me. I'm a proactive person and will generally aim to make the most of my experience wherever I end up.

1) Teaching hospital with medical students from three different schools.

- Scheduling: flexible (only 2 shifts a week)
- Position: Per diem (2 shifts a week)
- Hours: 10 hours
- Commute: 7 minutes!!!
- Facility: old, level II trauma, 40 treatment areas
- misc: no assignment. You assist whoever needs you.​

2) Non-teaching hospital with just as many opportunities to learn from ER doctors

- Scheduling: not very flexible (more scribes than shifts)
- Position: full-time (3-4 shifts a week) ~I prefer full-time.
- Hours: 12-13 hours/day
- Commute: 30 minutes one-way (through narrow, windy mountain roads)
- Facility: Brand-new (only 2 years old); NOT a trauma center; 33 treatment areas
- misc: Assigned to work one-on-one with EP per shift
​

Which would you work at and why? Why not the other location?

What are the pros/cons of being at a Teaching vs. Non-teaching hospital? Do I have a better opportunity at building relationships with physicians at a non-teaching hospital instead of a teaching hospital?

What are the pros/cons of being at a Trauma vs. Non-Trauma center in terms of learning opportunities?

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[Hospitalized]

I dunno, OP. I've been a scribe for almost two years and both situations you presented have great pros and minimal cons (I've worked at both teaching and non-teaching hospitals also). Flip a coin or something...

 

[KinesiologyNerd]

I would go to the place that pays more. Someone doesn't have to have known you since you were a baby to write you a letter. Maybe this is because of my own personal interests in EM, but I think medical resuscitations are more interesting that trauma. Obviously the wow factor for a pre-med is higher in a level 1 trauma, but I think there are teaching moments abound in a medical resus.

 

[702599]

I dunno, OP. I've been a scribe for almost two years and both situations you presented have great pros and minimal cons (I've worked at both teaching and non-teaching hospitals also). Flip a coin or something...

I might just xD

 

[CCMDOC9254]

I've scribed at both also, and I'd say definitely go with the teaching hospital, doctors are much much much more willing to answer your questions and not only will they answer them, they'll go more in depth than you want hahah, great learning opportunities with academic docs. In the community it's hit or miss, some docs like teaching and others just wanna do their job and go home.


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[702599]

I would go to the place that pays more. Someone doesn't have to have known you since you were a baby to write you a letter. Maybe this is because of my own personal interests in EM, but I think medical resuscitations are more interesting that trauma. Obviously the wow factor for a pre-med is higher in a level 1 trauma, but I think there are teaching moments abound in a medical resus.

That is so interesting, I don't often hear people holding that point of view. Do you mind sharing a little bit of why you find it more interesting? I'm fairly new to the world of EM so any insight is most appreciated

Also what was your post-shift commute/day like?

 

[702599]

I've scribed at both also, and I'd say definitely go with the teaching hospital, doctors are much much much more willing to answer your questions and not only will they answer them, they'll go more in depth than you want hahah, great learning opportunities with academic docs. In the community it's hit or miss, some docs like teaching and others just wanna do their job and go home.


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That sounds awesome! My concern however is what that interaction would look like. I've never been in a teaching hospital before, so I have no idea if it's basically a flock of medical students following each doctor. What did your experience look like at the teaching hospital?

 

[CCMDOC9254]

That sounds awesome! My concern however is what that interaction would look like. I've never been in a teaching hospital before, so I have no idea if it's basically a flock of medical students following each doctor. What did your experience look like at the teaching hospital?

Yes there will be residents, med students, and sometimes both present that the attending is responsible for, but you will physically be the closest to the attending given that you need to be documenting on the patients he sees. Also the interactions between the med students/residents is also a gold mine of knowledge, I would always eavesdrop when the resident or med student is presenting their case to the attending and what the attendings critique/how they're going to treat the patient instead.


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[CCMDOC9254]

I would go to the place that pays more. Someone doesn't have to have known you since you were a baby to write you a letter. Maybe this is because of my own personal interests in EM, but I think medical resuscitations are more interesting that trauma. Obviously the wow factor for a pre-med is higher in a level 1 trauma, but I think there are teaching moments abound in a medical resus.

You don't think resuscitations also take place at a trauma center? Why not go to the teaching institution which will give opportunities to see literally everything, including medical resus


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[KinesiologyNerd]

That is so interesting, I don't often hear people holding that point of view. Do you mind sharing a little bit of why you find it more interesting? I'm fairly new to the world of EM so any insight is most appreciated

So like I said, I want to get into the EM/CC business. For the sexy wow factor, a penetrating chest wound that arrests in the hospital parking lot is as cool as it gets. That patient, however, will be off to the OR as soon as their chest is cracked. A uroseptic octogenarian will spend a long time in the ED. You'll see the initial resus and subsequent management. You'll see a lot more medicine scribbling on that patient.

Why do I prefer medical resuscitation over trauma resuscitation for my career? Some times you just know ya know? There's obviously a ton of overlap between MICU and SICU, but I guess at the end of the day I don't want to be a surgeon haha.

You don't think resuscitations also take place at a trauma center? Why not go to the teaching institution which will give opportunities to see literally everything, including medical resus


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I didn't say that. My point was not being a trauma center doesn't mean cool stuff doesn't happen.

 

[takeurmeds02]

Yes there will be residents, med students, and sometimes both present that the attending is responsible for, but you will physically be the closest to the attending given that you need to be documenting on the patients he sees. Also the interactions between the med students/residents is also a gold mine of knowledge, I would always eavesdrop when the resident or med student is presenting their case to the attending and what the attendings critique/how they're going to treat the patient instead.


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I didn't know that there was a lot of scribing done at teaching hospitals. I mean essentially, the residents are there to see the pt and writes the notes, right?. At my shop, we don't work the shifts with the residents but the shifts we do work, every so often we'll have a med student working with us. In these cases, I still write the note since they don't have authorization.

I will say, after you've been scribing for a while, it's hilarious to watch a med student interview the patient without the attending and then come present the case. It's even more hilarious when the attending is pimping and you know the answer...

@KinesiologyNerd And yea, I agree. I love the traumas for the variety but medicine pt's are like puzzles and when you understand their presentation it's really dope.

 

[KinesiologyNerd]

I will say, after you've been scribing for a while, it's hilarious to watch a med student interview the patient without the attending and then come present the case. It's even more hilarious when the attending is pimping and you know the answer...

don't worry, your day will come.

 

[takeurmeds02]

don't worry, your day will come.

Hopefully by then, I'll be a touch ahead of the game haha

 

[KinesiologyNerd]

Hopefully by then, I'll be a touch ahead of the game haha

Scribing mildly helps, but you'll still know soul crushingly little.

 

[HopefulOP]

Sorry to comment on an old post but how did you receive scribe training? I'm really trying to stick my foot in the door at the hospital job wise and I'm having trouble finding how to get certified in things. Being a scribe sounds like the ideal job for me but I can't find anything! I know a couple surgeons at our local hospital and I'll ask one of them tomorrow while I shadow but I was wondering what your path was.

 

[CCMDOC9254]

Sorry to comment on an old post but how did you receive scribe training? I'm really trying to stick my foot in the door at the hospital job wise and I'm having trouble finding how to get certified in things. Being a scribe sounds like the ideal job for me but I can't find anything! I know a couple surgeons at our local hospital and I'll ask one of them tomorrow while I shadow but I was wondering what your path was.

There's no real formal scribe training. Once you get hired by a scribe company they will train you. My company was ScribeAmerica, I had zero scribe experience when I was hired, but they get you up and running.


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[thatwouldbeanarchy]

I vote teaching hospital/trauma center. Of course, there's no guarantee but I think you stand a better chance of seeing more interesting, higher acuity cases and you may find docs are willing to teach you alongside the residents. (That was more or less my experience scribing at an academic level 1 trauma center but, of course, it depends on the doc)

The real deal breaker for me, though, would be the 12-13 hour shifts. That's a long-ass shift to be on your feet, chasing doctors, listening intently, and typing. You'd be surprised how physically exhausting the job can be. I wouldn't subject myself to that for a measly scribe job. Don't get me wrong--it's a great learning opportunity. But there's also a boatload of scut!

 

[702599]

There's no real formal scribe training. Once you get hired by a scribe company they will train you. My company was ScribeAmerica, I had zero scribe experience when I was hired, but they get you up and running.


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Sorry to comment on an old post but how did you receive scribe training? I'm really trying to stick my foot in the door at the hospital job wise and I'm having trouble finding how to get certified in things. Being a scribe sounds like the ideal job for me but I can't find anything! I know a couple surgeons at our local hospital and I'll ask one of them tomorrow while I shadow but I was wondering what your path was.

I agree with CCMDOC. The company that hired you will train you. I have also heard of people working for the company for a bit and then leaving to scribe for a clinic where they get paid more.

There are tons of companies. ScribeAmerica and CEPAmerica are the two biggest ones in my region. Google those two up for a start, apply, and then google up some more. Now is a good time to apply since a lot of Scribes are matriculating into med school which means JOB OPENINGS! I personally applied in March and was not hired until June. So it's in your best interest to apply to many asap.

 

[702599]

I vote teaching hospital/trauma center. Of course, there's no guarantee but I think you stand a better chance of seeing more interesting, higher acuity cases and you may find docs are willing to teach you alongside the residents. (That was more or less my experience scribing at an academic level 1 trauma center but, of course, it depends on the doc)

The real deal breaker for me, though, would be the 12-13 hour shifts. That's a long-ass shift to be on your feet, chasing doctors, listening intently, and typing. You'd be surprised how physically exhausting the job can be. I wouldn't subject myself to that for a measly scribe job. Don't get me wrong--it's a great learning opportunity. But there's also a boatload of scut!

Thankfully (or not) my last job involved being on my feet for 10-12 hours 5 days a week so I'm used to it. I'm actually doing the 12-13 hour one right now which is exhausting but not too bad. Only thing is the odd hours. My last job consistently started at 7am, and i'm slowly trying to adjust to fitting my life around random hours.