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

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

Many premedical students consider EMT training and certification because it can provide excellent clinical experience and patient interactions. Could it be the right fit for you? 

There are a lot of benefits that medical school admissions committees view favorably.

• As an EMT, you will develop your leadership skills and understanding of some of the work and challenges physicians may face. 

• You will gain foundational medical knowledge and clinical experience that will be useful throughout medical school and may ease the transition between your undergraduate and medical studies. In a recent study at the University of South Carolina School of Medicine Greenville, which added EMT certification into the first-year curriculum, most students agreed that the certification eased the transition into medical school (82 percent) and “increased awareness of patient’s lives and circumstances” (91 percent). 

• You will hone your ability to stay calm and clear-headed under duress, which will certainly benefit you as a medical student, resident, fellow, and attending physician.

EMT Certification Process. To become a certified EMT, you must take the equivalent of about six college credits at an accredited school, which includes CPR, controlling blood flow, and patient communication and interactions. You will then take the NREMT exam which is made up of two components: a written, cognitive section that measures your medical knowledge and a psychomotor skills assessment that measures practical skills in patient assessment and emergency response skills. After passing the test, you can apply for EMT certification through your local EMS agency. 

After certification, you will want to consider paid versus volunteer opportunities. Paid employment generally takes shift structures. Volunteer work is more flexible. If you consider paid employment, you will want to look for emergency response or ambulatory work, rather than interfacility transfers. Emergency work will provide you with the most opportunities for meaningful clinical experiences. To understand the opportunities available, check with your local EMS agency, fire departments or hospitals. 

Is it the right fit?:

• What types of clinical and/or research experiences have you already had? In what areas might your future medical school application benefit most?  

• Do you have the time… really? If you want to gain EMT certification, consider it earlier in your undergraduate career or as an activity during a gap year. You won’t want to combine EMT certification with studying for the MCAT, coursework, and medical school applications and interviews.

• What volunteer or employment opportunities are available for you locally? Are they a good fit with your schedule and interests? Gaining the certification without the associated patient experiences from working or volunteering will not provide you with any meaningful benefit as an applicant or medical student.

Are you a Pre-Med in Need of Summer Research or Clinical Experiences? Check out the SDN Activity Finder.

If you are a premedical student looking to supplement your learning and enhance your medical school application this summer, check out the Student Doctor Network (SDN) activity-finder. The activity-finder allows you to sort through summer or next-term experiences, organized into the following categories: medical/clinical work experiences, volunteer/community service experiences, research experiences, and shadowing experiences. Then it provides a list of organizations and resources for you to consider by location.  

Trends in Medicine: Shortening the Preclinical Timeline

American medical schools have traditionally followed a similar structure: two years of preclinical work followed by two years of clinical rotations. But there is an emerging trend within medical education, which accelerates preclinical studies in order to allow students more time to gain clinical experiences. According to the Liaison Committee on Medical Education, during the 2019-2020 academic year, six percent of medical schools ended pre-clinicals after one year, 29 percent ended them after 1.5 years, and 56 percent retained the traditional two year structure. 

Kim Lomis, MD, and Vice President for Undergraduate Medical Education Innovations at the American Medical Association, explains that the reasoning for the curriculum update is so that students are better able to contextualize learning within patient care. “Proponents argue that learners are able to better anchor their learning of foundational sciences in a meaningful context, fostering professional identity formation as well as knowledge base,” she said. Early adopters include the elite medical schools at Harvard, Duke, Vanderbilt, and NYU Grossman. Each of these schools now condense preclinical learning into the first year, with students beginning clinical clerkships at the start of their second year. 

Rutgers Robert Wood Johnson Medical School recently launched its updated curriculum, which starts the clerkship after 18 months. Carol A. Terregino, MD, and Senior Associate Dean for Education and Academic Affairs at Rutgers, notes that the curriculum change is beneficial because it puts an emphasis on “knowledge for practice.” 

“Anything that is going to increase students’ clinical knowledge and ability to apply that knowledge to clinical practice is going to make students stronger as future physicians,” she said. She also noted the presence of unknowns related to the recent pass-fail update of the USMLE Step One exam, which could potentially increase the importance of the Step Two exam. “To make sure my students are able to do well and prepare for the licensing exam, I want a longer launching pad to get them there,” she said.

Others say that looking just at “preclinical” and “clinical” years oversimplifies medical education. Students at Ohio University Heritage College of Osteopathic Medicine, for example, follow the traditional two and two calendar, but are exposed to clinical experiences through observations and interactions during the first two preclinical years. “Distilling a college’s program to the length of time in preclinical or clinical curriculum misses all the nuances of what each college does to prepare its students. We emphasize patient-centered care from the first day of medical school, making our students well-rounded when they engage in their clinical rotations,” said Jody M. Gerome, DO, and Heritage College’s Senior Associate Dean for Medical Education.

Related Blog: U.S. Medical Licensing Examination’s (USMLE) Step One Moves to Pass-Fail Scoring

Pre-Med Students Face Stress as Clinical Experiences Become Harder to Find

The stress of applying to medical school has always been significant. A Kaplan survey of 400 pre-med students, taken in early 2020, found that 37 percent “seriously considered” changing their plans for a medical career due to stress. Just over a quarter (26 percent) said that they experience stress “pretty much always,” and another 45 percent said “frequently.” Over half (57 percent) said that self-medicating with alcohol or drugs is common for them as they work to grapple with the demands. 

And experts say that the pandemic is only increasing these stressors. “I don’t think we can underestimate how COVID-19 is impacting the mental health of the entire population, never mind students who are preparing to apply to medical school,” said Carol A. Terregino, MD, and the Senior Associate Dean for Education and Academic Affairs at Rutgers Robert Wood Johnson Medical School. “There are fewer opportunities to engage in the humanistic activities, to shadow and volunteer to demonstrate one’s passion for medicine because of the pandemic and more time to focus on metrics and study for the MCAT (Medical College Admission Test). And that isn’t necessarily a good thing.”

This sentiment was echoed in a Yale News interview with pre-medical students. Students spoke of their experiences with the closures and re-openings of “wet labs,” with seniors claiming to be overlooked in favor of younger students who could commit to multiple years of research. Students also reported difficulties finding opportunities to shadow doctors, or volunteer at local hospitals. “If you’re trying to volunteer at the New Haven Hospital or the HAVEN Free Clinic, it’s hard to do so because of COVID restrictions,” Courtney Li, pre-med class of 2024, explained. “There was definitely a time period where they weren’t accepting volunteers.”

In response, Dr. Terregino provides a calming perspective to applicants. “Medicine is stressful. Getting ready for medical school is stressful. But I’d offer that one can temper their stress knowing it’s more than just grades and MCAT scores that admissions committees are looking for, and there is a full understanding of the limitations on experiences placed by the pandemic. Personal development also counts.”

So, what should pre-medical students do? 

As limitations exist, so do opportunities. Showcase your adaptability by making the best of challenging times. We recommend considering the following experiences if you are not able to find in-person shadowing or clinical roles.

• Contact current or retired physicians in your network, or access your university’s alumni network, to interview them and learn more about their specialties, experience, and advice for aspiring physicians.

• Leverage your university network, including current and retired professors and alumni, to look for in-person or virtual research opportunities.

• Pursue virtual shadowing opportunities.

• Engage in volunteer work to demonstrate your commitment to serving others and working with diverse populations.

• Consider study abroad and summer programs that provide shadowing or clinical experiences.

Continuing to pursue learning and development opportunities, even in less-than-ideal circumstances, will still prompt meaningful evolutions in your perspective and will help convince the admission committee of your commitment to the study of medicine.