Shadow (verb shad·ow)1
· To follow and watch (someone) especially in a secret way
· To follow and watch (someone who is doing a job) in order to learn how to do the job yourself
Shadowing is clearly defined in the dictionary, but yet the role of the shadow is vaguely defined in the medical field. Some students may feel that shadowing is a medical school application requirement or an easy way to get a letter of recommendation. However, this attitude of going through the medical school application process like a checklist, fulfilling requirements, often mask the truly rewarding moments of shadowing. Shadowing can be the first experience for a pre-medical student in the medical setting, and can inspire and nurture the passion for medicine in a future physician. Each medically relevant experience, such as shadowing, inspired my passion for medical school in those darkest moments in my room studying for over 12 hours. They reminded me that at the end of my preclinical year journey, there were patients that I would eventually have the opportunity to help.
Shadowing gives premedical students a glimpse into the often secret lives of physicians and provides an intimate view of the medical field and its many components. Shadowing students can expect to work closely with physicians and medical staff, and develop insights into the detailed collaboration that is required to keep an office operating efficiently. The role of a shadow should be one of a sponge that can soak in as much information as possible. At the end of the experience the student should be able to answer “Is this what I want to do for the rest of my life?” without any hesitation. The answer should be carefully analyzed, because medicine is first and foremost about the patient and working closely with patients. I will never forget my own first experience at a dermatologist’s office, when a patient from Croatia was elated to learn that the dermatologist could remove the melanoma from his hand and he could return to a village that shunned him for the having a “contagious disease.”
Any experience with patient care can benefit premedical students because it helps with transitioning from preclinical medical school years to clinical years. Some of my fellow students had tremendous difficulty with this transition, going from highlighted board review books and question banks, to treating real patients that had fears and hopes. It was easier for me to make the transition to the clinical years, because I had observed and was able to emulate the physicians I have shadowed to improve my approach to patient care.
Unfortunately, there is no rulebook giving the expectations of a shadow and the student often flounders without direction in front of the patient and preceptor. However, all hope is not lost because everyone has had their fair share of shadowing nightmares. As a medical student with numerous shadowing experiences in various medical specialties prior to medical school, I would like to relay the feedback that I have received from the preceptors that I have shadowed and my own personal experience on “how to impress during shadowing. ”
First and foremost, be on time. There is no greater tragedy than watching a premedical student sweating, tachypnic, and tachycardic with shaky and sweaty palms attempting to properly introduce themselves to the physician as they are running late. There aren’t many excuses that are valid for a reason to be late, and the physician is the last person that wants to hear the reason. Please keep the reason for your tardiness to yourself and if you must be late, take a deep breath and in the words of Taylor Swift “shake it off.”
Second, be nice to everyone you meet. This is a basic human principle that should be obvious to everyone, but some premedical students fail to remember that everyone is watching them. The medical staff is a vital part of medicine and should be treated with respect regardless of their job description. As a shadow you can learn much from the medical staff about teamwork and the daily interactions of the practice that cannot be underestimated. Medical school does not teach the inner workings of a medical practice and the interplay that is necessary to provide the highest quality care. Shadowing can fill this gap in practical knowledge that a future medical student can use to excel on rotations.
Third, ask medically relevant questions at the opportune time. Premedical students can be often overwhelmed by the vast amount of information that is presented to them. Qualities that make a good student, such as curiosity and pursuit of knowledge, can be damage control in the shadowing experience. Timing is everything. Bring a notebook and write down questions as they arise, then ask those questions during break time. Break time may mean lunch or in-between patient encounters. A rookie mistake is asking questions during the patient encounter. This can be damaging because it ruins the intimate doctor-patient relationship and switches the focus on the premedical student. A wonderful thing about the internet is that you can look up questions in seconds, but that does not mean taking out your phone in-front of the patient to google “anal fissures”.
Fourth, be helpful. Premedical students are often limited by their lack of extensive medical knowledge and experience, so their contribution to the medical office may be minimal. However, do not underestimate the importance of a student contributing by fetching lab or imaging slips. This mundane task may seem trivial, but they can be used as an opportunity to familiarize yourself with various lab names or imaging studies. These helpful tasks allow a shadow to contribute to the team without disrupting the flow of the medical office and staff. Again, if you have a question about an order, write it down in your notebook and ask later.
Fifth, do not complain. It can be a difficult and lonely time for a premedical student shadow because they are in uncharted territory, but no one wants to hear how difficult it is to be a shadow. The experience can be uncomfortable and may drive your sympathetic nervous system into overdrive, but it gets better. Instead of complaining or feeling frightened about the prospect of having another patient stare at them blankly inquiring about the role of the student in the room, it is more productive to absorb as much knowledge and bedside manner as possible.
Shadowing is a rewarding and an important step on the path of becoming a physician and everyone should be encouraged to experience these uncomfortable and anxiety-driven moments in order to rekindle or even spark a passion for medicine. As noted above, the expectations of a shadowing student are often minimal, but a student that is eager and willing to learn and that can work within the confines of their shadowing role can certainly gain a tremendous amount from the experience. After each of my shadowing experiences I was able to identify which specialty was not for me. For example, after my obstetrics and gynecology shadowing experience I realized that the emotional turmoil of an unexpected pregnancy as the patient ran out of the office screaming and in tears, was probably not a good specialty choice for me. This was very important for my clinical years because it made it much easier for me to ascertain my true passion in life, which was none of the specialties I had shadowed. However, today, I can be confident in my decision to pursue my chosen specialty and continue to provide quality patient-centered care as was demonstrated by the many wonderful physicians I had shadowed.