This Saturday, I rounded in the hospital. I met up with Zainab, the president of the minority premed association for the University of Chicago, who asked to shadow me. While she was doing research at the hospital, she had not ever rounded in the hospital before. It was Saturday so our team was mostly off so it was just me and my very capable resident who is about to graduate and take a primary care job in the community.
But, yesterday’s rounds was different and it was because Zainab was there. Patients were excited to meet her giving her the thumbs up. Medical students walked by and asked her if she was going into medicine and scurried away but said ‘definitely do it.’ My resident, in face, told her it’s a great career. These positive endorsements were occurring in the middle of some difficult patient issues (one patient who wanted to leave against medical advice). It is also May – meaning the students, interns, and residents are tired. Even I felt energized as she was asking me about why I do this job and how I got here.
It was not the first time that I had taken shadower on rounds. I run a program for high school students to get clinical exposure and research experience. Interestingly, one of the high school students in the program was also in the hospital today interviewing a patient for one of the large studies we direct. He looked so professional as he was preparing to go find a patient to interview for the study. These students also shadow in the clinic and the hospital during the summer while they are doing research. So, it had been about a year since I had a shadower with me.
Shadowing is an important part of learning what being a doctor is like and doctors need to provide students opportunities to do so. It is also a factor that medical schools consider at when making decisions about who to admit – does the candidate have an understanding about what a medical career is like?
So how do you shadow a doctor? Here are some quick tips for premeds looking to shadow.
- Leverage connections – Zainab found me through her other summer job where someone I work with through the College told her to contact me. If you are on a college campus with a medical school, use your contacts through your premed office or via research opportunities. If you are not on a college campus with a medical school, you could offer to shadow your doctor in your hometown or contact local hospitals through their volunteer or community affairs office to see if they have a shadowing program.
- Be flexible with when you can come – It may be the best time for you to observe is either early in the morning or during off hours, like weekends or evenings. In the hospital, weekend rounds are sometimes easier to observe since many people are off so there are not as many learners on each team. In addition, things are usually not so rushed since attendings don’t have to rush to clinic usually. They may want to keep rounds short so they can get back to their weekend but they will probably appreciate that you are volunteering your time to do this on a weekend.
- Bring a notebook to take notes on what you don’t understand – I forgot to tell Zainab to do this so I gave her some paper and notes so that she could jot things down and afterwards we reviewed the questions one by one. On rounds, doctors also use a lot of abbreviations so you may not be able to follow everything but you can jot these down and ask about them later. Zainab later asked me what a “RTA” is to which my resident responded not to worry since he didn’t really understand renal tubular acidoses until this past year.
- Wait to ask questions until rounds are over– The focus of clinical encounters is the patient, not the student. This is unlike routine classroom interactions and can be difficult to get used to but it is the reality of patient care. Complex decisions are often being made and you don’t want to interrupt the doctor-patient conversation. Remember you can ask not only about the medical jargon but about what else you observed.
- Wear comfortable closed-toe shoes and appropriate dress– This is very important since you may be on your feet for a while and its important to project a professional image as a visitor. It’s also important that your shoes are not open-toed (sorry ladies) since your feet are at risk of coming into contact with equipment, body fluids, or sharps. A helpful power point with some tips on dress here.
- Reflect on your experience afterwards– During your medical school interview, you may want to recall your experience, the types of cases you saw or just generally how you felt. Writing a short reflection on your thoughts is a good way to keep those memories fresh (but remember not to include any identifying information – see # 8).
- Don’t forget to follow up– Don’t forget that you were a guest on rounds so its good to follow up with a thank you for the doctor. They may send more opportunities (shadowing or otherwise) your way if things went well. Yesterday, I got a great thank you from Zainab and invited her and her group to a medical student research poster session open to the University community.
- Respect patient privacy– There may be a patient who doesn’t want you in the room. And remember, everything you see in the hospital is private and not to be repeated or written about in a manner that could lead to the identification of the patients involved. If you aren’t already affiliated with the hospital in some capacity (i.e. doing research), some doctors and hospitals will require that you sign a form for HIPAA stating that you will respect patient privacy.
Good luck future docs and happy shadowing!
–Vineet Arora MD