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The burden of shadowing and volunteering in medical school admissions: a hurdle, not a measure of commitment

Myles Gart, MD
Education
February 9, 2025
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In recent years, the requirements for medical school admission have expanded far beyond academic excellence and personal statements. Shadowing physicians and accumulating volunteer hours are now seen as prerequisites for demonstrating commitment to the profession. However, these requirements, while well-intentioned, have become unnecessary hurdles rather than meaningful indicators of dedication or future success as a physician.

Unnecessary compared to other professions

Medical school applicants are asked to prove their commitment in ways that applicants to other demanding professions, such as engineering or music, are not. Engineering schools do not require students to shadow professional engineers, and music programs rarely mandate unpaid service hours in music-related fields. Instead, applicants are judged on their academic record, demonstrated talent, and passion for the field. By contrast, aspiring physicians are held to a subjective and often burdensome standard that extends far beyond classroom achievement.

A barrier to equity

The expectation that applicants spend hundreds of hours shadowing and volunteering creates a system that favors those with time, financial resources, and connections. For students who need to work, support family members, or attend schools without robust pre-medical support, these requirements are formidable obstacles. The assumption that unpaid shadowing and volunteering experiences cultivate empathy and dedication ignores the reality that many students are already managing significant responsibilities that demonstrate these qualities in real life.

Box-checking versus authentic experiences

Instead of fostering genuine growth, these requirements often encourage superficial “box-checking” behaviors. The focus shifts from meaningful experiences to ensuring that an application appears competitive. In many cases, shadowing consists of standing silently in exam rooms, observing physicians without context or interaction. While shadowing may offer a brief glimpse into the clinical world, it is unlikely to shape an applicant’s core motivation to pursue medicine.

Academic achievement speaks volumes.

An applicant’s academic record, along with research, leadership roles, and personal achievements, should already reflect their commitment, resilience, and intellectual curiosity. The decision to apply to medical school itself reflects years of preparation, sacrifice, and long-term dedication. By requiring additional unpaid hours in clinical settings, admissions committees risk devaluing the significance of academic and personal accomplishments.

A product of holistic admissions overcorrection

The rise of “holistic admissions” has led to an increased emphasis on non-academic qualities such as empathy, resilience, and altruism. While this shift aims to produce well-rounded physicians, it has also overcorrected, placing an excessive burden on applicants to prove their worth in ways that may have little relevance to their future performance as physicians. Many practicing physicians acknowledge that shadowing did little to prepare them for medical school or clinical rotations. Their clinical competence and compassion were shaped by formal education, clinical training, and real-world experience—not by shadowing.

Reimagining the path to medicine

It is time to reassess the value of shadowing and volunteering in the admissions process. Alternatives, such as structured interviews or reflective essays based on lived experiences, could provide more authentic insights into an applicant’s empathy and readiness for the profession. Programs should also consider making shadowing optional or reducing its weight in admissions decisions to avoid excluding highly qualified candidates who may lack the resources to meet these expectations.

Conclusion

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Medical school applicants should not have to demonstrate commitment beyond their academic achievements, research, and leadership experiences. The current system risks excluding passionate, capable individuals who have already shown resilience and dedication in meaningful ways. By shifting the focus away from hours logged and toward a more holistic understanding of applicants’ journeys, we can build a more equitable and effective admissions process—one that prioritizes future potential over arbitrary benchmarks.

In a profession that values empathy and service, we should ensure that the path to becoming a physician reflects those same values.

Myles Gart is an anesthesiologist.

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