Lessons From In- and Outpatient Shadowing Experiences

Shadow physicians in different clinical settings to become a well-rounded medical school applicant.



Through inpatient shadowing, prospective medical students can determine how comfortable they are working with very sick patients.

Physician shadowing is a nearly essential component of applying to medical school. The reason is relatively simple: Admissions committees want to know that applicants understand what practicing medicine as physician entails.

Are you comfortable around sick patients? Do you understand the professional interactions necessary to lead a multidisciplinary health care team? What type of practice do you envision yourself in? You can develop a basic understanding of these questions through shadowing experiences.

While many students choose a single clinical setting for this activity, I recommend selecting at least two different settings: one inpatient and one outpatient. Each type of experience offers unique benefits, and there are different areas you should pay particular attention to while shadowing.

Patient Population

Perhaps the biggest difference between shadowing in inpatient and outpatient settings is the patient population. Patients in inpatient facilities tend to be relatively sicker and have a more substantial burden of acute medical problems. A benefit of immersing yourself in this setting is that it will allow you to assess how comfortable you are interacting with very sick patients.

It is especially important to evaluate this honestly, because regardless of what you choose to practice, much of your clinical years of medical school and residency will be dedicated to taking care of patients who are very ill.

In contrast with inpatient settings, patients in an outpatient setting tend to have fewer acute medical issues that require immediate attention. As a prospective medical student, this can be beneficial because the patients' reduced medical complexity will allow you to focus on understanding the one or two problems that brought them into the facility.


This can also be an excellent learning opportunity. When time permits, ask the physician to clarify issues you don't understand and explain the rationale for choosing particular treatments.

Another significant difference between shadowing in the two different types of clinics is the socioeconomic status of the patient populations. While there are certainly exceptions to this rule – such as outpatient clinics that primarily treat underserved populations – in general, inpatient clinics have a patient population from a more diverse socioeconomic background.

This is an excellent opportunity to learn firsthand how economic circumstances, culture and education can influence the health of patients. This experience should help you to understand which patient populations you are drawn to and may begin to shape the type of practice you envision in your future.

Professional Interactions

Another major difference between these shadowing experiences is that shadowing at an inpatient facility often means that you will interact with a relatively large team consisting of medical students, residents, nurses, pharmacists and attending physicians. This will give you an opportunity to learn the dynamics of how a large medical team operates and will enable you to interact with individuals, such as medical students and residents, who are closer to your level of training.

While the attending physician may have relatively less time to interact with you in this setting, you will be able to ask medical students about their hours, responsibilities and work-life balance to determine if you could see yourself in this role in the future.


Inpatient settings also offer the opportunity to observe educational activities like grand rounds, morbidity and mortality conferences and tumor boards. These experiences will show you how health care professionals learn from each other and the ethos of continuously improving one's practice that is fundamental to the profession.

Moreover, this should impress upon you that choosing to become a physician necessitates humility, an ability to admit mistakes and a lifelong commitment to learning as the field advances.

In contrast with an inpatient facility, the health care teams at an outpatient facility tend to be smaller and more focused. While you may not have the opportunity to interact with many individuals at different levels of training, outpatient shadowing has the distinct benefit of allowing you to interact more extensively with the attending physician.

This is advantageous because, while the medical team at an inpatient facility may be too overwhelmed with managing their patients to engage in teaching prospective students, the attending physician in an outpatient facility will generally have relatively more time to spend with premedical students.

Additionally, if you are interested in obtaining a letter of recommendation from your shadowing experiences, this is an excellent opportunity to get to know the physician you are observing so that he or she can write you a more personal, meaningful letter.

Shadowing in both in- and outpatient settings offer distinct – and often complementary – educational opportunities that will help shape your vision of your future medical practice. Experiencing both will also make you a more informed applicant and, eventually, a better medical student.

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