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Why choose medicine as a career
- 1. Why Choose Medicineas a Career
- 2. Careers in MedicineOverview A structured, four-phase/four-year career planning program Provides students with a strategy for: • Understanding themselves and the world of work • Choosing a specialty and residency program • Making career and life decisions
- 3. Theoretical Foundations Careers inMedicine activities: help educate students on career options; help improve their medical specialty literacy; and teach decision-making skills.
- 4. Careers in MedicineModel Career/Specialty Exploration SelfAssessment Decisionmaking Implementation Residency in Chosen Specialty
- 5. Phase 1: Self-Assessment Gatheringinformation about self: Who Am I? What past experiences influenced my career decisions? What do I like to do? What is important to me? What are my greatest strengths? What are my work environment preferences?
- 6. Phase 1: Self-Assessment PersonalReview Interests Values Environmental Factors and Practice Needs Personality Skills Financial Situation Educational Experiences
- 7. Interests Things you enjoydoing Three options: Option A – Medical Specialty Preference Inventory (MSPI), 2nd Edition Option B – Party Game/Self-appraisal Option C - Self-Directed Search
- 8. Values Life principles thatinfluence you and the decisions you make Three options: Option A - Physician Values in Practice Scale (PVIPS) Option B - Values Checklist Indicate degree of importance for each value in the list Select most important and rank Option C - Values Card Sort Experiential, hands-on activity
- 9. Environmental Factors and PracticeNeeds Measures preferences for • Practice types • Size and location of practice • Working environment Results are likely to change over time depending on experience Especially useful for residency program selection
- 10. Personality Who you areand how you relate with others Two options: • Option A - The Myers-Briggs Type Indicator® • Option B - The Keirsey Temperament Sorter
- 11. Skills What you dowell Two options: • A - Informal Skills Assessment • B - Skills Assessment with Feedback Focus is on cross functional, or transferable skills
- 12. Phase 1: PuttingIt All Together—The Personal Profile A personal record of the results of their selfassessment activities Provides direction for the student in the search for “compatible specialties” Confidential – only the student can access their personal profile
- 13. Phase 2: Career Exploration Gatheringinformation about career options… What specialties exist, what do they do, & what are the people like in that specialty? What practice settings are open to me? What non-traditional/non practitioner options are available? How do my personal characteristics match with the specialties I am exploring?
- 14. Types of CareerInformation Duties, tasks, responsibilities Knowledge, skills and abilities Work environment / conditions Earnings Workforce information Future of the specialty Preparation Methods of entry Industries/employers/practice environments
- 15. The Process ofCareer Exploration During this phase, students must understand the world of work by gathering information about options available Start with high level exploration (All options, general information) Narrow down to three to five options Getting Personal: Conduct more indepth, personal research on remaining specialties & career options
- 16. Beginning Career Exploration Conduct libraryresearch Conduct online research • CiM Specialty Pages (112 specialties covered) • AMA FREIDA Specialty Statistics & Physician Workforce Data • Specialty organizations Attend school-organized specialty seminars and programs • School programs (brown bag presentations, panels) • Specialty Interest Groups
- 17. Career Exploration: Getting Personal Useinformation gathered to narrow down to 3-5 options for more indepth research Contact medical societies, alumni groups, and specialty associations • Review Publications – journals/newsletters • Student membership • Local chapter or activities Participate in preceptorships
- 18. Career Exploration: Getting Personal(cont.) Conduct informational interviews • • • • To learn about specialty areas To articulate career objectives. To learn about new developments To build a network Explore clinical clerkships
- 19. Phase 3: Decision-making Howdo I go about weighing the information I’ve learned about who I am and the knowledge I’ve gained about career options? What are my best matches? How do I evaluate my decision? How do I select residencies that will fit my needs and preferences?
- 20. Phase 3: Decision-making Decision1: Specialty Choice • Select most important self-assessment information • Compare with top specialties • Determine which is the best fit Decision 2: Selecting Residency Programs • Retake Environmental Factors assessment • Identify top factors • Compare to residency programs under consideration
- 21. Phase 4: Implementation Re-evaluationand follow-up Clinical clerkships and electives Applying for residency The Match(s) Moving on…
- 22. Student Evaluation ofCareers in Medicine Website 6 5 4.56 6 = Extremely helpful 1 = Useless 2 1 0 Get into residency 2 = Not very helpful 3 Choose specialty 3 = Somewhat helpful 4.22 3.63 Exploring options 4 = Helpful 4.5 4 Useful 5 = Quite helpful 4.2 Understanding self GRADING SCALE
- 24. Studies Abroad Couns SakshiEducation Consulting & Training (P) Limited, 34/1, K.S.Arunachalam Road, K.K.Pudur, Coimbatore-641038. Tamil Nadu, India. Telephone: (+91) 0422-4559900 Fax No: (+91)-422-4559914 E-mail: [email protected]
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Editor's Notes
- #3 Begin with an overview of the Careers in Medicine program, and the theory and philosophy that the program is based upon. The program is designed to encourage students to begin this process early in Medical school. It then has tools and resources to follow them throughout all four years of medical school and the career planning process. The most immediate goal is to help students choose a specialty. But the tools, resources, and guidance goes further, by providing tools and resources for self-understanding, and a rational process for exploring the world of work, and ultimately providing students with a strategy for making sound career and life decisions, not just now but in the future.
- #4 Career Planning allows students to: review their options make a career/specialty choice based on a variety of individual factors including: interests, skills, values, personality, and lifestyle develop a positive approach to decision-making
- #5 The model has four phases: Assessment, career exploration, decision-making, and implementation. Each focuses a student on the process of taking responsibility for her/his personal and professional success. Based on a well established higher education care planning model Students also will learn a PROCESS of decision-making that will be useful to them throughout their lives. The student is instructed that the process of career planning/development requires careful thought, planning and work. Careers in Medicine provides a framework to make sure that happens. The program includes suggestions for small group and (or) individual student activities for all four years of med school, ones that can be “fit” into the schools own schedule and needs.
- #6 The program for Phase 1 focuses on the first step or first stage of career planning, that is Self-Assessment. During this phase Students achieve greater understanding of themselves in terms of their interests, values, personality, skills and preferences in general and as they relate to the medical profession Begins to help student answer the question: “Who am I?” and “What do I want to do in my medical career?” More specifically, a thorough self-assessment helps the student ask and answer the questions listed here The objective is to develop students’ awareness / understanding of themselves in each of these areas. Later, they will be able to use this information to compare with their specialty options and then to select a specialty. Proposed activities in this phase include: Self-directed assessments on the Web site or in manual Workshops introducing importance of Self-assessment and how it will assist students in this process Individual Meetings/Advisor sessions to supplement workshops OR in place of workshops
- #7 The more students understand about themselves, the better their decisions will be and the better able they will be to implement them. There are several self-assessment areas, including “Financial Situation” which is part of the (MD)2 program provided by the AAMC’s Committee on Student Financial Assistance (COSFA). [(MD)2 stands for “Monetary Decisions for Medical Doctors”]. Self-assessment occurs during the first and second years of medical school. It is likely that, although schools may introduce the program to your first year students during new student orientation, most schools will not begin this phase of the program until the second semester of the first year. (except for the (MD)2 session mentioned above) Let’s take a look at these assessment areas in more detail: The Personal Review and Educational Experiences sections are areas where the student can take stock of their previous experiences, as well as what they have learned about themselves during medical school. All of this information is instrumental in understanding how they make decisions, what influenced them the most, and what sorts of environments they are most comfortable with.
- #8 Interests Key concepts: Interests are things you like to do, without regard to how well you do them. Interest assessment answers the question: what do you like to do? How do you enjoy spending your time? Physicians have some similar, general interests, but each specialty (and each physician) have various interest patterns. Learning about your interest patterns now will be of significant help as you go through med school and begin to evaluate your options for and subsequent choice of a specialty. Interests may shift somewhat over time and with new life experiences. Although careers or jobs are rarely “perfect fits,” the idea is to maximize the fit by finding and selecting a specialty that requires activities that you like to do, or at least, that requires few of those things you dislike or detest doing. Three options are presented for interest assessment: The first is the Medical Specialty Preference Inventory (MSPI). This is an instrument that has been in existence since the mid 1970’s. It was developed in direct response to the need for an instrument devoted specifically to the medical profession. The instrument contains 150 items that measure 38 preferences. These preferences are organized around the main areas of; Diseases and problems (10 preferences) Patients (4 preferences) Care and treatment (9 preferences) Knowledge (3 factors) Procedures and services (12 factors) Scores are available for 6 major specialties: Family medicine, internal medicine, pediatrics, surgery, psychiatry, obstetrics and gynecology Scores for emergency medicine have been partially analyzed, but need to be completed more thoroughly Additional research is required to expand the instrument to other specialties The second option is called “The Party,” is free and requires no additional materials The third option is the Self-Directed Search. It must be purchased and can either be taken online, or can be purchased in paper and pencil format by the Careers in Medicine liaison.
- #9 Values Key concepts: Values are those things that are important to us. Values assessment answers the question: what matters to me? Values underlie every choice and decision we make. They are the expression of our motivation for relationships and work and provide the basis for meaning in our lives. Understanding our values will make it easier to choose a career that is consistent with these values. There are no right or wrong answers when assessing your values. Values are reflective of your life experiences up to this point. Your values can change over time based on new life experiences and circumstances. Once you know what your work values are, you can find a career / specialty which is compatible with those values, or at the very least, are not directly opposed to them. For example, if you really enjoy working alone and find that interacting a lot with people really challenges you, you may find Pathology or Radiology to be more compatible with your preferences than perhaps Family Practice. There are a number of ways in which to evaluate / identify one’s values. Three options are presented as part of the CiM program. The PVIPS is our newest values tool and has been created specifically for medical students. It is a 60-item scale measuring six core values: Social Status/Prestige Social Service Autonomy Lifestyle Management Scholarly Pursuits. Responses yield a score on each of the six values, which can then be considered in terms of how they relate to particular specialty areas of medical practice.
- #10 Environmental Factors & Practice Needs Key concepts: These are the intrinsic and extrinsic factors that contribute to daily work satisfaction. All things begin equal, many people quit or change jobs over dissatisfaction in these areas. With the prospect of spending 125K hrs on the job, where you spend that time will have a large influence on your personal satisfaction. Life is a series of trade offs. What you choose today means that you eliminate other things. Ex., rural v. suburban hospital, or large v. small practice, or private practice v. HMO. Understanding environmental factors and practice needs that matter to you will help you select a specialty area that will meet those needs. You may not have had the opportunity to experience enough of these factors to make a well-informed decision early on in medical school. This is a chance for exposure to this info. You will have an opportunity to revisit this exercise anytime you wish. Also, new experiences may change your thoughts. Each of these self-assessment activities can be repeated periodically. This is actually recommended for the Environmental Factors and Practice Needs assessment because students are not likely to know much yet about the types of practice environments they are interested in while still immersed in the basic sciences. An Individual Advising Session would involved a discussion of what the student has thought about to date, exploring what some of their top factors and needs are, covering the key concepts described above, and exploring results of other assessment components in conjunction with the environmental factors assessment
- #11 Personality Key concepts: Personality assessment answers the question: What are my natural preferences or inclinations? What are my unique gifts or strengths? Personality involves the way we see our self and how we related to others. The MBTI requires that a professional counselor administer, score and interpret the instrument. Partnerships with the campus career or counseling center might provide a resource for such skilled personnel at schools that have undergraduate campuses associated with them. For ex, if you are a MBTI “extravert” you may prefer to work as part of a group or team, while if you an “introvert” you may prefer to work alone or 1:1. Again, two options are offered for personality assessment. The first, the MBTI, is one of the most reliable self-report personality instruments available. It has been used extensively in career counseling, and considerable research has been conducted relating personality type to career selection. The research shows that certain careers tend to attract certain types. The second option, the Keirsey Temperament Sorter is available “on-line” for a small fee and it does not require the services of a professional counselor. It is similar to (but not the same as) the MBTI.
- #12 Skills Key concepts: Skills are those things you do well (or can learn to do well) - without regard to whether you enjoy or like doing them. Skills assessment answers the question: What are you good at? Success in a specialty may depend on how well your interests and skills match that specialty. There is a difference between liking something and being able to perform it well. Likewise, there is a difference between good performance and enjoyment of an activity. Assessing skills may help you see areas that you may want to explore further. As with interests, skills may shift somewhat over time and with new life experiences and exposure to different activities. Skills assessment, while important, is only one component to consider in career planning, and any decision about a specialty choice should be postponed at this point. Once you know what you do well, you can combine that knowledge with the knowledge of what you like to do (interests), then you will ideally find a career / specialty that requires those skills and avoids / does not demand the skills you do not have or those you don’t particularly enjoy using. For example, if you have terrific manual dexterity and you like working with your hands, you’ll want to find a career / specialty that requires working with your hands, such as surgery. There are many ways to assess one’s skills. Both the student and advisor manuals present two different ways. They can be completed without any additional resources.
- #13 Personal Profile: Students will create a personal profile (portfolio) and store the results of all the Self-assessments and research conducted throughout the program. The Personal Profile is an individual student’s personal record of the results of their self-assessment activity. As a CiM advisor, you may ask that your advisees share their Personal Profile with you as the basis for an individual advising session at the end of the first year or mid-second year (whenever you complete the self-assessment activities), but the Personal Profile is a confidential resource for students and cannot be accessed electronically by advisors. The student’s Personal Profile forms the launching point for specialty exploration activities. It provides direction for the student in the search for “compatible specialties.” The CiM specialty pages include characteristics of physicians in the major specialties such as MBTI type, values, interests codes allowing students to compare their personal profile results with physicians in practice
- #14 Career Exploration Essentially, what the student needs to do in this phase is to find out as much as possible about the options available Understand world of medicine and its specialties – what it is, how it is done, where it is performed, what tools they use, etc. The types of questions they need to be asking are wide ranging and cover more than just clinical practice. Students also should address non-traditional, or non-clinical opportunities as well.
- #15 There is a variety of information available that anyone engaged in career exploration should be reviewing. This includes: Duties, tasks, responsibilities Knowledge, skills and abilities Work environment / conditions Tools and equipment used Earnings: Current beginning; Wages for experienced workers; Basis: hourly, weekly, monthly, yearly; Geographical differences Workforce information: Current employment by geographic area; Relative size of the occupation compared to others Future of the Specialty: Projected growth in both demand and supply; Description of factors affecting outlook Preparation: Description of required experience, training, education, residencies; Available programs and institutions; Licensing requirements; School subjects, useful or required Methods of entry: Common methods (formal and informal); What qualifies person to enter the occupation Industries/employers/practice environments
- #16 Process of Career Exploration Students begin by exploring all specialties at a high level of detail, in an attempt to get an idea of the options available Then they select 3 to 5 options that have better connection to their own personal equation Followed by more in-depth research on the remaining specialties/career options
- #17 When exploring career options, the student should access information from a number of sources, such as Library Research Journals, Textbooks, Newsletters, Books on choosing a specialty (Iserson, Taylor, etc.) Online Research Sources: CiM Web Site (Specialty Pages), AMA-FREIDA, Specialty Organizations, NBME, CMSS, ABMS, ACGME Our Specialty Pages pull together as much as possible, the kind of information about specialties that we addressed earlier, namely the nature of the work, personal characteristics, training and residency information, employment outlook, links to online journals and newsletters, and specialty organizations. AMA FREIDA provides Specialty Statistics and Physician Workforce Data. These data are important, “real time” data about specialties in general, not about specific training programs. Our Specialty Pages incorporate direct links to FREIDA’s specialty specific data. Many of you also encourage Basic Science students to explore options by offering Specialty Interest Groups (SIGs), brown bag lunches and a wide variety of other programs and activities designed to provide students with opportunities to get to know the specialties better. This is one of the areas where you can integrate what you’re already doing on your campuses with CiM so that the exploration activities complement one another.
- #18 After exploration of the full array of specialty choices, Careers in Medicine asks students to narrow down their search to a smaller, more manageable number of specialties (we recommend three to five options) to investigate still further, in more depth. Students are also directed to the World Wide Web and to the CiM website which features an exhaustive list of specialty and subspecialty associations and societies. They are encouraged to find specific information (listed above) about the societies representing the 3-4-5 specialties in which they are interested. Contact Local Medical Societies, Alumni Organizations, and Specialty Associations – these sources provide networking opportunities, names and contact information to get a feel for the specialty on a more personal level and ask the questions you can’t ask a book or web site.
- #19 Informational Interviewing – one on one discussions with people in the field Clinical Clerkships Additional source for networking, Help student explore different environments, patient populations, etc first hand
- #20 Decision-making This is the point at which the student can finally start putting together everything they have learned about themselves and the world of medicine, and choose a specialty that fits with their own values, interests, and preferences. The Decision-making phase involves two decisions: First the student selects a specialty, then begins to explore residency programs they would like to apply to.
- #21 CiM provides two decision-making exercises: A Specialty Choice exercise,to compare the 3-5 specialties the student has been focusing on. Residency Programs to apply to This phase encourages students to select their most important personal factors (interests, skills, environmental factors, values, test scores, etc.) and compare their perceptions (based on career exploration) about how well the specialties they are considering meet those personal factors. These exercises are only meant to give the students a more objective way to think about this decision. It IS NOT a matching function (at this point) but rather a way to integrate and look at all the information they’ve gathered about themselves and their specialty options. By the end of the third year, most students will have made a preliminary decision (perhaps a first and a second choice specialty), usually after completing several clerkships. Then students can also complete a decision-making exercise on choosing residency programs - similar to the specialty decision-exercise. Uses environmental factors and practice needs.
- #22 Implementation Implementation generally will begin in the spring of the third year. This is the phase that addresses the question: “How do I get from here (the selection of a specialty) to there (a training position)? Workshops are recommended on the various matches, on ERAS and NRMP, on how to construct a CV and personal statement, on interviewing skills, and so forth. This also is where, as mentioned earlier, AMA FREIDA comes back in - to help students explore their training program options (now that they’ve selected a first and second choice specialty). Of course, students’ clerkships continue into the fourth year, so to some extent, so does their career or specialty exploration and their networking. For some students, their day-to-day activities during their fourth year will assist them in making the specialty decision; for others, the fourth year clerkships will assist them to secure the training program of their choice; and for others still, the fourth year will help confirm their earlier choice of specialty. And, during the summer/early fall, the Medical Student Performance Evaluation (MSPE, formerly Dean’s Letter) interviews are an excellent time to review the entire career planning experience of students, their growth and development in thinking about careers that happened over the last three years.