Guide · the basics
Clinical hours: what counts and how to log them
The same two words mean four different things depending on where you are headed. Here is what each path counts, who can actually check it, and one logging method that satisfies all of them.
Clinical hours are time in a healthcare setting that some institution will eventually count toward your eligibility. That institution might be a PA program, a medical school, a certification board, or a state licensing board, and each one defines, categorizes and checks the hours differently. Much of the confusion in forum threads comes from advice that was true for one path being applied to another.
What clinical hours mean on each path
| Path | What the hours are called | Who can check them |
|---|---|---|
| Pre-PA (CASPA) | Patient care experience, healthcare experience, shadowing | Programs, using the supervisor contacts you list |
| Pre-med (AMCAS) | Clinical experience, shadowing | Schools, during secondaries and interviews |
| BCBA (BACB) | Supervised or concentrated fieldwork | The BACB, through signed verification forms |
| LCSW (state board) | Supervised experience and supervision hours | Your state board, at licensure |
The deep dives: patient care hours for CASPA, shadowing hours for medical school, and BCBA fieldwork requirements, 2022 vs 2027.
What counts, in general
Across every path, three questions decide whether an hour counts:
- What were you responsible for? Observing, assisting and delivering care sit in different categories everywhere. CASPA splits patient care from healthcare experience on exactly this line, and the BACB splits restricted from unrestricted activities on a similar one.
- Who was supervising? Pre-health wants a contactable supervisor. Licensure wants a qualified supervisor who meets the board's criteria, plus a minimum amount of their time per period.
- When did it happen? Boards cap how many hours a month can count and set windows for how long experience stays valid. Applications care less about timing, though recency helps.
Get those three right per entry and the categorization work at the end becomes mechanical rather than archaeological.
How to log clinical hours
One method covers all four paths. For every shift, the same day it happens, record:
- The date, and the hours you actually worked, not the shift you were scheduled for
- The site and department
- The category the receiving system uses, in that system's own words
- Your supervisor's name, credential, and a contact that will still reach them in two years
- One line about what you did, which later becomes essay and interview material
Then three habits decide whether the log survives contact with reality: never edit a past entry in place, keep supervisor contacts current as people move on, and get hours signed close to when they happened instead of saving the signature for the end.
Who actually verifies clinical hours?
There is a spectrum, and knowing where you sit on it tells you how much rigor your logging needs.
On the pre-health end, neither CASPA nor AMCAS audits what you type in. But CASPA collects a supervisor contact for every experience and asks whether programs may reach out, and interviewers ask about numbers. The check is discretionary rather than absent, which is the worst combination for anyone relying on memory: nothing happens until it suddenly matters.
On the licensure end, verification is structural. The BACB requires monthly and final fieldwork verification forms signed by your supervisor, and both of you must retain that documentation for at least 7 years and produce it on request. State social work boards review supervision documentation before granting a licence. There is no version of these paths where an unsigned personal spreadsheet is enough.
The failure mode to design against
It is always the same: the hours were real, the record was not portable. A supervisor leaves the organization and stops answering email. A clinic closes. A spreadsheet gets reconstructed two years later and the totals no longer agree with the forms. The work happened, and none of it can be proven.
So everything above reduces to one instruction: make each hour verifiable at the moment verification is cheap, which is the day it happens. That is what Hourcrest automates, a log that takes 20 seconds, a supervisor signature by email link with no account required, and sealed records you can export in the format your path expects. Licensure tracks are in development: BCBA fieldwork and LCSW supervision.