Advice for pre-medical students
Like many medical schools across the country, the University of Washington School of Medicine wants to make sure that applicants are making an informed decision before they spend their time and money to apply to and attend medical school. One of the common pieces missing in applications is the experience of shadowing. In order to “test-drive” future career options, applicants should shadow physicians in the United States whose practice most closely resembles the applicant’s potential career goals.
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.
Shadowing means specifically observing the physician-patient interaction.
By observing physicians at work, applicants can see how physicians deliver bad news or deal with difficult patients. Applicants will also develop a more realistic understanding of what medicine can and can't do. Although participating in medical mission work abroad may involve shadowing and is a wonderful form of service learning, it will not adequately provide an applicant with what the practice of medicine will be like in the U.S. Shadowing in the U.S. is an opportunity for prospective physicians to witness firsthand what they are getting into.
We recommend shadowing physicians even if you are a nurse, physician assistant or medical assistant as this allows you to appreciate the life of a physician without your role intruding upon your perception. Perhaps you should do this outside of your usual place of employment.
The UW School of Medicine recommends that applicants shadow for at least 40 hours in the U.S.
The 40 hours do not have to be with one physician or all in one week. In fact, shadowing multiple physicians over several months to years will give applicants an opportunity to explore not only different medical fields, but also to compare different practice settings and different physician styles. The 40 hours of shadowing, with an attending or a resident, is the suggested amount of hours that should be completed before submitting an application.
You should try to shadow physicians in the field you are interested in. Your experience should be consistent with your goal. If you are unsure about what direction you want to go in, we recommend shadowing a diverse range of physicians if you are able to.
- Find out what the career is all about
- Clarify and validate initial impressions
- Understand the realities/limitations of medicine
- Test level of commitment
- Discover likes and dislikes
- Enhance motivation
- Improve the articulation of goals
Questions to ask yourself when shadowing
- Can I see myself doing what this doctor does on a daily basis?
- Can I see myself as a colleague of this doctor?
- What are the joys and frustrations of this career?
- What are the pros and cons of this particular type of medical practice?
- Consider: size of practice (solo or group), types of patients (age, sex, problems/diagnoses, insurance), size of community, salaried or self-employed, paper charts or electronic medical records, hours and call schedule, family life, community service and/or influence, ability to practice in rural area or overseas
- Am I drawn to diagnostic problem solving?
- Am I drawn to procedures?
- Is the doctor involved in clinical research?
- Is the doctor involved in "bench" (lab) research?
- How does a doctor learn more about his/her patients' personal lives? How is this knowledge factored into the patients' care?
- How does the doctor relate to his/her patients?
- Consider: formal or friendly approach, standing up or sitting down, rushed or not rushed, listening or interrupting, speaking with words that the patient can understand or speaking medical jargon or speaking in patient's primary language if it isn't English
- What factors seem to play into how the patients respond to the doctor?
- How do I feel when there is no "cure" or treatment options?
- How do I feel about chronic problems compared with acute problems?
- How do I feel when I see patients who don't listen to advice or who don't take good care of their health?
- Did all patients with the same diagnosis seem the same? If not, how and why might they have been different from one another?
- Do I like situations in which a decision has to be made quickly?
- Do I like the pace of this type of practice?
- What did the doctor do when s/he didn't know the answer to something?
Arranging a shadowing experience
As an aspiring medical student, it is your responsibility to make the initial contact with the physician. Hospitals or county medical societies may be able to refer you to physicians who are willing to have shadows.
Practices and hospitals have different regulations for having observers in the room with the doctor and the patient. It is your responsibility to find out what these are in order to meet them. At the least, you will need to demonstrate that you understand the Health Insurance Portability and Accountability Act, better known as HIPAA. Documentation may be required that you are fully immunized and therefore do not present a risk of infection to a patient.
For shadowing experiences at UW Medical Center, please visit the Clinical Observations page to learn more. Other physicians, practices and hospitals may require different or additional forms.
Shadowing documents for non-specific clinics or hospitals
Below are agreements we have created for your use as is, or to customize for your specific clinic or hospital.
Ideas for finding shadowing opportunities:
- Ask your personal physician if you might be able to shadow him/her. If not, is there someone s/he could recommend?
- Network with friends and family to contact physicians they may know.
- Get a job as a scribe or medical interpreter.
- Volunteer at a hospital or clinic and network with physicians there.
- See the list below we have compiled for ideas and contacts.
- Scribe program for Emergency Departments: Search the internet for 'How to become a Scribe'
- Scribe America
- Summer Health Professions Education Program (SHPEP)
- AAMC "How do I shadow a doctor"
- Shadowing Guidelines for Pre-Health Professions
- Tips for students who want to shadow doctors
WWAMI Area Health Education Centers (AHECs): The Area Health Education Centers (AHECs) in the WWAMI region work to attract young people into health careers. They want to help qualified students in their states be successful applicants to medical school. They can be helpful in identifying shadowing experiences for medical school applicants.
- WWAMI Region: WWAMI AHEC
- Eastern Washington: Eastern Washington AHEC, Contact: email@example.com
- Wyoming: Wyoming AHEC Centers
- Alaska: Alaska AHEC Centers
- Montana: Montana AHEC Centers
- Idaho: AHEC Idaho Centers
- King County Medical Society (KCMS) Student Shadowing Program
- Pro-Scribe: Provides medical documentation services in Northwest
- Pre-Med Mentorship Program for pre-med students through the Washington Academy of Family Physicians
- Internships at UW
- University of Washington SHPEP
- Healthcare Alternative Spring Break at UW (HCASB) use the "Applying and Planning" for shadowing opportunities
- Washington State Hospital Association (WSHA)
- Washington State Medical Association (WSMA)
Volunteer physicians for shadowing experiences
- Tim Brininger, M.D. - Family Practice/OB, Mountain Home, (near Boise) ID firstname.lastname@example.org
- Lisa Galbraith, D.O., MPH - OB/GYN, Kadlec Medical Center, Prosser, WA BL6395@aol.com
- Jim Irwin, M.D., CMO - Samaritan Healthcare, Moses Lake, WA email@example.com
- Carl Plonsky – Pediatrics in Tacoma, WA, Assistant: Patricia Davis -firstname.lastname@example.org
For physicians interested in being shadowed
Thank you for making this opportunity available!
Clinical Volunteering: Helping or participating in a clinical setting. Primarily benefits others. May include verbal and/or physical contact with a patient. May lead to shadowing.
Shadowing: Observing doctor-patient interactions. Primarily benefits the shadow. Usually includes no patient interaction or physical contact. The doctor is not required to teach the shadow, and is likely NOT to write a letter of recommendation. May lead to mentoring.
Mentoring: Advising or training, especially a younger colleague, generally benefits both mentor and mentee. Involves teaching. Could involve physical contact with a patient and/or learning procedures. May lead to letter of recommendation.
Having a shadow shouldn’t take the physician any extra time. By nature, most physicians like to teach and it is hard to resist that urge when having a budding physician at your side. Because of the lack of hands-on interaction with the patient, there is limited liability other than privacy. An affiliation agreement with UW is NOT necessary. If you are associated with a hospital, the applicant should arrange a volunteer experience with the volunteer office. Arranging for shadowing should go through the medical director’s office. These offices could collaborate on training and forms to sign. Once someone has been trained as a volunteer, they should understand what they need to know about confidentiality for shadowing. You may wish to establish some parameters with the applicant, either in writing or verbally, regarding the shadowing experience. These may include conforming to your facility’s privacy, health and safety rules, as well as acceptable and unacceptable behavior while shadowing. You should be explicit about whether pre-medical students can ask questions, and if so, when and where. Should the student remain in the room and interact with the patient if you have to temporarily leave the room? What is your preferred dress code?
Shadowing provides prospective physicians with the opportunity to witness firsthand both the joys and frustrations of practicing medicine. They get to see how we handle delivering bad news or dealing with recalcitrant patients. They develop a more realistic understanding of what medicine can and can’t do. You can decide how much time and how often you are willing to be shadowed. HIPAA is not a barrier; the students can be trained briefly by your office staff if they don't already have HIPAA training.
The shadowing student should understand HIPAA and sign a document acknowledging that they understand that what they see and hear stays in the office. Use our sample documents listed above or create one specific to your facility.
The Washington Academy of Family Physicians provides opportunities through its website for students to request a mentor and be matched to a family medicine physician in the state of Washington. Some of the regional AHECs (Area Health Education Centers) also match prospective medical students with physicians for mentoring and/or shadowing.
We are trying to broaden the resources available to applicants by compiling a list of physicians in a variety of specialties and locations who are willing to have students watch them as they care for patients. You may want to check with your malpractice insurance carrier or hospital legal department to be certain that having an observer does not put you at any increased risk. Please see some sample documents below to use or modify to fit your circumstances.
If you are willing to have pre-med students “job shadow” you for a day, or a few hours per week or month, please contact LeeAnna Muzquiz, MD, Associate Dean for Admissions at the University of Washington School of Medicine.
Shadowing Documents for non-specific clinics or hospitals
Below are agreements we have created for your use as is, or to customize for your specific clinic or hospital.
UW Medical Center-specific
Please visit the Clinical Observations page to download their form and learn about shadowing opportunities at UWMC.