Counting Clinical "Hours" Isn't Enough For BS/MD

You’re all always asking me “is xyz number of hours enough for BS/MD?”

I hate that question.

Because I promise you, even though you have to count your hours for the Common App, we absolutely do not look at one applicant and say "he/she had 10 hours more than this other applicant, we should take him/her.”

And you’ve also heard us say this before - “it’s not the number of hours.”

But, I get it. That’s not helpful for you because you’re also being told “you need clinical experience.” So the natural next question is “how much?”

Let me simplify this for you.

If you’ve never shadowed a physician, we don’t know if you know what you’re getting yourself into. That’s a red flag.

If you’ve shadowed a physician but that’s all you’ve done, then we know you’ve put yourself in a passive clinical environment, we don’t know if you would do well actually interacting directly with a patient, but at least we know you’re interested in the field is legitimate. That’s an orange flag. (So 50 hours of shadowing versus 100 hours is arbitrary, if that’s all you did).

If you’ve shadowed a physician and then 6 months after shadowing them, that same physician hired you to scribe for them, we now know you enjoyed medicine enough to stick around it long term, you’re a committed individual, and you were well-liked by your physician that they wanted to prolong the relationship and now you have access to direct clinical thinking as you write down everything the doctor says. Green flag.

OR

If you’ve shadowed a physician, then got your phlebotomy license, and that physician allowed you to draw blood in their office and wrote you an excellent letter, we know that you interact well with patients and have maintained a deep relationship with a physician who can vouch for your clinical skills. The Greenest Flag.

What’s my point?

Stop counting hours, start learning how you can deepen the experiences you are already in.

BUT if you have zero hours, start by getting some hours.

Let me tell you why adcoms care so much about this.

First of all, it’s because this is the job you’re signing up for at the tender age of 17-18 for BS/MD. So you have to know what this job means: the good, the bad, and the ugly.

Every single morning, we walk into rooms where people are scared, confused, sometimes angry, and almost always in pain. And we have maybe 15-20 minutes per patient. In that time, we have to figure out what's actually wrong, communicate it clearly to someone who may not understand half the words we're using, manage what they're feeling, make a decision that affects the rest of their treatment, and move to the next room.

And often, we present that patient to a team. We defend our reasoning in front of colleagues who may disagree. We sit in rooms where other attendings have opposite opinions on the same case and we have to navigate that friction without losing professionalism or respect, no matter how ‘fired up’ we get.

We get paged in the middle of it all. We give bad news to people who weren't expecting it. We have to convince a patient who doesn't trust us that the plan we're recommending is the right one. And we have to do this with plummeting reimbursement costs, rising paperwork and frequent conversations convincing insurance companies who won’t pay that your patient needs their treatment.

Medicine is not just knowledge. It is performance. It is communication under pressure. It is the ability to walk into a room where you are not automatically trusted and leave it having built a relationship.

That is what an admissions committee is trying to figure out if you can do, because almost always, it is a charisma they simply cannot teach.

So, yes, you need the hours to prove you want to do medicine, but what you have to actually show is that you understand what I just described.

Students who have watched a physician do their job are more prepared than students who have only read about it.

But students who have done something with their hands while watching that same physician do their job (scribing, CNA work, phlebotomy) can show that they have been a part of the healthcare team too.

That is the type of clinical experience that we are looking for. Even though it starts with something that seems “not enough,” like shadowing.

So, ask yourself, after all the hours you've accumulated, could you describe a specific moment where you did more than watch a physician do their job? Could you speak to what that moment taught you about the actual demands of this career?

If you can, you have clinical experience. If you're reaching for an answer, you have clinical exposure, and you might need to do more before application season starts.

Practical Tips

If you don’t know where to start, and you have not been able to find shadowing experience yet, use the Clinical Scholars Grand Rounds Symposium to jumpstart your clinical hours. In this program, students learn how to give Grand Rounds and present clinical cases in front of a live physician panel that will be evaluated.

It’s not a replacement for in-person shadowing, but it’s an opportunity to gain clinical hours, win a personalized research mentorship with one of the doctors, and earn a letter of recommendation based on your performance. Free to apply.

-Dr. Samarrai

PS: Deadline for applications will be on June 22. Acceptances are sent out on a rolling basis and the total cohort is capped. Apply for free and save your seat.

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