A building showcasing the architecture of the city of Genoa.
A building showcasing the architecture of the city of Genoa in Italy (an Atlantis site).

Healthcare Exposure With Greater Depth, Breadth, Quantity, & Intercultural Perspective

The first pillar of med/PA school admissions is healthcare exposure. Read on to see how Atlantis provides it comprehensively.

Compare the Shadowing Experiences

Relative to typical shadowing or other clinical experiences, Atlantis programs, which follow our 360 Shadowing model, tend to be better at four elements, all of which med/PA schools ultimately evaluate: depth, breadth, quantity, and intercultural perspective. Explore this overview comparison chart and dive into deeper detail below the chart.

Areas of Evaluation

Typical Shadowing

Typical Shadowing

360 Shadowing

Areas of Evaluation


  • Exposure to healthcare setting in general
  • Observing day-to-day tasks + appointments
  • Exposure to healthcare setting in general
  • Observing day-to-day tasks + appointments


  • Generally, regularly observe surgeries + complex procedures
  • Focus on the MD profile + perspective


  • Exposure to one or few specialties
  • Shadowing one doctor and potentially meeting colleagues
  • Exposure to one or few specialties
  • Shadowing one doctor and potentially meeting colleagues


  • Multiple specialties (typically one per week)
  • Usually shadowing multiple doctors + meeting many department staff and residents


  • Smaller number of hours
  • Spread out over a longer period of time, often during the semester
  • Smaller number of hours
  • Spread out over a longer period of time, often during the semester


  • In a 6-week program, 120+ shadowing hours (20+ hours per week)
  • Concentrated during breaks, allowing focus during the semester

Intercultural Perspective

  • Not expanding horizons if shadowing in the U.S.
  • A good learning experience if shadowing in developing countries, but volunteers are still applying their own country’s approach
  • Not expanding horizons if shadowing in the U.S.
  • A good learning experience if shadowing in developing countries, but volunteers are still applying their own country’s approach

Intercultural Perspective

  • Experiencing a highly developed healthcare system as a genuine outsider, fostering compassion for others
  • Distinguishing for yourself what is essential vs. culturally contingent in medicine
  • Setting yourself apart with an informed, mature perspective on comparative healthcare systems
What’s the Point?

Overview of How Atlantis Addresses the Need for Healthcare Exposure in Medical School Applicants

Atlantis alumni have been admitted to 40 of the top 50 (and 16 of the top 20) U.S. MD programs, and these 40 U.S. MD programs include 20 of the worldwide top 50 medical schools; they’ve also been admitted to other U.S. MD programs, as well as to DO, PA, and other healthcare programs, and alumni often tell us that Atlantis played a role in that. This has to do with how med/PA programs assess applicants.

Med/PA schools want you to have seen medicine in the real world, mostly to ensure you know what it looks like and your commitment is genuine. The reason med/PA schools value clinical experience (such as shadowing) in their admissions process is that it allows schools to know that their future students understand what they are getting themselves into.

The more and the better the clinical experience that a pre-health student has, the more likely he or she is to make the right choice on whether or not to go into medicine or another healthcare path. The stakes are high, and we can understand the relationship between exposure and vocational clarity by looking at what happens when exposure to healthcare is not available. An article in the Journal of Surgical Research, recognizing that “the COVID-19 pandemic has resulted in a lack of in-person science courses and laboratories, reduced ability for face-to-face experiences in shadowing or volunteering, [etc.],” concluded that ” these changes may impact the next generation of medical students” since “this reduced ability for premedical students to experience the day-to-day interactions of a physician may lead to applicants with unrealistic expectations and contribute to the already high rate of physician burnout.” The implied lesson here is valid in post-pandemic times as well: the quality and quantity of healthcare exposure seems to go hand in hand with vocational clarity, higher job satisfaction, and lower burnout.

There are three ways of gaining exposure to medicine, namely: (1)observing it at a very complex level (the ideal), (2)doing it at a very basic level (e.g., being an EMT), or (3)practicing it without training (against AAMC guidelines, which sometimes happens with programs in developing countries). Atlantis focuses on the first way – intensive observation – which offers some of the best insight into your future role as an MD/DO/PA.

Keep in mind, medicine is such that if you are pre-health and you are doing medical work legitimately (e.g., as an EMT), you are probably doing something very basic and very narrowly defined. Otherwise, it would require years of training. Such experience is legitimate and valuable, but on its own, it will not provide you the depth of exposure you receive through observing at a complex level. In an ideal world you’d have both experiences.

Med/PA schools want to see that your clinical experience has depth, breadth, quantity, and, if possible, intercultural perspective. This can certainly be obtained inside the U.S., but most med/PA school applicants miss out on some or all of these four components. The most popular pre-med study abroad options still fall short, including university programs. However, 360 Shadowing fully captures all four.

The following section will describe in-depth each of the four elements where our shadowing stands out:

  • Depth
  • Breadth
  • Quantity
  • Intercultural Perspective
Exposure Element 1 of 4


It is not sufficient to be exposed to a healthcare setting; students need to see the actual tasks that doctors do. Moreover, shadowing and clinical experience should ideally expose students to the more complex elements of medicine, such as surgeries, while still being AAMC-compliant. Typical pre-meds, even at top 20 universities in the U.S., often struggle with this dimension, and settle for very basic healthcare volunteering options that not only don’t expose them to doctors often enough, but when they do, the exposure is often superficial. No wonder (sadly) that so many pre-meds realize so late (and often in medical school or later) that they don’t want to be doctors). Keep in mind:

  • Atlantis programs focus on the MD profile and perspective while exposing students to the entire healthcare spectrum.
  • Atlantis students in almost all programs generally observe surgeries and complex procedures, and that commitment is validated by our alumni, who often describe the value of this experience in their testimonials, hundreds of which are available both in our site and beyond.
  • Group sizes tend to be small, allowing you to take advantage of more personalized experiences.
  • Having close, in-depth exposure can sometimes help with letters of recommendation. Atlantis’ student-to-physician ratio is 1:1 or 2:1, and, depending on the situation, physicians may be able to write a letter (but you should only ask them if you know them well and for enough time, which is only possible in some cases).
  • The shadowing in Atlantis programs is compliant with AAMC guidelines: it is observation-only, which is crucial, and if we approached this differently we’d be hurting the med/PA admissions prospects of our alumni. This is because med/PA schools will often reject candidates with untrained hands-on experience of the kind that can be found in some (but not all) volunteer abroad programs. Ask your pre-health advisor about this, since they are well informed on this topic, and since more than 1 out of every 10 U.S. pre-health advisors has visited our programs in person and has seen how we approach this important dimension.
An arch in the city.
An arch in the city of Athens, Greece (an Atlantis site).
Exposure Element 2 of 4


All else equal, med/PA Schools prefer a set of clinical experiences where students have seen multiple specialties and multiple doctors. (Note: consult your pre-health advisor to verify these and other points we make; you should also ask them about Atlantis, since more than 1 out of every 10 advisors has been to our programs in-person.)

  • Atlantis programs, using the 360 Shadowing model, introduce undergraduates to multiple specialties and multiple doctors by default.
  • One specialty per week is the norm, and in each specialty participants generally interact with multiple doctors. A student, for instance, in a six-week Atlantis program, usually sees, over the course of 120+ hours, six different specialties and often several doctors in each of these.
  • Students can also enroll in multi-country programs, exposing them to an even broader range of environments. This means several times greater breadth of exposure than typical shadowing, in addition to depth.
A student smiling on a trip abroad.
An Atlantis student (Europe, 2019).
Exposure Element 3 of 4


Med/PA Schools look at your number of shadowing hours to ensure you really understand the field. How many pre-meds do you think have good grades, love science, love TV shows about medicine, and then hate medicine when they witness it first hand in real life? You already know many people fit that description, and med/PA schools know this too, which is why they require not only exposure to healthcare, but enough of it that applicants can be sure of their path.

  • 360 Shadowing with Atlantis gives you a large quantity of hours, usually 20+ per week. E.g. a 6-week program usually brings 120 hours + (and usually about six different specialties where several doctors are shadowed per specialty, as mentioned above).
  • Crucially, all of those hours are concentrated during breaks, allowing you to focus on academics during the year. (This is the challenge with most pre-med study abroad: not sacrificing your coursework.)
  • By far most U.S. pre-meds, when they have international shadowing or clinical experience, have it in developing countries. Med/PA schools often do not count that type of clinical experience in their hours requirements because they deem the experience too different from the day to day life of a doctor in the U.S.. Our programs primarily take place in Europe in part to avoid this problem, since the essence of the job is the same (similar technology, diseases, patients, processes, routines, physical environment, etc) but the cultural context is still different, with all the benefits that brings.
  • This doesn’t mean you shouldn’t obtain U.S. shadowing and other clinical experiences. Our alumni usually do both U.S. experiences and our programs. We should note, however, that our alumni do find themselves constantly being asked about Atlantis, often far more than other clinical experiences they did, during interviews.
Atlantis students walking on the beach.
Atlantis students walking on the beach on a program excursion (Athens, Greece, 2019).
Exposure Element 4 of 4

Intercultural Perspective

Application committees do not just want talented candidates; they want a class with a diverse set of experiences for the sake of everyone’s learning. You will notice in many medical school websites statements to the effect of medical education being better when it’s done with a diverse student body. That diversity means primarily diversity of students’ overall background, but it also means diversity of collegiate experiences, and exposure to diverse backgrounds. 360 Shadowing gives you more perspective than domestic clinical experience in several ways:

  • It helps you be more of a thought leader on questions of healthcare policy – most Atlantis programs happen at hospitals in Europe, which runs universal healthcare systems, and students see the pros/cons of single-payer systems firsthand. Our alumni are very often asked about this at length during their med/PA school interviews. As you can see in videos here in our website, our alumni often believe this is one of the biggest assets they brought to their interviews, and they say that because of the sheer amount of time that their medical school interviewers chose to spend on questions such as “tell me more about the pros and cons of universal healthcare given your experience in Europe.”
  • Atlantis is one of very few ways to experience being a true outsider in a healthcare system (with all the medical school application benefits that brings) while still ensuring that the system is similar enough to your own so as to count as valuable healthcare exposure and med/PA application material. Someone who shadows even in a very diverse setting inside the U.S. still faces the same rules, economic factors, and medical training as anywhere else in the U.S. On the other hand, shadowing in Europe makes students witness fundamentally the same profession but one that is done in an entirely different culture. And although that European approach has many “cons,” one of its “pros” is its population having about 5 more years of added life expectancy over the U.S., often at one-third of the cost.
  • Finally, Atlantis is a way to step back and see what is essential about the medical profession – having seen other cultures’ approach to medicine, you will navigate changes and disruptions to the world of medicine with a mature, nuanced perspective. If you like the idea of being a doctor by seeing one work in the U.S., but you also like that same image when you see it in Europe, you probably get what’s really essential, and you’re more likely to like that job when the world around it changes radically as it will in the next few decades.
A view of a city street.
A view of a city street in Trieste, Italy (an Atlantis site).

Watch Video: Three Alumni Talk About The Breadth And Depth Of Their Atlantis Healthcare Exposure

Watch Video: Several Alumni Explain The Role of Atlantis Specifically On Their Med/PA Interviews

The Essence of Healthcare in The U.S. and Europe Is the Same, but With Cultural Differences — Making Europe the Ideal Place for U.S. Students to Shadow, Since It Is Both Realistic (for Your Future) While Also Allowing You to Build Cultural Competence (1 of The 15 AAMC Competencies)

U.S. Hospital European Hospital Low-to-Middle-Income

Country (LMIC) Hospital

High High Low
High High Low
of Regulatory
High High Low
of Healthcare
High High Low
of Hospital
High High Low
Unique Unique Unique

Healthcare Exposure: Questions & Answers

Why does being an outsider in a developed healthcare system have value?

Med/PA schools often mention the importance of appreciating the perspective of “outsiders” to the American healthcare system, especially immigrants and other marginalized groups. As you know, many of your patients during your career will come from these groups.

360 Shadowing places you yourself as the outsider in another advanced healthcare system. That opportunity is impossible to replicate in the U.S., even in very low-income and rural areas.

Even if you volunteer in a low-resource country, you are not really an outsider; together with local care providers, you are still part of “the system” in some ways. On the other hand, 360 Shadowing immerses you in a developed, high-resource system abroad and forces you outside your comfort zone – and that is where rapid growth happens.

Atlantis alumni entering med/PA school are some of the few members of their incoming class who have experienced, deeply, what it is to be an outsider in healthcare but also what it’s like to be in a universal healthcare system, with its many “pros” (five years of extra life expectancy in the population at one-third of the cost of U.S. healthcare) and many “cons.”

Ultimately, when Atlantis alumni meet patients who have immigrated or who are in some way “outsiders” to our system here in the U.S., they will be able to better relate to them.

Why is shadowing in Europe one of the best ways to expand your perspective of medicine?

Shadowing in Europe is the only way to step back and see for yourself what is essential versus culturally contingent in medicine. If you want to see developed-country healthcare, but do so in a different cuulture, it’s crucial that the experience be outside the U.S., and specifically in other developed countries. Typical pre-med study abroad involves volunteering in low-resource environments, where the focus is on helping rather than learning, and this is a noble pursuit so long as it follows AAMC guidelines, but it is not the only way to do pre-med study abroad, and has disadvantages. To see even more nuances of medicine, there is great value in crossing to the other side of the high-resource healthcare world, namely, Europe and related systems.

The healthcare environments (population and diseases) are essentially the same in the U.S. and Europe, with relatively similar economies, life expectancies (though in southern Europe these are slightly higher), epidemiological environments, and ultimate goals of healing similar health problems. There are cultural and financing differences that affect the delivery, but undergraduates shadowing with Atlantis see the same essential roles that they would see in the U.S.–while also seeing a fundamental difference.

The difference is that, unlike almost all of their peers, Atlantis alumni enter med/PA school with direct experience of two different approaches to solving the same healthcare problems. They are better able to distinguish what is essential and what is not essential to medicine. Atlantis alumni are also better equipped to handle technological change as what is not essential will be stripped away or modified in the coming decades.

What do Atlantis alumni learn from seeing how the U.S. and Europe differ?

Having seen where the U.S. and Europe differ, Altantis alumni understand what is secondary in healthcare, for example: software, hardware, the role of the government as a payer of healthcare, some unique cultural practices, the income doctors receive relative to other skilled professionals, the system of incentives, and so forth.

Atlantis alumni have also seen what U.S. and European health professionals have in common – what is really essential – namely, their love for the healing process, their desire to help people, their love for science, and their attraction to hard challenges.

How does Atlantis’ approach help put the right people in healthcare?

An undergraduate who sees health professionals on both sides of the high-resource world and who comes away attracted to healthcare is more likely to be attracted to what is essential in healthcare. That student is then more likely to retain their passion for the profession thirty years from now, regardless of how the field evolves.

On the other hand, those students who enter medical training assuming that the field must always look the way it does now may later find themselves in a profession they don’t recognize and don’t love.

Atlantis seeks to help prospective healthcare professionals have a more informed, mature perspective before they jump into the field.


In sum, Atlantis programs provide shadowing that has the depth, breadth, quantity, and intercultural perspective required to understand the role of health professionals and to show that you are fully committed to it. As an added benefit, that level of exposure also helps you with your own vocational clarity – figuring out if medicine is really for you.

Take the Quiz

We’ve built the “Shadowing and Extracurricular Readiness Score” calculator to allow you to look at several expert statements and track to what extent your current extracurriculars follow best practices. We believe this exercise to be very useful regardless of whether you end up considering Atlantis.

Explore the Other Admissions Pillars