Shadowing During Busy Clinics: Timing Errors That Annoy Doctors

You are standing in the corner of a cramped exam room at 4:45 p.m. The clinic was supposed to end at 4:30. Your attending is on patient number 25. They have not eaten since 7 a.m. The nurse just whispered, “We still have three walk-ins,” and your attending’s pager will not stop going off.

You choose this moment—this exact moment—to ask:
“So, how did you decide on your specialty?”

Watch how fast a supportive teacher turns into a silently irritated, time-pressured clinician.

This is what timing errors look like during shadowing in busy clinics. You may not realize you are causing stress, but the physician feels it immediately. And they remember it when they are asked if they will host another student.

Your goal: be the shadow who never creates friction around time.

Let’s walk through the specific timing mistakes that annoy doctors in clinic—and how to avoid becoming “that student” everyone quietly warns others about.

---

1. Showing Up at the Wrong Time: Before You Even Step Into Clinic

Most shadowing problems start before the first patient.

Mistake 1: Arriving “On Time” Instead of Early

You were told: “Clinic starts at 8.”
You walk in at 8:00, proud of your punctuality.

The attending is already in the room with the first patient. The MA has scrambled to find you a name tag. The front desk is trying to figure out if you are allowed to see charts. You think you are only five minutes “off.” The clinic staff feels like you have already disrupted their flow.

What you should do instead:

• Ask in advance:
  “What time would you like me to arrive before the first patient?”
  Many attendings will say 15–20 minutes before the first appointment.
• Aim to arrive:
  • 20–30 minutes early the first day at a new site (parking, check-in, badges always take longer).
  • 10–15 minutes early on subsequent days.

If the clinic starts at 8, you standing in the hallway at 7:59 is already borderline late in their mental clock. They were thinking about the first patient at 7:45.

Mistake 2: Staying Home Until the Exact Start Time of Clinic

Students sometimes time their commute so they arrive “just right.”
Then:

• The elevator is slow.
• They cannot find the right building.
• Security wants paperwork.
• They need a mask, badge, or orientation.

Now the attending hears: “Your student is on the way up.” At 8:03. During the first visit. That is a terrible first impression, even if everything was “out of your control.”

Avoid this by:

• Doing a test run of the route (if possible) the day before.
• Planning to be in the parking lot 30–40 minutes before clinic the first day.
• Assuming check-in will be inefficient and slow. It often is.

You do not get credit for saying, “Traffic was bad.” Everyone’s traffic is bad. The physician just hears: “This student did not build in buffer time.”

---

2. Talking at the Wrong Moments: Great Questions, Terrible Timing

Your curiosity is not the problem. Your timing is.

Mistake 3: Asking Education Questions in Front of Patients

Scenario: You are in a busy pediatrics clinic. The resident just told a family their child likely has asthma. The parent looks visibly anxious.

You jump in with:
“So, is this more of an atopic thing or could it be early COPD or…?”

Now the mother is terrified her 7-year-old has COPD. The resident has to spend extra time undoing the confusion. The attending is annoyed, not because you are dumb—but because your timing was careless.

Safer rules:

• During patient encounters:
  • Only ask questions if the physician directly invites you to engage.
  • Keep questions simple, neutral, and non-alarming.
  • Avoid speculation, differentials, or anything that might confuse or scare the patient.
• Save your real teaching questions for:
  • Between rooms.
  • Walking in the hallway.
  • End of session, if they are not in a rush.

If you are unsure, ask this once, early in the day:
“Would you prefer I ask questions during the visit, after the visit, or at the end of clinic?”

Then actually follow what they say.

Mistake 4: Launching Big Career Questions at the Worst Possible Times

You may only see this physician once, so you are eager to ask:

• “How do I match into derm with a 230?”
• “What do you think about DO vs MD?”
• “Could you look at my CV?”

Good questions. Horrible questions to ask:

• When they are obviously behind schedule.
• When they are returning calls.
• When the nurse is hovering with the next chart.
• While they are frantically typing notes at the end of the day.

Timing rules for personal / career questions:

• Glance at the schedule board (if visible):
  • If they are 30–60 minutes behind: do not ask.
  • If you hear: “We’re really backed up today,” treat that as “no career questions during clinic.”
• Use calmer time windows:
  • Right after lunch if they are not slammed.
  • At a natural break when the clinic slows.
  • In the last 2–3 minutes of the day only if they seem relaxed and sit back.

And phrase it with an easy “out”:

“If now is not a good time, would you be open to me emailing one or two quick questions about specialty choice?”

That single sentence signals you respect their time. Many attendings relax immediately when they hear it.

---

3. Misreading Clinic Flow: When You Slow Them Without Realizing

Busy clinics are about flow. You will annoy doctors when you interfere, even unintentionally.

Mistake 5: Blocking Doors, Computers, or Pathways

You think you are staying out of the way by standing “in the corner.” Except that “corner” is:

• Where the MA stands to take vitals.
• Where the nurse reaches for supplies.
• Directly in front of the computer the attending needs.
• In the hallway where the attending and nurse pass each other every 2 minutes.

What happens:

• Staff constantly squeeze past you.
• The attending has to say, “Excuse me,” five times per hour.
• They begin to associate “having a student” with physical obstruction.

To avoid this:

• Ask once:
  “Where is the best place for me to stand so I am not in anyone’s way?”
• Watch where people naturally move during:
  • Vitals.
  • Exam.
  • Charting.
• If someone even slightly adjusts their path because of you, move yourself, not them.
• In tight rooms, stand:
  • Behind and slightly to the side of the physician,
  • Or against the wall opposite the patient, away from drawers and sinks.

You want them to forget you are physically there while still benefiting from being there.

Mistake 6: Walking Slowly Between Rooms

Clinics run on seconds, not minutes.

A single student who walks at a leisurely pace between rooms can:

• Add 15–30 seconds per patient.
• Over 25 patients, that becomes 6–12 wasted minutes.
• Six minutes behind at 4:30 p.m. feels like an hour to a hungry, tired physician.

Shadowing timing guidelines between rooms:

• Stay slightly behind and to the side of the physician.
• Match their walking speed, not yours.
• If they speed up, you speed up.
• If they stop to answer a question for staff, step aside so others can pass.

Never be the reason an MA or nurse has to wait to enter a room.

Mistake 7: Lingering in the Room After the Doctor Leaves

Sometimes the physician will say, “I’ll be right back,” and step out. Students then:

• Stay in the room awkwardly.
• Try to make small talk.
• Correct or explain something medical.
• Ask the patient questions.

Major timing and boundary failure.

In clinic, when the physician leaves, that usually means:

• They need to see the next patient to stay on time.
• They are trusting that the interaction ends cleanly.

You should:

• Follow the attending out immediately unless they say:
  • “Stay here and ask any questions,” or
  • “I’ll send the nurse in; you can observe vitals.”
• Do not independently extend the visit with your own questions.

If the patient tries to keep talking to you as you leave, you can say:

“Those are great questions for Dr. Smith; I want to make sure they get back to see you quickly.”

You protect time and boundaries at once.

---

4. Choosing the Wrong Day or Clinic Type to Shadow

Sometimes the mistake is not your behavior during clinic, but when you chose to show up.

Mistake 8: Shadowing on “Crazy Days” Without Realizing It

Certain clinic patterns almost guarantee chaos:

• Monday mornings (post-weekend backlog).
• Friday afternoons (everyone squeezing in “before the weekend”).
• Before or after holidays.
• Post-call clinic days for residents.
• Double-booked overbook clinics (common in primary care, OB/GYN, some subspecialties).

Shadowing is not forbidden on those days. But you must recognize the attending is on a knife edge.

You will annoy them if you:

• Expect lots of teaching.
• Ask if you can practice histories in each room.
• Request a mid-clinic feedback session.

How to avoid this misstep:

• Before confirming, ask:
  • “Are there particular days that would be better or worse for shadowing, in terms of clinic flow?”
• If they say:
  • “This Thursday is a really crazy overbooked day, but you can still come,”
    translate that as:
    • “Do not expect teaching.”
    • “Stay invisible.”
    • “Do not lengthen a single encounter.”

On packed days, your success metric is simple:
The clinic should not run even five minutes later because you are there.

Mistake 9: Picking the Wrong Type of Clinic for Your Goal

If your goal is:

• Lots of explanation
• Slower pace
• More time for Q&A

Then you should not choose:

• Rapid “urgent care” style clinics.
• Walk-in clinics with unpredictable volume.
• 15-minute primary care templates with 20–30 patients.

Students sometimes mistakenly pick “busy” clinics to “see a lot.” Then they feel frustrated by limited teaching and ask more questions during clinic to compensate. That irritates time-pressured physicians.

Better strategy:

• Ask:
  • “Is there a half-day that is a bit lighter / has longer visits where shadowing works best?”
• Some great options:
  • New-patient subspecialty clinics (often 30–60-minute slots).
  • Follow-up oncology clinics where physicians know their patients well.
  • Academic clinics with built-in teaching time.

Pair your expectations to the clinic’s reality. A 10-minute urgent care slot is not the place for a bedside mini-lecture on signal transduction.

---

5. Note-Taking, Phones, and Breaks: Subtle Timing Traps

You might think these are minor details. Busy physicians do not see them as minor.

Mistake 10: Taking Too Long to Write Notes or Jot Things Down

You want to remember what you learn. So you:

• Pull out a notebook after each visit.
• Stand in the hallway writing for 1–2 minutes.
• Fall behind the physician.
• Miss the beginning of the next encounter.

They will not wait for you. They will simply go in without you. That breaks your continuity and frustrates both sides.

Better approach:

• Mental note first, physical note later.
• Jot down 1–2 keywords only after you have caught up to where they are going next.
• Use very brief, cryptic reminders:
  • “COPD vs asthma counseling style”
  • “How they handled angry patient at 10:20 a.m.”
• During lunch or at the end of clinic, expand those prompts into full notes.

If you are the reason they have to say, “We’re going into room 7 now,” more than once, you are taking too long.

Mistake 11: Checking Your Phone at the Wrong Time

This is a timing issue, not just a professionalism issue.

Students assume:

• While the physician is charting,
• Or while the MA is in the room,
• “Nothing is happening. I can look at my phone.”

Here is what the physician actually sees:

• You disengage when the less glamorous, time-consuming parts of medicine happen.
• You miss important teaching opportunities in how they manage time, notes, and messages.

In a busy clinic, 30 seconds of phone distraction can mean:

• You fail to follow them into the next room.
• You hear only the end of crucial explanations.
• You signal, “My time is more important than this flow you are trying to maintain.”

Safe phone rules:

• Airplane mode or silent with vibration off.
• Check only:
  • During clearly announced breaks.
  • While they leave you in a room specifically to wait.
  • At lunch.
• If you must be reachable for a serious reason:
  • Tell the physician at the start of the day.
  • Example:
    “I may need to step out for a call about a family emergency; it should be brief, and I will keep my phone on silent and leave if needed.”

Mistake 12: Disappearing at Inconvenient Times

You need to use the restroom or grab water. That is fine. The timing is what matters.

What irritates attendings:

• Student vanishes right when they are finally caught up.
• Student reappears exactly when the clinic hits another bottleneck.
• They have to repeat, “We are going into 12 next,” every time you return.

Instead:

• Tell them briefly when stepping away, if you can do so without interrupting:
  • “I will step to the restroom—back in 2 minutes.”
• Choose times strategically:
  • When they are clearly charting between patients.
  • When they are on a phone call.
  • When they have to go speak with staff about scheduling.

And then be truly fast. Not “scroll-Instagram-in-the-bathroom” fast. Actual 2–3 minute fast.

---

6. Ending the Day: Knowing When To Leave (and When Not To Linger)

Ending the shadowing day is another timing minefield.

Mistake 13: Staying Long After Clinic Officially Ends

You think it shows dedication to “stay as long as they do.” Sometimes it does. In busy clinics, it can also backfire.

Possible perceptions:

• “This student does not recognize that I am behind and trying to leave.”
• “Now I feel pressured to keep teaching even though I am exhausted.”
• “I have to find a polite way to get them out of here.”

Safer approach:

• Before clinic ends (for example at mid-day), ask:
  • “What time would you like me to wrap up today?”
• Many will say something like:
  • “Once the last patient is done, you can head out.”
  • Or, “You can stay for 10–15 minutes while I answer questions, but then I have notes.”
• When the specified time arrives:
  • Thank them.
  • Offer to leave without requesting more time:
    • “Thank you so much for having me today. I will head out so you can finish up.”

If they want you to stay longer, they will invite you to.

Mistake 14: Choosing the Worst Moment for a “Letter of Recommendation” Ask

If you are impressed with the physician, you may eventually want a letter. Shadowing clinic is often an early step in that relationship.

Asking poorly timed:

• At the end of a very backed-up day.
• Right after they dealt with a complicated or upsetting case.
• While they are clearly rushing to another commitment.
• Without letting any time pass to show longer-term interest.

Better timing strategy:

• Use the first shadowing experience just to:
  • Make a strong, low-friction impression.
  • Demonstrate reliability and respect for clinic flow.
• After multiple sessions or some ongoing interaction, send a concise email:
  • Reference the dates you shadowed.
  • Mention something specific you learned.
  • Ask whether they would feel comfortable writing a strong letter.

Do not corner them at 5:15 p.m. on a Thursday with:
“Would you maybe write me a letter at some point?”
That forces them to give a rushed, non-committal answer while they just want to go home.

---

FAQ (Exactly 3 Questions)

1. How can I tell if a clinic is too busy for me to ask questions during visits?

Watch for these red flags:

• The physician is consistently 20+ minutes behind schedule on the electronic board.
• Staff keep saying things like, “We are really slammed today.”
• The physician is typing while walking, answering calls between every patient, or skipping lunch. In those situations, assume questions happen only in the hallway after the visit, and keep them very brief, or save them for an email later.

2. Is it rude to leave exactly when the last patient is done?

Not if you have clarified expectations earlier in the day. A simple, “What time would you like me to wrap up today?” in the morning gives you permission. When that time comes, thanking them and leaving promptly often signals you understand their time pressure and are not trying to extract extra unpaid teaching from an already overextended schedule.

3. What is the safest default behavior if I am unsure about timing in a busy clinic?

Default to being:

• Early to arrive.
• Fast to move between rooms.
• Minimal in questions during visits.
• Invisible in physical space.
• Brief when speaking near the end of clinic.

When uncertain, ask one meta-question at the start:
“How can I be most helpful—or at least not in the way—given how busy clinic is today?”
Then follow what they tell you precisely.

---

Key points to remember:

1. In busy clinics, timing is everything; even small delays from you compound across many patients.
2. Your curiosity and professionalism must be matched with situational awareness—ask what you want, but at the right moments.
3. The best shadow in a high-volume clinic is the one who learns a lot while never making the clinic run one minute later than it would have without them.