FAQ: Pre-Med Extracurricular Activities

Pre-Med & Medical School Pre-Med Topics
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There’s a saying in medical school admissions: Your stats get you to the door, but it’s your ECs that get invited inside for an interview,

So what exactly are the ECs that all pre-meds are expected to have? There are 6 categories; 3 are “critical, must-haves”; the other 3 are “good to haves” if you want to be competitive applicant.

With regard to the ECs, it’s not the number of hours you have accumulated over the course of your pre-med journey, but what you have learned from them. The capacity for self-reflection is one of the 14 expected competencies that all med schools expect in incoming med students.

I am reluctant to list a specific number of hours for various activities, but except for physician shadowing, which has diminishing returns after about 75 hours, you should consider any hours listed as the minimum expected.

Have people been accepted with fewer hours? Of course they have. But some schools do screen for minimums in clinical exposure and community service.

Since these activities won’t be done all at once and it easy to lose track of information, I strongly recommend that all pre-meds keep a log sheet/spreadsheet/journal of your ECs starting your freshman year of college.

You need to record:

  • the name and location of the activity
  • the name and contact information for your supervisor or someone who can vouch for your involvement in the activity
  • how many hours you spent involved in the activity
  • first and last date you participated in the activity

Having this information handy will save a great deal of time when you go fill out your medical school applications.

The 6 types of pre-med ECs are:

  1. physician shadowing
  2. clinical experience/ clinical employment
  3. community service with disadvantaged groups
    ^^^Must haves
  4. Leadership
  5. Research
  6. Community Health Advocacy
    ^^^ good to have

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Physician Shadowing 50-75 hours

Physician shadowing means exactly what it says. You spend time observing the daily routine of a physician. (And it needs to be a physician, not a nurse, not nurse practitioner, not a physician assistant or any other physician extender.)

You should shadow in a variety of different specialties. Your shadowing experience should last at least one full day so you can see what a physician’s day looks like—the patient visits, the interactions with other medical professionals & staff, the paperwork, dealing with insurers, answering patient emails, practice administration.

Your shadowing experiences must include at least one full day with a primary care physician. A primary care physician is one who provides longitudinal care to patients. Family medicine physician, internist, pediatrician, geriatrician.

Why primary care? Primary care is the field most med students go into. So even if you are 100% sure you want to be a cardiothoracic ortho-neurosurgeon, you still need one day of shadowing in primary care.

Shadowing in the OR or Emergency Department is very intense and exciting, but it’s not what most physicians’ days are like. One or two days shadowing in those is plenty.

How to find shadowing opportunities?
Network. Network, Network.

Start by asking your own primary care doctor if you can shadow them. If they say no, ask if they would suggest someone who might allow you to shadow.

If you have family, friends or relatives who are physicians, ask them. Again, if they decline, ask for suggestions of who they think might allow you to shadow.

Be patient and persistent. Many large medical groups have rules against allowing students to observe in their facilities for HIPAA and insurance reasons.

Ask your school’s health professions advisor if they have a list of physicians who have allowed students to shadow in the past.

Counterintuitively, you may find that shadowing is the last EC you complete before applying to med school. Allowing a non-medical person into your daily medical routine is a big ask. It requires a certain amount of trust on the physician’s part that you, the student, are mature, reliable and discreet, that you won’t violate patient privacy. It takes time to build that trust. Most students find shadowing opportunities through their clinical volunteering activities. After a period of time, after you have proven your trustworthiness and the physicians get to know you better, they will be more amenable to allowing you to shadow them.

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Clinical Experience/Clinical Exposure 250+ hours

Clinical exposure requires working or volunteering in close proximity to patients. (“Close enough to smell the patient.”)

These experiences can come through volunteer positions or through paid employment.

The critical part of clinical exposure is that there must be some sort of doctor-patient interaction going on that is adjacent to the position/job and that you are able to observe.

Any position that is medical adjacent, but does not involve actual patient interaction is NOT a clinical experience. This includes jobs that are largely clerical like front reception desk at a medical office or hospital, or a supply stocker in the emergency department.

Another critical part of the experience is that it doctor- patient adjacent. If the individual being observed or interacted with is described using another term, it’s not clinical experience. For example, a clinical research coordinator will usually be recruiting test subjects or participants for an experiment, not patients. There is no doctor-patient relationship involved so these positions are usually NOT considered clinical. Working as therapy aide in home with autistic children is typically not clinical because there is no doctor-patient relationship being observed. It’s a therapist-client relationship.

However, when in doubt whether the position is clinical consult your health profession advisor who can help you determine if the position involves clinical exposure.

Jobs that are clinical—

  • Patient transporter
  • Certified Nurse’s Aide
  • Phlebotomist
  • Emergency Medical Technician
  • Patient Care Technician
  • Patient minder
  • Medical Translator
  • Medical Scribe
  • Medical Assistant

Volunteer positions have widely variable duties and may or may not be clinical depending on the exact duties required.

When in doubt, ask your pre-med advisor how they would classify your position.

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Community Service with the Disadvantaged 250+ hours

Empathy and compassion are one of the 14 key competencies (see: The Premed Competencies for Entering Medical Students | Students & Residents) that all medical schools expect medical school applicants to have.

Medical schools look for evidence of those traits in your ECs.

Community service needs to be hands-on and face-to-face. This means activities like fund-raising and administration of charitable organizations—while admirable and worthy—are not things that fulfill this expected competency.

Medical school adcomms are looking for long-term involvement in activities that directly help alleviate the suffering of others.

Typical activities include: food distribution (food bank, Meals on Wheels, soup kitchens, community gardens), housing rehabilitation (Habitat for Humanity, etc ), tax preparation assistance or job search assistance for the indigent or unhoused individuals, assisting at homeless shelters or shelters for those fleeing domestic violence, homeless outreach programs, providing transportation to/from medical appointments for indigent or unhoused individuals, and similar activities

Community service generally does NOT include activities like tutoring children or teaching ESL classes. These activities are considered academic activities where you are acting in the roles of an expert and therefore are not community service.

Adcomms are looking for future med students who are willing to go outside their comfort zone and work with individuals from very, very different backgrounds than themselves.

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Leadership

Medicine is a team sport. Physicians are the de facto leader of the team. Because you will need this skill for the entirety of your career, medical school adcomms are looking for evidence that you have it.

Leadership involves using persuasion and other social means to get other individuals to cooperate with you and each other to achieve a common goal. It doesn’t involve coercion and it doesn’t involve using your power over others to force them to comply.

Leadership can come in many forms and in many different activities. It needn’t involve holding a formal office. (President of the pre-med club is quite common and highly over-rated. It’s not given much weight by adcomms.)

Being a team coach or a TA is not a leadership position since you are operating from a place of power to get others to follow your directions.

Leadership could be the lead server at a restaurant, or a trainer for new employees. It could be being the team leader on a group project for a class or internship. Or an officer of your fraternity/sorority. Or captain of your intramural team.

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Research (optional, but strongly recommended for traditional students)

Research is an EC that is often over-valued by pre-meds and their parents. Patient-facing experiences are much more valuable on a med school application than research.

However, having some research exposure is helpful for traditional pre-med students.

Traditional pre-meds are those who intend to apply to medical school within 2 years of graduating from undergrad, and who have taken some or all of their pre-med required classes during undergrad.

The purpose of research is to gain exposure to the process of research. How to identify a research problem, doing a literature review to learn about a potential research topic, formulating a testable hypothesis, designing a research protocol, collecting data, analyzing data, drawing conclusions and sharing your findings.

For most pre-meds, a summer research intensive program or 1 year of being a research assistant in a lab is enough.

You want to learn about the sometimes frustrating and complicated process that is research. What are the pitfalls? What are the potential benefits?

For students aiming for research intensive medical schools, research takes on a larger importance. Not only is research expected, often hundreds to thousands of hours, but research productivity may be considered. Students do not necessarily need publications/posters/presentations. This is because some fields of research take longer to develop meaningful results. Also because not all labs are equally funded or equipped. But a letter from your PI will be expected as part of your application portfolio attesting to your lab abilities and productivity.

For non-traditional med school applicants, having research experience is not expected. In fact, having no research lab experience is perfectly acceptable because adcomms understand the difficulty of obtaining research lab experience once one has graduated from college.

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Community Health Advocacy (optional, but recommended)

This is AMCAS ‘s newest category for activities.

FROM AMCAS’s handout

https://students-residents.aamc.org/media/14256/download

Purpose:

The Community Health Advocacy experience type provides you with an opportunity to describe sustained efforts that contribute to improving community health and public health. This category reflects the professional responsibility of physicians to engage in activities that strengthen the health and wellbeing of the communities they serve.

What is a Community Health Advocacy experience?

A Community Health Advocacy experience is one in which you have actively worked to
influence, support, or advance conditions that improve community or population health. These experiences are characterized by initiative, sustained engagement, and a focus on impact rather than participation alone. They emphasize intentional efforts to improve community or public health outcomes beyond individual or episodic service.

How does this differ from other Work and Activities experience types?

  • Community Service (Medical or Non-Medical) typically reflects direct service or
    volunteerism with immediate, individual-level impact. Community Health Advocacy emphasizes efforts to influence systems, policies, or conditions that affect community or population health more broadly.

  • Leadership captures roles focused on managing people, programs, or organizations. Community Health Advocacy is used when the primary purpose of the experience is advancing community or public health outcomes.

  • Teaching or Tutoring focuses on instructional roles. Educational activities may be included under Community Health Advocacy when they are part of a broader effort to
    advance community health.

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