Of the 53,042 applicants to U.S. medical schools in 2016–17, just 21,030 (40 percent) matriculated. That’s down from 49 percent in 2002–03.
And most applicants aren’t getting into their school of choice. Among 115 ranked medical schools, the average acceptance rate in fall 2015 was just 6.9 percent, U.S. News & World Report found in an annual survey.
Test scores will only take you so far. Often it's the quality of your clinical experience that makes the real difference between acceptance and rejection.
One of the best ways to get that experience is to become a medical scribe.
I was in my third year of undergrad and considering becoming a PA when a friend who was scribing convinced me to apply.
Not only did my scribing experience help me to eventually get into PA school, it taught me a myriad of things that school did not.
What PA Schools Don't Teach You
As a scribe, you work with different providers each shift, so you see the art of medicine as practiced by a variety of individuals and disciplines.
Although a scribe can't directly contribute to procedures or medical decision-making, they have a rare opportunity to see the process up close.
They also witness effective — and ineffective — communication among nurses, techs, staff members, and patients.
One great experience I had as a scribe was working alongside a physician who only gave “good news." Once test results came back, regardless if they were negative or positive, he would always explain them to the patient in a positive light.
For example, when he talked with a patient with a positive CT scan for appendicitis, he would say, “Good news, your test results are positive for appendicitis, and now we know exactly how to treat this. You are in the right place and we have the best surgeons, who are very experienced with successful outcomes.”
Or if a CT scan for appendicitis was negative, he would approach the patient saying, “Good news, the results of your CT scan and physical examination show that you do not have appendicitis. That’s great that we have ruled out any condition that would require emergent surgery at this time. ” This clearly demonstrates how bedside manner is imperative for successful communication.
Scribes also learn how doctors consult with specialists and admitting providers and how to present cases to colleagues. They also learn how to work with strong provider personalities. This can be a critical skill in the hospital setting — especially in the highly charged environment of the ED.
The experience scribes get is invaluable. They enter professional school knowing what a patient encounter looks and sounds like.
They can also document such encounters accurately and effectively. This can come in handy later, as documentation is not given much airtime in most health professions programs.
Hopefully programs will increasingly recognize the value of the medical scribing experience. Personally, I can't think of better preparation for the medical field.
Making the Most of the Physician-Scribe Relationship
Being a scribe is also the best pre-medicine, pre-PA, pre-NP experience you can have. Not only are you exposed to medicine right in front of you, you're able to ask questions and get feedback in real time.
It’s important to learn when to communicate with your provider, in particular when to ask questions. Most physicians love to teach, but at the right time. Not, for example, when they’re inundated.
Try to ask your clinical questions right after seeing a specific case, after orders are written, your documentation is complete, and the provider has finished stabilizing the patient. (But never be afraid to ask for clarification during the visit when you need it for documentation purposes.)
When approached thoughtfully and in the appropriate setting, physicians can be both your best teachers and your biggest champions. Their advocacy could prove especially important when the time comes to get reference letters for your professional school application.
Life After Scribing
The time I spent as a scribe made my decision to enter the medical field an easy one. After scribing for three years, I enrolled in the PA program at Touro University.
Conversely, scribing helped a friend of mine realize that she did not want to go to into healthcare. That's yet another benefit of real-life clinical experience. It will either solidify your goal or steer you in a new direction.
If you do decide to pursue professional school, here are some tips. Hopefully they'll help you leverage your scribing experience on your application as well as once you’re enrolled:
- Try to see as many types of procedures as possible. Also, learn to document them.
- Learn how to document effectively and accurately, much like a physician would.
- Communicate with everyone — providers, administrators, hospital staff, and patients.
- Practice asking questions of appropriate people at appropriate times.
- Observe and become familiar with pathophysiology.
Upon graduation, I was lucky to get hired by Vituity (at Palomar Health). I highly recommend that other scribes give Vituity a try. This physician-owned group is focused on building a culture of caring that makes medicine a joy to practice.
And make no mistake: when I became a PA, one of my core goals was to get my own scribe. That’s because I knew firsthand that they make the provider experience so much better.