April 19, 2021

Virtual vs. In-Person Shadowing - What Should Medical Schools Accept?

The Savvy Premed

By: Savvy Pre-Med Staff

Virtual shadowing experiences can run the gamut in terms of their quality - ranging from pre-recorded videos with no interaction to interactive live observations with physicians and patients in real-time.

With this high level of variance in mind, it’s understandable for medical schools to be skeptical and apply a degree of scrutiny to applicants’ virtual shadowing hours. After all, shadowing is one of the key indicators of candidates’ knowledge of the medical profession and their tested commitment to the field.  

But from the applicants’ perspective, this scrutiny can seem incredibly unfair given how difficult it has been to secure meaningful shadowing (whether in-person or online) amid pandemic restrictions that have lasted over a year. 

We want to consider both viewpoints - the schools and the applicants - to posit our argument about what kinds of shadowing that medical schools should accept for the 2021-2022 cycle.      

Virtual vs. In-Person Shadowing - What Should Medical Schools Accept?

Recently, we compiled data from 162 medical schools and analyzed their responses to various questions about virtual clinical experiences vs. in-person ones.

To sum up some of the important data, here’s what we found (keep in mind that medical schools often submitted more than one response): 

“Virtual experiences are of lesser value”

Chosen by 11 out of 162 medical schools (6.8%)

“Virtual experiences are equal to in-person during COVID”

Chosen by 71 out of 162 medical schools (43.9%)

“Virtual experiences are always equal to in-person”

Chosen by 18 out of 162 medical schools (11.1%)

“View virtual experiences in the context of the entire application”

Chosen by 78 out of 162 medical schools (48.1%)

“Prefers in-person”

Chosen by 23 out of 162 medical schools (14.1%)

“Virtual experiences accepted”

Chosen by 106 out of 162 medical schools (65.4%)

So, there’s some good news here! The vast majority of medical schools are accepting virtual experiences (65.4%) and almost half view them as equal to in-person experiences during COVID (43.9%). And at the very least, nearly 50% will consider the experiences within the context of the entire application (whatever that means?).

Why Would Medical Schools NOT Accept Virtual Shadowing?

But what about the 56 medical schools that did not claim to accept virtual experiences? Or even the 11 that flat-out said virtual experiences are of lesser value? What gives? Don’t they understand the position the applicants are in?

Let’s look at some of the justifications from those 11 schools:

Justification #1: Applicants Should Have Secured In-person Experiences Earlier in College

“For most applicants, we would hope that they began researching the medical profession from early in college and participating in medical volunteering to display the consistency of motivation for medicine. We will include the virtual experiences to those that have displayed their motivations throughout college. Those who only present virtual experiences this cycle will likely be at a disadvantage. Virtual experiences should involve a close one-on-one working relationship with a physician, ideally in a situation where they are interacting with patients. Classrooms of people virtually watching a physician are of lesser value. In most places, there still are scribing and small clinic opportunities that are not virtual, but you’ll have to seek them out and be determined.”

Justification #2: We’ll Take Virtual Experiences, but We’re not Thrilled About It

“The Admissions Committee will consider virtual shadowing hours achieved during the COVID-restricted protocol period. However, please note that in-person shadowing is much preferred and will always be favored over virtual.”

Justification #3: Virtual Experiences Let You Stay in Your Comfort Zone

“In general, virtual experiences do not carry the same weight as an in-person. We look for experiences that exemplify our desired criteria and show how you've grown or gone outside of your comfort zone for these activities.”

Justification #4: Some Virtual Experience is Fine, but It Shouldn’t be the Only Thing You Have to Offer

In light of COVID, the Admissions Committee will consider virtual experiences, but an applicant should not only list virtual experiences on their application.”

Justification #5: Applicants Can Find Telemedicine, Virtual Scribing, and Contact Tracing as Good Substitutes

“While in-person clinical experiences are preferred, the committee knows that is difficult due to COVID so they don't weight them differently if they are of similar quality. Shadowing through telemedicine or virtual scribing has been what we've seen most at this time. We've also seen contact tracing or call center work. The key to a clinical experience is being in a healthcare setting where there is some form of patient interaction. Just being in touch with medical professionals or going to a case study or presentation with them isn't the same.”

Is Not Accepting Virtual Shadowing Inequitable for Applicants?

In our opinion, yes. It’s unfair for medical schools to flat-out reject the practice of virtual shadowing. Why?

  • Because there are many candidates who DID secure in-person shadowing BEFORE the pandemic, mostly out of luck, privilege, or circumstantial timing, but this was clearly not possible for the majority of applications
  • Even those who could find in-person shadowing during the pandemic may have opted not to pursue it to protect themselves, their families, or the patients/staff at the hospital (remember that whole “do no harm” thing?)
  • It’s particularly unfair towards disadvantaged applicants who might live in multigenerational households, be consumed by the financial struggle of the pandemic, or lack any connections to help them overcome the “nonessential” status that prevents them from accumulating in-person hours 

We’re NOT saying that medical schools should accept ANYTHING AND EVERYTHING, but we believe that virtual shadowing should be universally accepted IF it meets certain important criteria. 

What Kind of Virtual Shadowing Should be Universally Accepted?

Let’s consider why schools require shadowing and clinical hours in the first place:

  1. Medical schools want to see whether you understand a physician's demands, lifestyle, and duties, especially compared to other healthcare roles (shadowing does this more than other clinical experiences). In short, do you know what it takes to be a physician?
  1. They also want to see how well you interact with patients, especially those who are different from you. What are your people skills like? Can you exhibit professionalism in a clinical setting? 

Can these skills and exposure be replicated on a virtual platform? We think it depends on what’s actually happening during these virtual experiences.

Our Criteria for Measuring the Best Virtual Shadowing Opportunities:

  1. Is it active or passive learning?
  2. What is the consistency and accessibility of the sessions?
  3. How much credit can you get? And how restrictive is the process?
  4. What is the content presented?
  5. How closely does it reflect actual in-person shadowing?

Virtual shadowing could potentially offer all these missing criteria, but it will be important for you to seek the right platforms that will maximize your virtual experience).

Weak Virtual Shadowing:

Some virtual shadowing opportunities consist of doctors talking over PowerPoint presentations. They’re passive and not very immersive, meaning that you don’t truly see the performance of duties or get the full picture of a doctor’s job.

We understand if medical schools view these with a level of scrutiny. 

Solid Virtual Shadowing:

Other virtual shadowing experiences involve pre-meds learning clinical skills from recorded patient interactions. These are more active and can actually build diagnostic skills through insights into real cases and a firsthand view of the job’s demands and duties.

These types of experiences should be accepted if the applicants can accurately and convincingly describe the value of the shadowing. 

Strong Virtual Shadowing: 

The most sophisticated virtual shadowing experiences involve the doctors walking pre-meds through the cases themselves. This is the best of both worlds, in the sense that you get to build skills while also directly discussing the cases with the physicians themselves. 

These experiences should be universally accepted, since they most clearly simulate in-person shadowing and will lead to the most value for the applicants.  


As an applicant, part of the onus will be on YOU to make sure that the medical schools fully understand the quality of your virtual shadowing and what you learned from the process.

That means you’ll need to write about these virtual shadowing experiences in an effective, persuasive way - which is the subject of our next blog post, so stay tuned!

Have any questions about virtual shadowing experiences for medical school? Let us know in the comments below, and we’ll respond to you personally!

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