• Home
  • Health & Wellness
  • Disclaimer
    • Terms of Use
    • Privacy Policy
    • DMCA Notice
  • Home
  • Health & Wellness
  • Disclaimer
    • Terms of Use
    • Privacy Policy
    • DMCA Notice
24/7 Health News
No Result
View All Result
Home Article

‘May cause serious side-effects’: How medical school admissions can perpetuate inequality and reward privilege

April 11, 2023
in Article
‘May cause serious side-effects’: How medical school admissions can perpetuate inequality and reward privilege
Volunteering for global health experience is a common way of gaining clinical observation experiences for medical school applicants. This, and other opportunities to get close to the practice of medicine, also have unintended consequences. (Shutterstock)

Would-be physicians are often told that a winning medical school application requires stories about observing clinical care. Applicants’ quests to get clinical experiences — through, for example, physician shadowing, global health experiences or medical scribe work — can have harmful unintended consequences.

Such activities can perpetuate inequality when they disguise privilege as merit, reinforce damaging narratives or even hurt patients in poorer countries, and contribute to exploiting a vulnerable labour force.

We are medical anthropologists who have researched social and cultural dimensions of medical education. As teachers, we have worked with thousands of undergraduate pre-meds. We recently published, together with two co-authors, an article that we believe is the first to draw attention to how medical-school applications can cause broader harms.

Aspiring physicians encounter many sources of advice, from the admissions websites of medical schools to pre-health advising centres to paid coaches. All of these advisors recommend experiences that put medical-school applicants adjacent to medical care.

The advice may seem sensible. Watching medical professionals at work could serve as an occupational test drive. Applicants might better understand the profession before starting a long and gruelling training period — and possibly taking on a heavy burden of student debt. Admissions committees may also hope that such activities can provide evidence of personal qualities desirable in a physician, such as determination, altruism and a commitment to service.

It’s hard to say whether such experiences actually make for better doctors; the evidence is limited. The quest for such experiences does have other effects, however — and as anthropologists, those interest us. In particular, we want to shine a bright light on the effects that these activities have, in the broader social world:

  • How do applicants’ social backgrounds affect their access to clinical observation experiences?
  • Which potentially great doctors get lost along the way, discouraged even from applying?
  • And how might pre-med students’ presence as observers matter, for practising clinicians and their patients?

Three common pathways to gaining clinical observation experiences are physician shadowing, global health experiences and medical scribe work. Each offers opportunities to get close to the practice of medicine, but each also brings unintended consequences that run counter to the values of the medical profession.

Table of Contents

  • Physician shadowing
  • Global health experiences
  • Medical scribes

Physician shadowing

Physician shadowing involves following doctors during their day-to-day working routines.

A doctor shakes a patient's hand while a young woman with a clipboard watches
Physician shadowing is strongly recommended or even required by medical schools, but it is increasingly difficult to arrange without family or social connections to physicians.
(Shutterstock)

What a student is invited to observe varies considerably, depending upon policies around patient privacy and the idiosyncrasies of individual physicians. What patients are told about this “member of the team” may vary too.

The ethics of shadowing can be troubling, and the implications for equity are problematic. Though strongly recommended or even required by medical schools, shadowing is increasingly difficult to arrange without family or social connections to physicians. Studies show that students from less privileged backgrounds struggle to find shadowing opportunities and may become discouraged and give up.

Shadowing launders social privilege into individual merit, preserving medicine as a field for elites that masquerades as a meritocracy.

Global health experiences

Global health experiences are short-term volunteer stints in low-income countries. These opportunities have expanded dramatically in the last two decades.

Some are university led, others are run by for-profit groups and packaged as (expensive) tours. They bring students from wealthier countries to communities in poorer parts of the world to observe health problems and medical care, often across stark racialized divides. Without historical context for the differences they encounter, students can easily fall into regarding poverty and illness as somehow natural or inevitable, rather than recognizing them as outcomes of colonial relations and their contemporary legacies.

A child in the foreground as a young woman wearing a stethoscope smiles behind her
Global health experiences bring North American students to communities in poorer parts of the world to observe health problems and medical care.
(Shutterstock)

Placement organizations often market these experiences as helpful for strengthening one’s medical school application. Some of our own students feel caught between a distaste for what they call “poverty porn,” and the worry that such experiences are critical. For some, the cost is also prohibitive. We see additional reasons for concern: undergraduate global health tours can also reinforce colonial or “white saviour” narratives, slotting students and those they encounter into rescuer and victim roles.




Read more:
How white saviourism harms international development


When inexperienced students actually participate in delivering treatment, such as extracting teeth or delivering babies, they can also cause medical harm.

Medical scribes

Medical scribe work involves clerical labour created by the adoption of electronic health records.

A scribe is present in the clinic, typing notes into a computerized record in real time while a physician speaks with or examines patients. The work is not well paid, and offers few opportunities for advancement, but companies that employ scribes advertise it as “the ultimate clinical experience that you can get before medical school.”

A doctor examining a patient, while a woman typing on a laptop sits in the background
Medical scribe work: pathway to a physician career or poorly paid dead-end job?
(AP Photo/Jeff Chiu)

And, indeed, young people with excellent college training in biology or other science fields compete fiercely for these otherwise unpromising jobs, in hopes that they will strengthen applications to medical school, although there is little evidence that they do.

Much as the slim hope of playing in the NFL helps fill the ranks of student-athletes on U.S. college football teams, the slim hope of gaining admittance to medical school helps staff low-ranking clerical positions within medicine. In this way, the competition for medical school admissions may contribute to exploitative labour conditions.

All three of these pathways to clinical experience worsen the inequalities that trouble medicine as a profession. None of them has been demonstrated to make better doctors. Some of them cause harms far afield. All of them are likely to put excellent applicants from less privileged backgrounds at a disadvantage.

It is time to apply “first, do no harm” to the medical-school application process.

The Conversation

The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

ShareTweetSharePin
Next Post
Brain training probably doesn’t help ADHD – new study

Brain training probably doesn't help ADHD – new study

Most Read

What causes stuttering? A speech pathology researcher explains the science and the misconceptions around this speech disorder

What causes stuttering? A speech pathology researcher explains the science and the misconceptions around this speech disorder

December 15, 2022
morning back pain

Morning Again Ache Trigger Is Not the Mattress

October 11, 2021

Why Circadian Rhythms Matter for Your Health

July 30, 2024
lower back pain relief exercises

5 decrease again ache aid workouts

October 11, 2021

4 steps to building a healthier relationship with your phone

January 28, 2025
3 years after legalization, we have shockingly little information about how it changed cannabis use and health harms

3 years after legalization, we have shockingly little information about how it changed cannabis use and health harms

October 15, 2021
Nasal vaccines promise to stop the COVID-19 virus before it gets to the lungs – an immunologist explains how they work

Nasal vaccines promise to stop the COVID-19 virus before it gets to the lungs – an immunologist explains how they work

December 14, 2022
bleeding in gum

When The Bleeding in gum Is Severe ?

October 11, 2021
Good Night Sleep

6 Causes of Good Evening Sleep

October 11, 2021
Kick up your heels – ballroom dancing offers benefits to the aging brain and could help stave off dementia

Kick up your heels – ballroom dancing offers benefits to the aging brain and could help stave off dementia

January 3, 2023
Biden is getting prostate cancer treatment, but that’s not the best choice for all men − a cancer researcher describes how she helped her father decide

Biden is getting prostate cancer treatment, but that’s not the best choice for all men − a cancer researcher describes how she helped her father decide

May 20, 2025
Ten small changes you can make today to prevent weight gain

Ten small changes you can make today to prevent weight gain

October 12, 2021

COVID vaccines: how one can pace up rollout in poorer international locations

October 5, 2021

This Simple Hygiene Habit Could Cut Your Risk of Stroke, New Research Reveals

February 1, 2025

Multiple sclerosis: the link with earlier infection just got stronger – new study

October 12, 2021
Support and collaboration with health-care providers can help people make health decisions

Support and collaboration with health-care providers can help people make health decisions

December 16, 2021
Greece to make COVID vaccines mandatory for over-60s, but do vaccine mandates work?

Greece to make COVID vaccines mandatory for over-60s, but do vaccine mandates work?

December 1, 2021
Five ways to avoid pain and injury when starting a new exercise regime

Five ways to avoid pain and injury when starting a new exercise regime

December 30, 2022
woman covered with white blanket

Exploring the Impact of Sleep Patterns on Mental Health

August 4, 2024

Maximize Your Performance – Sync with Your Circadian Rhythms

August 9, 2024
Why are some people faster than others? 2 exercise scientists explain the secrets of running speed

Why are some people faster than others? 2 exercise scientists explain the secrets of running speed

April 29, 2024
Backlash to transgender health care isn’t new − but the faulty science used to justify it has changed to meet the times

Backlash to transgender health care isn’t new − but the faulty science used to justify it has changed to meet the times

January 30, 2024
News of war can impact your mental health — here’s how to cope

Binge-eating disorder is more common than many realise, yet it’s rarely discussed – here’s what you need to know

December 2, 2022
As viral infections skyrocket, masks are still a tried-and-true way to help keep yourself and others safe

As viral infections skyrocket, masks are still a tried-and-true way to help keep yourself and others safe

December 14, 2022
GPs don’t give useful weight-loss advice – new study

GPs don’t give useful weight-loss advice – new study

December 16, 2022
Nutrition advice is rife with misinformation − a medical education specialist explains how to tell valid health information from pseudoscience

Nutrition advice is rife with misinformation − a medical education specialist explains how to tell valid health information from pseudoscience

January 28, 2025
FDA limits access to COVID-19 vaccine to older adults and other high-risk groups – a public health expert explains the new rules

FDA limits access to COVID-19 vaccine to older adults and other high-risk groups – a public health expert explains the new rules

May 21, 2025
Four ways to avoid gaining weight over the festive period – but also why you shouldn’t fret about it too much

Four ways to avoid gaining weight over the festive period – but also why you shouldn’t fret about it too much

December 22, 2022
Nurses’ attitudes toward COVID-19 vaccination for their children are highly influenced by partisanship, a new study finds

Nurses’ attitudes toward COVID-19 vaccination for their children are highly influenced by partisanship, a new study finds

December 2, 2022
How hot is too hot for the human body? Our lab found heat + humidity gets dangerous faster than many people realize

How hot is too hot for the human body? Our lab found heat + humidity gets dangerous faster than many people realize

July 6, 2022
  • Home
  • Health & Wellness
  • Disclaimer

© 2020 DAILY HEALTH NEWS

  • Home
  • Health & Wellness
  • Disclaimer
    • Terms of Use
    • Privacy Policy
    • DMCA Notice

© 2020 DAILY HEALTH NEWS