Need Clinical Experience? Consider a Medical Scribe Position.

If you’re a pre-med on the hunt for some high-quality clinical experiences, medical scribing could be an excellent fit. This paid position can help you to develop a strong network of provider relationships, gain an excellent foundation in medical terminology, observe clinical decision-making first-hand, and learn about the daily work and challenges of life as a physician. 

The work. Medical scribes serve as assistants to a physician (or multiple physicians) taking notes and charting patient encounters, inputting documentation into the Electronic Health Record (EHR), responding to patient questions and messages as directed by the physician, locating health records, and even researching information as requested by the physician. Scribes play a key role on a medical team as they free up the physician to focus on patient interactions while the scribe takes responsibility for administrative tasks. Scribes work closely under the supervision of a physician and do not have independent decision-making responsibilities. They work across a variety of specialties, including but not limited to: Emergency Medicine, Oncology, Dermatology, Gastroenterology, Family Practice, Pediatrics, Internal Medicine, and Pain Management.

The training. After obtaining the position, medical scribes receive between a few weeks to a month of training in preparation for the position. This training is typically paired with a period of shadowing a fellow medical scribe. Even with this onboarding, most scribes feel overwhelmed early on in the role due to the steep learning curve. Scribes need to learn the styles and preferences of the physicians that they work alongside, including their preferred charting methods, as well as the EHR system and the new terminology. 

The benefits. 

• Medical school admissions committees view scribing favorably. A scribe’s work demonstrates their commitment to a career in medicine by showing that they have an intimate understanding of the work of a medical provider. They will gain foundational medical knowledge and experience that will be useful throughout medical school and may ease the transition between their undergraduate and medical studies, and inform their future career path.

• Scribes can gain experience within a specialty, including a more thorough understanding of the challenges that physicians in those roles face. 

• Scribes will have the opportunity to develop a wide network of provider relationships, some of whom may be willing, and able to write detailed recommendations based on their work alongside of them.  

• Scribes will demonstrate their ability to thrive on a team. Scribes must learn to work well with a variety of physicians who will each have a different style. They will also learn to deal with stress and be proactive in asking questions and picking up information quickly, which will benefit them as a medical student, resident, fellow, and attending physician.

Related: The Must-Knows if You’re a Premed Considering EMT Training

Medical Researchers Gain Patient Experience Insights via Social Media Posts

Scrolling through Twitter may feel like a casual downtime activity, but a recent Wall Street Journal article describes social media’s growing utility as a medical research tool. Increasingly, researchers are using AI and other data-culling techniques, to sift through social media comments and gather real-time, unfiltered feedback on patient experiences—from the patients themselves. 

In an interview with the WSJ, Dr. Graciela Gonzalez-Hernandez, an Associate Professor at the University of Pennsylvania’s Perelman School of Medicine said, “Collecting abundant social-media data is cost-effective, does not involve burdening participants, and is available in real time.” She also points out that it may be more inclusive of populations often underrepresented in biomedical trials or cohort studies. And, most importantly, social media provides researchers direct access to unfiltered patient commentary on their experiences. “Healthcare providers report what they deem important, such that serious events are overrepresented, while bothersome side effects that may be of great importance to patients and lead to nonadherence and non-persistence are underrepresented,” Gonzalez-Hernandez said.

The article describes how researchers studying an opioid withdrawal drug have benefited from social media scans. Dr. Abeed Sarker, an Assistant Professor of Biomedical Informatics at Emory University, and his team used natural language processing algorithms to search Reddit for comments on opioid withdrawal experiences. Dr. Sarker’s team found that Reddit contributors frequently described concerns about withdrawal drugs causing “precipitated withdrawal,” or extreme withdrawal symptoms, among those who have used fentanyl. Importantly, many of these users’ comments expressed concern that their medical providers did not understand this condition. The study also found that the quantity of posts about fentanyl and withdrawal have increased over a seven-year period. These findings have played a key role in bringing to light the urgency of this issue for physicians researching withdrawal assistance drugs. 

In France, a similar study took place to better understand breast cancer patients’ quality of life. The researchers used an algorithm to scan comments left on Facebook and a French online forum for breast-cancer patients. Researchers compared these insights with the European Organization for Research and Treatment of Cancer’s quality of life questionnaire to ensure it was inclusive of the most pertinent topics. The online comments brought to light two additional topics that were top of mind for patients—nonconventional treatments and patients’ relationships with their families—which will be added to future iterations of the questionnaire for formal study. 

Many researchers seem intrigued by the possibility of using social media data in combination with traditional research. Su Golder, an Associate Professor at the University of York in England, is working on a medical literature review on HPV vaccines, which will incorporate Twitter and WebMD comments. “It’s important to research what the public is worried about,” Dr. Golder said. She notes that the benefits of social media data—patient perspectives and real-time information—can be meaningful, and that its shortcomings—comments that may confuse association with causation—can be overcome by combining the findings with traditional research efforts. 

Social media data might also work in combination with electronic medical records to improve patient care. A recent study by Dr. Munmun De Choudhury, an Associate Professor at Georgia Tech, created an algorithm to predict psychosis relapses and re-hospitalizations using the social media posts of 50 adult and adolescent psychosis patients who suffered relapses and hospitalization, along with their medical records. The study found that in the month preceding the relapse, there were distinct changes to social media usage in the form of language patterns—words related to “anger, death, or emotional withdrawal”—and the number of posts between midnight and 5am. The algorithm was able to accurately predict about 71 percent of relapses. Dr. De Choudhury is currently working with the state medical system to determine how to incorporate the algorithm into physicians’ clinical care processes. 

Medical Schools Plan to Resume Clinical Learning Experiences

In May, the AAMC provided an update on medical schools’ plans to resume operations.

For medical students working in clinical care, most schools plan to resume work this summer.  As of early May, 103 of 155 total schools had reported their plans to the AAMC; 15 percent planned to restore students’ clinical care work by the end of May, 55 percent (cumulative) by the end of June, and 77 percent (cumulative) by the end of July. An additional 15 percent were still finalizing plans.

The AAMC noted the delicate balance necessary for returning students to clinical care. Patient safety and containing COVID-19 must be parallel goals alongside allowing students access to the patient-centered learning hours they need for a timely graduation. Medical schools are also struggling to create meaningful learning opportunities due to the diminished capacity of many supervising physicians to teach and the fact that routine surgeries and visits have been limited or restricted.

According to an article published in Crain’s Health Care Forum over the weekend, during this period, many schools have front-loaded virtual course work. The article also mentioned that some schools, such as the Cleveland Clinic Lerner College of Medicine, were able to allow students’ access to patients using virtual clinics and virtual hospital rotations.

As many students prepare to return to clinical care, obstacles will remain. Many schools and hospitals are not going to allow students to work directly with confirmed or suspected COVID-19 patients and some hospitals are limiting the number of people who can enter a patient’s room simultaneously. This suggests that training will continue to require creativity and a dependence on technology, with schools working with state boards and accrediting bodies to determine what will be approved.