In the shadows: medical student clinical observerships and career exploration in the face of COVID-19

The value of medical shadowing for high school students: A three-dimensional view

Medical shadowing helps provide clinical exposure to aspiring and current medical students, mainly at the college level. This paper makes a case for making medical shadowing opportunities more widely available for high school students. Through the perspective of a high school student who got such an opportunity, we demonstrate that high school students can gain valuable clinical knowledge and exposure to the ethics involved in patient care, inspiring them to explore further pathways that will help them make better-informed academic and career choices. This high school student provides pointers on preparing for medical shadowing encounters through background research and developing a note-taking template. We also offer early-career and experienced physicians' perspectives on how providing medical shadowing opportunities to high school students benefits practicing physicians by energizing their motivation, reaffirming their commitment to the profession, and gaining a fresh perspective on their work. We believe that medical shadowing for high school students can open channels to attract and motivate a young and diverse talent pool to the medical profession that will help mitigate the projected shortfall of physicians in the next decade.

Overshadowed by shadowing: exploring how Canadian medical students experience shadowing

Background

Preclinical medical students commonly perceive shadowing as beneficial for career exploration. However, research is sparse on the broader impact of shadowing as a learning strategy. We explored students' perceptions and lived experiences of shadowing to understand its role and impact on their personal and professional lives.

Methods

Between 2020-2021, individual semi-structured video interviews were conducted with 15 Canadian medical students in this qualitative descriptive study. Inductive analysis proceeded concurrently with data collection until no new dominant concepts were identified. Data were iteratively coded and grouped into themes.

Results

Participants described internal and external factors that moulded shadowing experiences, arising tensions between intended and perceived experiences, and how these lived experiences impacted their wellness. Internal factors associated with shadowing behaviour included: 1) aspiring to be the best and shadowing to demonstrate excellence, 2) shadowing for career exploration, 3) shadowing as learning opportunities for early clinical exposure and career preparedness, and 4) reaffirming and redefining professional identity through shadowing. External factors were: 1) unclear residency match processes which position shadowing as competitive leverage, 2) faculty messaging that perpetuates student confusion around the intended value of shadowing, and 3) social comparison in peer discourse, fuelling a competitive shadowing culture.

Conclusions

The tension between balancing wellness with career ambitions and the unintended consequences of unclear messaging regarding shadowing in a competitive medical culture highlights issues inherent in shadowing culture.