Clinical exp.?

<p>So I've heard that med. schools pretty much expect that premeds had done clinical experience/volunteering. What exactly does clinical experience/volunteering entail? (i.e. something to do with patients, but what exactly do you do w/ patients?)</p>

<p>Obviously the majority of clinical experience will involve spending time with patients and shadowing physicians. Many of my classmates (at Duke) were involved in assisting administratively in urban or international projects.</p>

<p>One of my friends (now at Harvard) was heavily involved as a documentary photographer, assistant, and administrator at an AIDS project in Ghana. I performed (a very minor) surgery in the middle of a civil war (while being given instructions in Spanish), and generally served as a hospital translator.</p>

<p>Shadowing docs is probably what you will find most intriguing. (Although it takes on a whole other level when you actually have some real medical education. It's amazing the difference it makes when you have some real knowledge about what is going on)</p>

<p>Other hospital volunteering is usually pretty menial. I volunteered on a Ortho wing, and most of my time was spent re-stocking linens and delivering meals. As I got more comfortable seeing patients I began to talk to them, especially the elderly men, because they often had a ton of great stories. I think that patient interaction was really meaningful to both myself and the patients. But I also just got a feel for what the flow of a hospital is like and how the health care team really goes about caring for patients...</p>

<p>Level I trauma centers are also interesting Especially in areas where lots of crime happens. The pace of them will blow your mind away. It will really separate those who don't belong in medicine from those who do. The smells, the people coming in bleeding everywhere, it really shows you what intense medicine is like. Desk jobs are pointless as far as clinical skills but in an ER if you are good and the nurses, techs, and docs like you then they will let you see and participate more and more. If you aren't go you will still see a lot, but you won't get to gown up for traumas, etc. But from my own experience I recommend a busy ER, even if its just to shadow, but lots of ER docs aren't exactly the nicest people and there is very little standing around mostly running so you might get in their way.</p>

<p>What's the implication of "gowning up"? I know "scrubbing in" is disallowed in the States if you don't have proper training.</p>

<p>When you gown up for a trauma you put on the full face protection, the yellow gown (at my hospital), and gloves etc. Within the trauma room, IF they trust you they will let you get them things, set things up quick, etc. For most volunteers, you won't be allowed in the trauma room during a trauma, and you will wait outside just to go an run labs, and you won't really see much. And in my state I know as a fact you can go scrub into a surgery, sure you won't actually cut anything, but they will let you hold retractors, and see whats going on. But thats only if the surgeon is someone you know, or they know enough about you that they can trust you. Sometimes they put the joke on you and make you hold the heart shaped retractor (which name is completely slipping my mind now), which prevents you from really seeing anything going on in the surgery. But plenty of surgeons I've talked to have said if they trust someone they will let them hold one, and to hold on you basically have to scrub in and be sterile.</p>

<p>Huh. Weird. I guess I should replace "in the States" with "in my state".</p>

<p>Is it better to go in asking for a volunteer position with some skills in your bag like CPR etc.</p>

<p>Doesn't really matter. But if you try going into the ER bragging about being and EMT, knowing CPR, etc. They will tell you to get out and not come back. If they want you to know how to do anything they will show you how and tell you when to do it. Never is it worth it to try to brag about what skill you may think you have. In a real ER medical training that isn't from nursing school or medical school means nothing. And they will gladly tell you not to ever come back if you question them.</p>

<p>i disagree, my cousin has gotten me in at level 1 trauma centers in new york city and ive told the ER docs and nurses that i am an EMT and they let me do more then i would prefer sometimes. It shows that you arent just some kid who has seen ER one too many times, that you actually have some level of knowledge in emergency medicine. They will trust you when you show them you know your stuff. </p>

<p>I actually strongly suggest you go into ER shadowings with at the very least CPR training. You need to let the nurses know you are useful to them. If you cant even take a blood pressure, they are gonna make you change beds and hand out food all day, especially at busy ED's.<br>
Just dont tell them that you are an EMT in a condescending kind of (I know everything) way. They will def make you practice what you know if they place gets slammed. </p>

<p>Bottom line, dont go in there without any training. If you are looking for it to be just a learning experience for yourself, you are better off staying out of the ED because the staff has very little patience for that sort of thing. </p>

<p>Also, knowing an ED nurse makes things alot easier. I suggest a nurse because while docs may have the ultimate say, the nurses have more patient contact and less paperwork. As an EMT i did a few ED rotations with a nurse friend of mine and he let me take bloods cause he knew i wasnt a moron. So yea, basically, i think if you are gonna do ED work, get some training, whether it be CPR, First Aid, EMT...anything. Dont go in there with only memories of last weeks ER epsiode.</p>

<p>Btw, no EMT in their right mind would EVER go into an ED bragging about being an EMT...you will get laughed at. They dont care, just tell them at the beggining of the shift that youve had (blank) training and ask if you could help the staff in any way with the patients.</p>

<p>I highly suggest becoming an EMT though, you will see and do alot.</p>

<p>side note: ive been an EMT for about a year, a CFR for 3 and have been involved in EMS for about 4 years....i love every moment of it.</p>

<p>I also wanted to add in that i read something about scrubbing in and stuff...yea ive had my share of those times, but you guys have to remember that especially in emergency medicine 95% of your patients are gonna be medical, meaning chest pain, diff breathers, etc. You will rarely get that bloody trauma where you have arterial bleeds squirting on the ED ceiling (depending on where you are of course, but even in the busiest level 1 trauma centers, that stuff is still not the majority)</p>

<p>You are gonna have to have a HUGE amount of patience. Because you will often have people who dont really feed your need for adrenaline, and who dont really know whats wrong with their own bodies lol...so yea its not all its cracked up to be in the ED...those high intensity stories are kinda rare...sometimes.</p>

<p>Chest pain doesnt go in trauma rooms, neither do S.O.B.'s . Trauma is reserved for people who are unconscious or close to it. In the ER I work at S.O.B's and CP's go into the Chest Pain Center tucked in the back of the ER. The trauma room is also no a constant use room as it is basically an operating room. The hospital I work at is in an area with a lot of crime, and shooting and stabbing victims usually end up in the trauma room. Thats maybe a weekly occurance or so, so as you said not constant. Trauma gets used for other things also, like severed fingers/arms/legs, big traffic accidents. But for the most part trauma sits there during the day empty. But in general ER cases are pretty boring routine stuff, and its mostly older people in their 60s+ who end up there. Then you have your constant guest who seem to end up there every day looking for a free meal, these are usually the homeless. </p>

<p>Even with what you said Doogie, you are treading water that should not be treaded by offering help in the ER. At my ER the slightest mention of something like that will get you kicked out or on the s*** list of one of the Doc's or nurses. Thats if they don't decide to teach you a lesson and throw 20 cases at you at the same time. In the ER I'm at the volunteers do their job, keep the ER running as smooth as possible and help with patients when asked, which ends up being frequently anywars. The Tech's do the job you described in the ER I'm at, so this is why they don't need volunteers to even offer their help. There are tons of tech's and their job is pretty much blood draw, etc etc.</p>

<p>haha listen buddy, i can guarentee you whatever hospital you volunteered as isnt better then the ones ive worked at in New York City</p>

<p>and i never said SOB's or CPN's go into trauma centers...an ED is designated as a trauma center because they have the necessary resources...the ED still has to handle the medical cases...thats what i said.</p>

<p>Thats is irrelevant anyway. </p>

<p>At my ER the slightest mention of something like that will get you kicked out or on the s*** list of one of the Doc's or nurses. Thats if they don't decide to teach you a lesson and throw 20 cases at you at the same time.</p>

<p>Idk what hospital thats at but i can tell you one thing...any professional who treats people like that shouldnt be in the medical field...plus i highly doubt it happens, and if it does, you are in a very shi**y hospital.</p>

<p>trust me, im pretty sure NY Presb, Our Lady of Mercy, Montefiore, Univ. Chicago, UVa know what they are doing in their ED's...you have some of this country's finest doctors in these places and none of them have ever acted in the manner you have described...in fact they all were very happy to have me there since i was trained as an EMT</p>

<p>o and any ED that has that kind of relationship with their EMT's....sucks, i can promise you that.</p>

<p>Plus, im pretty sure ive handled more GSW's, stabbings, and alllll different kinds of traumas then you could possible dream of in the south bronx.</p>

<p>Yes I forgot you have a special EMT certification that to the regular world is known as an MD. You brag about being an EMT more than any of EMT I know, or have had to interact with. Everyone who I interact with is all business. Everyone knows their rolls, and follows them, if you don't the ER doesn't function and there is no room for you. For you everything seems to be a competition, and you always try to pound through your view that you are the most supreme EMT in the universe and have seen the most anything, Like in the post right above.</p>

<p>what are you talking about, this has nothing to do with me being an EMT</p>

<p>
[quote]
For you everything seems to be a competition, and you always try to pound through your view that you are the most supreme EMT in the universe and have seen the most anything, Like in the post right above.

[/quote]
</p>

<p>typical premed</p>

<p>I was trying to hold off on saying anything to let you two duke it out...but here goes....</p>

<p>I've been an EMT for over a year and a half now, I volunteer with my college's EMS corps and I just joined the central park EMS unit (in NY). I also volunteer as a research assistant in the ED of one of the level 1 trauma centers in manhattan. I am going to lean more toward agreeing with bigndude than doogie311 here for a few reasons. First of all, EMTs are on the lowest rung in the ER...essentially what an EMT does is take a person from one place to another and make sure that they are alive. Most of the people who come into an ER do not need CPR (which is rarely ever used to begin with of course) or any other skill you learned in EMT class. You will never take a manual BP in any ER of course and in general your skills as an EMT are pretty useless once you step into a hospital, they are only useful in the field. I feel that the only way being an EMT helps you in the ER is that it gives you a head start on understanding terms and abbreviations and lets you know whats going on more. As for skills, I think the skills that will be most useful are like interacting with patients and not being afraid to help them out if they ask for something minor. Also, you speak as if you are an FDNY EMT, which i doubt that you are. And a word of advice, when you try to sell this to med school dont use this type of tone you should make it out to be a good stepping stone to bigger things but I would drop the air of excellence if i were you.</p>

<p>i dont have one, never did...and i agree with everything you said, except i think the ED's ive been at have given me more responsibility because i was an EMT. Thats what im saying. Being an EMT is a great experience as im sure Shraf knows. It will teach you to see medicine in a very different light then you would if you werent an EMT. I dont deny anything Shraf said because no1 ausciltates BPs anymore in the ED and if there is ever a need to perform CPR, chances are a volunteer isnt gonna be doing it. The only reason why i do feel being an EMT will help you if you decide to shadow in an ED is because of insurance reasons for the hospital (this is what I have been told). Also, because you know how to talk to a patient about their situation, you know what information you need...you basically know how to get the ball rolling. It would be alot easier to latch on to an ED because they know that you have some experience with the whole field. Think about it...if you were in charge of the ED and 2 kids called u, 1 whos a premed and has no clinical experience, the other an EMT for 2 years...both looking to do a rotation, who would you feel more comfortable giving it to?</p>

<p>Im not sure of the details behind the whole liability thing, but thats what the doctor at bronx lebanon told me when i did a shadowing there. He said they only allow EMTs to actually engage in any type of patient care (anything within THEIR scope of practice...vitals, O2 therapy...things like that), anyone else is gonna get stuck at the desk or moving people from floor to floor. </p>

<p>Thats where i was going with all this. I dont agree with bigndudes statement that they will look down upon EMTs. However, i do agree that if you tell them you have some sort of knowledge with some sort of condescending tone, you are gonna get sum shi*. </p>

<p>As a side note to shref...just so he knows im not a BS artist lol</p>

<p>Im not FDNY, i am OLM per diem though. I did a few shifts with some FDNY located in the south bx, that was a greeaaat time. Also worked with some NYPD ESU guys for a little because I knew someone. Central park should be a fun time though, what hospital to you guys txp to?</p>

<p>And listen, it seems as if bigndude has this problem with me every time i bring up being an EMT...whatever, i dont really care...give it a rest guy. I dont think im better then any1 for being an EMT, but i do think i deserve the respect for actually knowing what I am talking about when it comes to having clinical experience. All i gave was my POV</p>

<p>But your problem is you come into every thread and bring up being an EMT. You do it in a tone that is not exactly compassionate. If you did it in a nicer way I wouldnt say much, but the things you bring up sometimes make you seem like a whack job. Other times you seem normal, but it all depends on the tone of what you have written, for me at least. At times you write as if you are the go to EMT for all of NY.</p>

<p>Now I'll bring up some experiences from today in the ER since it was a long day with few interesting cases. I talked with a bunch of EMT's. In my hospital and in others in my state they do not do anything with the patient once in the hospital other than transfer them to a hospital ER stretcher and give info about the patient. Thats it. Now as far as volunteers go in my hospital doesn't matter if your a nurse or doctor thats volunteering, you are not touching a patient unless you are on the staff of the hospital. You can observe all you want and ask questions all you want about the procedure and why they are doing certain things. But if you start trying to do anything that they have not told to you do, thats it for you. </p>

<p>And for others reading this with no clinical experience I will shed some light on the subject that others never really seem to mention in these threads. Its boring for the most part in the hospital, if you are expecting Grey's Anatomy/House type stuff you aren't gonna find it. Most cases in the ER are elderly people with a few younger people thrown in every once in a while. There aren't 100s of people being rushed in gushing blood everywhere like on TV. In fact there aren't as many traumas as they may make you think there on TV. Today in my 4 hour shift the were three traumas. One was a modified trauma with a male involved in a car wreck. Another a full trauma with a female involved in a high speec car wreck. And the last was another male with higher fever and the rest I don't know because my shift was over. Needless to say none of these people were gushing blood. The modified trauma had a cut basically. Full trauma turned out not to be a trauma at all, and the last guy I have no clue. </p>

<p>So for those who haven't done clinical work before, don't expect anything. If you have low expectations you will only be pleasantly surprised. If you go in with dreams of granduer and being a savior, not gonna happen. Maybe for that 1 in a million kid it might, but for most people it won't. My advice is take it in, the smells, the sights, the pace. See how crazy it is and ask doctors and nurses as many questions as possible and observe as many procedures as possible. If you do this your experience will be worthwhile, and you will have a much better idea of whether or not you want to be a doctor. </p>

<p>Thats my 2 cents.</p>

<p>its because i strongly suggest doing it for anyone looking to go into the medical field.</p>