August 9, 2021

5 Reasons Why Pre-Med Shadowing Requirements are Unfair

Iqra Hashmi and Huzaifa Safeer

By: Iqra Hashmi and Huzaifa Safeer

Imagine being a pre-med student in Grant, Nebraska. There are no physicians in your city, the closest clinic is miles away, and you have no connections with anyone in the healthcare field. But your dream is to go to medical school, and all of them require shadowing hours, something you simply don’t have the luxury of pursuing. 

Physician shadowing is often considered to be one of the most important things a pre-med student can do to prepare for applications and get real-world experience. But while shadowing can be an incredible asset, it’s not always feasible for every pre-med.

Pre-meds who have to work may not have the same amount of available free time as others and may be less willing to participate in something that they see as unpaid labor. Not only is it inequitable and calls unnecessary attention to social status, but it is also limited in its scope and medical schools rarely accept alternatives. 

5 Reasons Why Pre-Med Shadowing Requirements are Unfair 

Reason 1: Not All Pre-Meds Have the Same Amount of Available Time

For pre-meds already juggling other commitments like work and extracurriculars on top of school, they might not have enough time in their day to even entertain the idea of physician shadowing. This is even more problematic if we consider the role of privilege. Pre-meds from affluent families who help pay for their tuition and necessities will have a lot more time to pursue activities than those who must pay for their tuition and necessities out of their own pocket. 

Reason 2: Shadowing Can Be Regarded as a Form of Unpaid Labor

As a pre-med shadowing a physician, you will most likely have to observe as they interact with patients and family members and fill out charts, and you might even have to do menial tasks for them. In this way, shadowing is essentially a form of unpaid labor, and pre-meds who have to work out of necessity may see it as an impractical use of their time. If pre-meds have a job, they might worry about shadowing hours taking away from paid hours. 

Reason 3: Shadowing is Not Always Equitable

Sometimes, physician shadowing can even call attention to social status. Shadowing is often contingent on having pre-existing connections to physicians, which can be easier for some pre-meds who come from privileged backgrounds. Someone with family or friends who work in the medical field can ultimately obtain more hours, experience, and letters of recommendation, which is unfair to those who don’t have these connections.

Furthermore, there is a huge disparity in the number of hospitals and opportunities depending on where a student lives. This article talks about the differences between urban and rural hospitals, with rural hospitals being less common and available than urban hospitals on average. The suburbs of California will have a large number of hospitals and opportunities when compared to a city in Wyoming. 

Reason 4: Medical Schools Can Be Biased Against Alternatives

Medical schools are often biased towards traditional shadowing, even if it’s not a requirement for the application. Furthermore, there is very limited accountability when it comes to traditional shadowing. Students can fabricate experiences with little chance of that information being corroborated. For students who choose to engage in alternatives, they may have a lower chance of being accepted into medical schools. 

Reason 5: Shadowing is Limited in Scope

Shadowing by itself is extremely limited in its scope. Many times, these experiences fail to capture the entire medical experience for the students who are trying to learn as much as they can about the medical field. Shadowing is limited by elements like patient confidentiality where patients' information can’t be shared, so a lot of time the mentee is left lost and confused about what they’re witnessing. They will think being a doctor is mostly just sitting behind a computer screen, or scribing and taking notes, because that's all they are either witnessing or required to do. Interactive hands-on experience is extremely lacking in shadowing.

In conclusion, physician shadowing has a lot of drawbacks: students spending hundreds of hours on medical exposure instead of their own college lives, students spending thousands of hours not getting paid when they could need the money, a disparity in the amount of available opportunities depending on students' circumstances, and an unwillingness from medical schools to accept alternatives.

Medical schools have a responsibility to care about their applicants more than they do. Only 41% of all medical school applicants get in, meaning 59% fail to achieve the goal thousands try to reach. That means tens of thousands of students wasted thousands of hours, working away unpaid, through already arduous schedules.

All medical schools should accept and treat virtual shadowing with the same credibility as in-person. To make life easier for students, they need to be more accepting in other avenues as well, such as remote or independent research, or other more interactive, hands-on applications of learning beyond the normal parameters of shadowing. This would help create a more equitable application system and lead to better, more motivated doctors across the country.

About the Authors:

Iqra Hashmi is an incoming sophomore majoring in Biomedical Sciences at Arizona State University. She is currently researching the effects of opioid use in pregnant women and hopes to pursue a career in the medical field in the near future. Besides science, her other interests include animals, art, and Taekwondo.

Huzaifa Safeer is a senior pre-med student at Virginia Commonwealth University studying bioinformatics. He has large dreams to become an influence in the health field, whether that starts in the field or on the paper.

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