With the start of a new academic year and a rapidly approaching start to the next application cycle, I thought this was a good time to fulfill a request I recently received from a reader regarding the impact of pre-medical shadowing on patients. It was their contention that shadowing by premeds occur absent of consideration for the uniquely vulnerable state of patients with the mix of fear, confusion, anxiety, and other strong emotions that illness brings. They further describe the overall experience as “voyeuristic” and cite the potentially coercive impact of being asked permission to have a student in the room from one’s physician.
Before offering my response I would first like to apologize to this patient as she has clearly not been treated with sufficient respect by those students by which she has worked. This, in turn, leads to the point that the purpose of shadowing is not to simply be present for the sake of checking off a box on an application but actively considering if one is suited for a career in medicine. Critical to this process is both the careful evaluation of one’s preceptors for the strengths and weaknesses in their approach to patients anas well as gaining an active awareness of the vulnerability described in the email I received. At the time most of us begin to shadow we are often blessed with few significant health concerns and so the immersion in the world of the hospital is a critical introduction to a world we have not previously occupied. Looking at my own early shadowing experience I see them as a refutation rather than an encouragement of voyeurism. In pediatric neurology, in particular, I became aware of the broad-ranging impact a physician can have not only clinical but on aspects of life such as learning disability screening. At least for me, this was motivation not only to more deeply consider the lives and circumstances of patients outside the clinic but to more deeply engage with the community to address in small ways a select few of the wide-ranging issues which can deleteriously impact health.
Medicine is ultimately a field rooted in the desire to meaningfully improve patient’s lives, a student who makes those patients with whom they interact feel disrespected and exploited should revaluate either their approach to those around them or their career aspirations.