A recent incident at a hospital in Syracuse, New York raised some serious concerns about shadowing. An anesthesiologist allowed a college student to endotracheally intubate a patient in the operating room. This was a problem on many levels. Students who are shadowing are not supposed to touch or examine patients. The patient who was intubated likely did not know that an unlicensed college student would be doing a procedure on him. And of course, there's HIPAA.
According to the article, the director of Consumers Union's Safe Patient Project, called the incident an "egregious violation of patient-doctor trust."
I've had a problem with shadowing for many years, and I'm not the first to say so. Dr. Elizabeth Kitsis, director of bioethics education at Albert Einstein College of Medicine in New York, has blogged about the topic.
She told of a male pre-med student who was introduced to patients as a "student doctor" and watched a gynecologist perform pelvic exams. The student himself said he felt a little awkward. One wonders how the unsuspecting patients would have felt had it been known he was a college student thinking about becoming a doctor.
There were many comments pro and con on both Dr. Kitsis's blog and a follow-up piece that appeared on another Einstein blog.
Dr. Kitsis co-authored a paper which found that few studies have looked at shadowing by pre-med students. She called for guidelines and a code of conduct for this activity.
Several questions come to mind.
With all the information available on the Internet, is shadowing really an effective way for college students to decide whether to become physicians or not?
Is there any research comparing career outcomes of pre-med students who shadowed doctors to those who did not?
What about the patients? Do they have any say in this? Are students who shadow introduced as who they really are?
How does a student choose a doctor to shadow? As far as I can tell, there is no quality control for this aspect of shadowing.
Is shadowing mandatory in other fields? Must one shadow before becoming an engineer [civil, railroad, or sanitation], an accountant, a fighter pilot, a shepherd, or an exotic dancer?