Tracking Your Hours

Pre-med, on an early May afternoon, opens the computer and logs into the medical school application. It's time to fill out the activities portion of the application. So pre-med opens a spreadsheet and tries to remember. The hospital volunteering started in October of freshman year, or maybe November? Twice a month, except for finals and for the stretch in March, maybe? For two summers of clinical work, how many hours? Pre-med is estimating, rounding, and wondering if it's true and honest.

She is not dishonest. She simply does not know.

And there is no way to find out now.

On Memory, Desire, and Experience

There is an old practice, older than medicine, older than universities: recordkeeping (mind blown). The ancient Egyptians kept records, once-existent monasteries, ship captains, farmers who didn't want to lose the harvest, and even nature recordkeeps.

Thousands of years of history is a warning to heed. Truth is preserved by writing things down. People, our memories are not a vault; we have a limited capacity to remember everything, unless you have a photographic memory. The nature of memory is inherently a narrative, and this narrative is gonna be shaped by desire. This is a portion of why reality is malleable, because the objective (the external world) is only at liberty to be understood by a subjective (our minds) using subjective capacity (the capabilities of our minds), which is finite and based on prior sets. Please excuse the philosophical rant. The point is simple: keep records.

AMCAS asks you for:

• Start and End dates for each involvement and position within the involvement.
• Total completed hours for each position in the specific experience.
• Anticipated hours.
• A contact who can verify the experience.

The application assumes you have been keeping records. If you have not, you are now reconstructing a legal document from a feeling. Big no no! Don't!

First The Story…

286/1000 posts from the Threads of Regret said: keep a running log, just keep one. That was the answer that appeared more than anything else, including questions about minimums and totals, and what looks competitive.

When it comes to activities, there are two main anxieties. The first is numerical: do I have enough? The second is narrative: can I say anything real about what those hours meant?

The numerical anxiety is what students expect. The narrative anxiety is what destroys applications.

The many students who have struggled prior to you want you to know: keep a journal of the moments that mattered, the teamwork, the patient experience that had an effect on you. Because if you do, later, those small moments become your essays and your activity descriptions. And for the essays of the application, the difference between an essay and a really good essay is the story. I will tell you a secret: the greatest marketers, the biggest brands, billion dollar companies all understand the power of stories. Stories have started revolutions, kept societies together, and stories make a world of difference in applications.

You cannot reconstruct a moment of genuine feeling from numbers, so keep notes of interactions!

Then The Numbers

There is no universal official minimum for clinical hours. AAMC and AACOMAS do not publish a number you must hit. The Threads of Regret have developed over time some consensus: somewhere around 200 to 300 clinical hours as a baseline, a baseline of 50 shadowing hours, and 100-plus in clinical and nonclinical service each.

THESE ARE NOT RULES! They are the collective memory of people who applied and watched what happened. They deserve the same respect as a landline from the 1960s does, sheer awe of it, and realizing its ancient status.

The more smartphone message is: consistency matters more than accumulation. Long-term experience with substance beats frantic short-term accumulation. A student who spent two years in one clinical setting has a story that has had time to bloom and grow, and time to create connections. All of which a student who crammed 300 hours in a summer doesn't. And remember, 1500 hours with a terrible story is not as powerful as 500 hours with a really moving story.

You Choose Moral Anxiety & Distress

The Threads of Regret show many students in discomfort of having to balance truth and estimating hours. Some students admit they rounded up because they never kept a real log and did not want their totals to look thin. Others say they rounded down because they were afraid of appearing dishonest. Both groups were uncomfortable making a judgment call about their own integrity under pressure, with no documentation to support.

A running log removes this chosen anxiety. And remember that keeping a record doesn't require you to be perfect. Write down moments and stories.

The ancient Egyptians kept it without a phone or the internet. You can do it too, a lot easier.