Why Shadow a Physician?

Shadowing physicians is an important element of the pre-med years. In addition to giving prospective medical students a feel for what the work of a doctor is truly like, shadowing provides exposure to a range of specialties while developing professionalism skills. It can also help build connections with healthcare providers and possibly result in a letter of recommendation to add to your application portfolio. However, shadowing is quite intimidating if you have not done it before. Moreover, it is absolutely true that you will get no more out of it than what you put in. That being said, here is a list of DOs and DON’Ts that will help you get into the right mindset for shadowing as a pre-med.

DOs

1. Do your homework and come prepared

Once you find a doctor who will allow you to shadow, it is incredibly important to do your homework. Read up on the doctor’s specialty, his/her medical education (DO vs. MD), the nature of the medical practice, schedule, and other relevant information. Most of this information should be available online, so make sure to find it prior to arriving on your first day. You may also need to participate in HIPAA and specific healthcare organization training before being approved to shadow with certain doctors. You may even need to get an identification badge for the time you will be shadowing. If you cannot find this information, ask. Some hospitals require this well in advance of the start of your shadowing. Act promptly; be considerate to the physicians, other students who are shadowing, and yourself by staying on top of the process.

You will often find that the differences between a physician’s osteopathic and allopathic education are slight when played out in practice. However, if you are shadowing a DO who practices osteopathic manipulative medicine (OMM), you will have a much different experience than you would if you were shadowing an MD. Even within the allopathic field, for example, your experience will vary greatly based off of the nature of the physician’s practice. For example, a family medicine practice will vary in a number of ways from an orthopedic surgery center. Keep this in mind when choosing additional shadowing opportunities in order to create variety and cover all areas of medicine that interest you.

When it comes to work hours, you may have to contact a physician’s medical assistant or physician assistant for updated information about a doctor’s schedule. I have had experiences when a physician had a meeting of which I was not aware, and I was forced to sit doing nothing until he finished. Remember that physicians’ schedules are variable and may change rapidly, so be flexible, prepared and understanding.

2. Dress professionally

The way you dress on your first day may shape others’ impressions of you, so always air on the side of professionalism and modesty. Business casual is almost always a safe bet, unless you have been specifically directed otherwise. Even if you will be observing surgery all day, you should still show up in business casual clothing before changing into surgical scrubs at the hospital.

For men, dress slacks, a button down shirt and dress shoes are usually appropriate. Ties are typically optional, and some physicians even recommend avoiding them due to the fact that they carry germs. For women, business casual is less straightforward. However, when shadowing, a safe outfit includes dress slacks, closed toe shoes, and a blouse. Sleeved tops are usually a more professional choice, and if your blouse airs on the low cut side, always wear a cami or undershirt. If you choose to wear a dress or skirt, make sure it is appropriate in length. Finally, although heels are allowable, remember that you will be on your feet all day.

3. Ask relevant questions at appropriate times

This may seem obvious, but it will take some adjusting to know when the appropriate time is. This is especially true when you understand the busyness of a physician’s day. There is little to no down time between patients, so you may need to hold on to your burning question from the morning until lunchtime. Remember that you typically will want to wait until you have left the exam room to ask a question, especially when it has to do with a specific patient. However, if the physician asks if you have any questions while you are still in the exam room, it is usually appropriate to ask.

A physician assistant or nurse on staff may also be a valuable resource as they typically work very closely with the physician. Never assume that these healthcare providers will not know the answer to a question. In some cases, seasoned nurses, physician assistants or medical assistants will know more than a physician in certain subject areas due to the fact that they may have much more experience under their belts. Lastly, as a student, always be sure to comply with HIPAA, as patient information is highly protected. Refer back to your training modules or guide if you have any questions about what you can or cannot discuss with the physician or other healthcare providers after seeing a patient.

4. Send thank you notes

It is shocking how a thank you note can so pleasantly surprise a physician. This small token of appreciation can go a long way. One day, when you are a physician, you will likely desire to give back to help inspire future physicians. You will not expect a thank you, but we all know how nice it feels to put our time and effort into something and receive gratitude in return. Do this for the physician you are shadowing. It takes less than five minutes to sincerely write a thank you card and place it in an envelope. Think of all the time the physicians have spent with you during your shadowing; five minutes is nothing compared to that. It may also be appropriate to write cards for the assistants or other staff at the practice depending on your interactions with them. I often mention multiple people with whom I spent time in a single thank you card.

5. Discover other specialties to shadow

While shadowing, you may have time to discuss other specialties with the physician. For example, during a free moment, you could ask: Did you always want to pursue (insert specialty)? What other fields did you consider? These questions are straightforward and will often prompt the physician to talk about various other options he/she may have considered. Some physicians may have known early on what they wanted to pursue and stuck with it, but plenty of others have changed their minds quite a few times.

Asking these questions may open the door to a networking possibility. Remember that doctors have colleagues practicing in many different fields; you may be able to access the contact information of someone in a specialty that interests you through your relationship with your shadowing physicians. Even if this is not the end result of your conversation, you can begin to think about fields with which you have been unfamiliar until this point.

Don’ts

1. Show up late

Remember that early is on time and on time is late. Make a goal to arrive fifteen minutes prior to your start time. Do whatever you can to avoid showing up late, as this reflects negatively on your professionalism. This should be obvious, but you should always account for factors  outside of your control ahead of time. This may include traffic, an unexpected detour, or an unforeseen morning delay. If you are late one time because your car breaks down on your way to the hospital, it is not the end of the world. Just be sure to call the office and inform someone who can relay the information to the physician who is expecting you. Even if you arrive at the hospital early, you can spend that time looking up background information about the cases you saw the day prior or studying flashcards, for example.

2. Be discouraged if a patient does not want you in the room

Imagine showing up on your first day of shadowing with excitement and readiness to learn. As you walk with the physician into the first exam room, the patient says she does not want you there. This will likely happen at least once over the course of your shadowing, although more often, nurses or PAs who enter the room prior to the physician will ask the patient for permission to admit a student observer. No matter what happens, always be professional. Respect the patient’s decision to have a more private appointment, if that is what he or she desires. Just remember that most patients will love playing a role in your learning experience. In the rare instance that a patient would prefer that you not be present, respectfully exit and go along with your day.

3. Shadow solely for a letter of recommendation

It is wonderful to receive a letter of recommendation from a physician you shadow, as you will need such letters for your medical school applications. However, shadowing solely to obtain a letter of recommendation is not a good idea. You cannot assume that a physician will be willing to write you a letter simply because you spent time shadowing her.

If you had a successful and interesting shadowing experience, and the physician had enough time to get to know you, it may be appropriate to request a letter. The doctor may even offer to write one for you. However, who you ask and whether that doctor agrees is up to both of your discretion.

You want letters of recommendation to speak to your character, professionalism, and ability to function in the medical environment. If a doctor does not feel that she can compellingly speak to this, she may deny your request and you would probably not want that letter to be included in your application portfolio anyway. When considering who to ask, keep this in mind. Additionally, it is important not to procrastinate when requesting letters. Physicians are busy; most do not have the time in their schedule to write a letter that is due in the next month. Give physicians plenty of time in advance to obtain necessary information from you and draft a cogent letter of recommendation that will improve your chances of gaining admission to medical school.

4. Disrespect other healthcare providers or staff

The way you present yourself and treat others in the shadowing environment is extremely important. Even if the physician is not present, he will likely be informed if you disrespect a member of the healthcare team or even a receptionist at the front desk. Do what you can to show respect to all members of the workplace. Everyone with whom you interact is as important as the physician. You are a student and a guest in the workplace. Show respect in the same way you wish to be respected.

5. Break HIPAA or other rules of the organization

If you are preparing for your first shadowing experience, you may be wondering what HIPAA is and why it is so important. Briefly, HIPAA stands for the Health Insurance Portability and Accountability Act and serves to protect the health information of patients, giving them rights to specific aspects of their health records. In order to ensure that you fully understand these regulations, you will likely be required to participate in HIPAA training before you commence your shadowing experience.

Conclusion

If you keep these DOs and DON’Ts in mind before, during, and after every shadowing experience, you will most likely have a very successful and productive time observing physicians. If you have questions or need clarification, reach out to the physician with whom you are working, other health providers, or other students who have gone before you. Remember to track all shadowing hours to easily transfer information to your applications in the future. Most importantly, enjoy the experience. Take it all in, learn everything you can, and get a glimpse of what your future may look like as a physician. Best of luck!