The Unwritten Premed Curriculum: Insights from Physician Shadowing

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By: Jennifer Y. Wang, a senior medical student at the Stanford School of Medicine

It’s not entirely clear when I decided to affix the dreaded “premed” label upon myself. As a freshman at Stanford University eight years ago, I was also considering the possibilities of becoming a computer scientist or a biomedical researcher or engineer. But sometime between starting organic chemistry at the end of freshman year and declaring my biology major (one of the most premed-compatible majors) at the end of sophomore year, it seemed like I had already committed myself to the full-time job of getting into medical school.

For me, the decision to apply to medical school was not difficult. Having family members in medicine, I was somewhat familiar with the career path, both its hardships and rewards. Overall, the medical profession seemed a natural fit for my love for science and innovation and my desire to do tangible good in people’s lives. Yet, despite my enthusiasm for the field of medicine, I am not sure my nineteen-year-old self could have told you, in specific terms, what exactly a physician does to “treat patients.” I regularly volunteered on a hospital ward during college, hoping to gain a better understanding of what being a doctor actually entailed. But while I learned to interpret the various beeps and chimes on an inpatient ward, I did not get to truly see patient care from the physician’s perspective.

Halfway through my sophomore year, I was among the first cohort of students to enroll in the Stanford Immersion in Medicine Series (SIMS), a physician shadowing program for premedical undergraduate students described in our Innovation Report. I saw SIMS as the perfect opportunity to explore medicine more in depth and confirm my early commitment to being “premed.” The program, though in its infancy at the time, provided an easy and rather streamlined entryway into the clinical realm: some paperwork and patient privacy training; at least four shadowing sessions with an assigned physician mentor; and a reflective essay at the end. In some ways, it seemed almost too good to be true. Over the course of my undergraduate career, I was fortunate enough to shadow three different physicians through SIMS, as well as eventually serve on the program’s administration.

As a senior medical student now looking back at my old SIMS reflective essays, I realize that shadowing only played a minor part in propelling me towards a career in medicine. As with many of the SIMS students we surveyed in our study, physician shadowing did little to change my mind about whether or not medicine was right for me. Shadowing certainly strengthened my convictions about pursuing a career in medicine, but perhaps more importantly, it truly opened my eyes to the daily work of the physician. Much of what I wrote about as a sophomore revolved around my realizations and observations of how doctors actually go about caring for their patients, not just in terms of the basic mechanics of clinical practice but also the deeply personal connections between physicians and their patients. As I had noted: “This is what being a doctor meant: it was more than just poking and prodding, questioning, and scoping (occasionally) the patient—it was about helping people straighten out their lives so that, holistically, they would be healthier.”

Gaining this firsthand perspective of medicine undoubtedly helped me form a more concrete vision of what I wanted to get out of my premedical coursework and who I wanted to be at the end of that long journey. Contrary to what I had hoped going into SIMS, shadowing as an undergrad did not help me pick a medical specialty, nor did it provide me with much insight into the challenges of medical school and residency. Instead, as I concluded in one reflective essay, I feel that the early guidance of my SIMS physician mentors, particularly their role modeling of how to be physicians, did provide me with “the inspiration to look past the tedious schooling and training towards an emotionally rewarding career.”

In other words, it made being “premed” worth it.