75% of medical students

Change their minds about their specialty choice from when they enter to their M4

year

Careers In Careers In MedicineMedicine

The “Vigilant” Decision Making The “Vigilant” Decision Making ProcessProcess

Phase IPhase I

CiM Four Year Timeline

M-1 August CiM Intro

March Phase I Self Assessment

Summer Shadowing

Research

Volunteer

M-2 February Phase II Career Exploration

M-3 Fall Alumni Panel Discussion

Clerkships

Student AMA lunches

December Phase III Career Day

April Phase IV Strolling thru Match

M-4 Fall ERAS

Dean’s Letter

Today, we’re going to . . .

• Focus on the process of career choice decision making

• Show you the importance of being proactive in initiating and continuing this process

• Stress the need for “Ownership” in this process

Your homework

• Visit the Careers in Medicine website.

• www.aamc.org/careersinmedicine

• www.aamc.org/students/cim

• Get to know yourself by completing the self-assessment sections on the site.

Objectives

• Today’s session will provide you with:– A process that will help start you in selecting

your specialty– An opportunity to discuss self-assessment

and its importance in making a rational career decision

Anxiety about this decision

• Why is making any important decision so hard to do?– Must face conflicts-

• People prefer procrastination

– Need information- • Significant effort to obtain• Don’t know where to get the information

– It takes time-• Too many more pressing distractions

– Need a process to address this

What CiM is and isn’t

• It is-• A decision making

process• A thorough on-going

effort• Primarily specialty

oriented• A source of useful

information• A self-help process

• It is not-• A decision• A quick fix• Comprehensive career

counseling

• A substitute for your own research

• A substitute for interpersonal counseling

What if I already know what I want to do?

• You should still go through the process

• It will help you withstand the pressure to justify your decision

• Give you peace of mind to overcome the negativism and obstacles along the way

• You may have made your decision based on misinformation

• You may have to make a career switch unexpectedly and will need an alternative

Appraising the Challenge

• Importance of being proactive– In less than a year you will have to choose

electives, sign up for away rotations, send off for application materials, set up interviews

• Assume Responsibility

• Avoid adhering to an unexamined choice

• Determine a time schedule and commit

To make a valid decision

• You must “Know Thyself!”

• Hardest part of the process

• You must now determine your “own” goals

– Up until now, someone else has always set up your goals –

• Undergraduate school application• Exam content and timing• Med school applications and deadlines

– You must now envision “real” future goals – not just deferred gratification

What do you need to define about yourself?

• Interests

• Values

• Personality and Learning Styles

• Skills

• Environmental Factors and Practice Needs

• Financial Situation

• Educational Experience

Self-assessment

• Requires reflection, introspection and imagination

• Must obtain objective information as well– You have to ask other people about you– You may not like the answers

• Yields inferential knowledge, “conclusions” subject to revision

• Requires coming to terms with your own self image

• Must balance positives and negatives- what you like about an aspect of medicine as well as what you want to avoid.

• As you learn about yourself, don’t be inflexible about your decision

• Be objective about your strengths and weaknesses, interests and ambitions.

• CiM website will walk you through evaluating each of these characteristics

Interests

• CiM offers two ways to help define your interests

• The Party-An informal method of assessing interests that you can complete on your own

• Self-Directed Search - $8.95

Values

• Physician Values in Practice Scales (PVIPS)

• Careers Values Checklist

• Values Card Sort

PVIPS- “Critical Factors”

• The following is a laundry list of factors determined to be important to physician contentedness

• Some are more important than others • Some may be insignificant to you

personally• Some may not even be listed –

spouse’s career, geography, etc.

Critical Factors Checklist

• Autonomy• Caring for Patients• Continuity of Care• Diversity • Focus of Expertise• Innovative thinking• Intellectual Content• Interacting with other

Physicians• Manual/Mechanical

Activities

• Pressure• Responsibility• Security• Sense of

Accomplishment• Status among Colleagues• Patient Characteristics• Types of Illnesses

Considerations in “Working” the Critical Factors

• What I want vs. What I want to avoid• Self vs. Others• Short Term vs. Long term• Changing environment of Health Care System

Environmental

• Large or small practice

• Level of compensation

• Hospital, academic, private practice, etc

• Work hours – structured, # of calls, etc.

• Rural, suburban, urban, etc.

Personality and Lifestyle

• Myers-Briggs Type Indicator

• Keirsey Temperament Sorter-$14.95

Skills

• Help determine areas in which you excel.

• Assess your adaptive, functional, and specific content skills.

• Informal Skills Assessment• Skills Assessment with Feedback

Financial Situation

• How you balance your financial resources and lifestyle will greatly impact your life in medical school.

• Things you do now will help you financially survive medical school and help broaden your specialty options.

• The Budget Worksheet

Educational Experience

• Which courses did I especially enjoy and succeed?

• What made them enjoyable? • In which subjects, or subtopics and

tasks did I excel? • In what subjects would I like to gain

more experience?

Once you know what you want in life . . .

You must look at yourself in terms of what you want in a medical field

www.capitalonehealthcarefinance.com/

Self-assessment exercise

• You are going to take turns discussing with your neighbor– Your reasons for going into medicine in

the first place

– Current goals, expectations, changes

– Top 5 Critical Factors

Pair Off with Your Neighbor

• Take 8 minutes to discuss your thoughts then listen as your partner talks for 8 minutes.

• Take turns talking and listening• Listen attentively and with

empathy• Try not to interrupt• Ask questions to clarify but

don’t criticize or make judgments.

www.deathreference.com/Bl-Ce/

Critical Factors Checklist

• Autonomy

• Caring for Patients

• Continuity of Care

• Diversity

• Focus of Expertise

• Innovative thinking

• Intellectual Content

• Interacting with other Physicians

• Manual/Mechanical Activities

• Pressure

• Responsibility

• Security

• Sense of Accomplishment

• Status among Colleagues

• Patient Characteristics

• Types of Illnesses

Now that you know yourself

Some of you may have experienced some significant insights into yourself or how others view and approach the same challenge

This exercise was meant to give you a taste of what you need to do with other significant people in your life

Seek further help clarifying your strengths, weaknesses and goals.

Resources to help with the process

• CiM website

• Faculty – – Any of the clerkship directors– Student affairs office– Master Clinicians– Faculty Mentors

Next- Phase II Career Exploration

• Don’t pass up the opportunity to use your summer to gain valuable first hand information about various careers.

• Consider Shadowing a Physician or Researcher.

• Participate in research during the summer.

Exploration

• Work in an overseas clinic in a specialty you are considering.

• Especially important for those students considering competitive or early match professions

Take Ownership!

Don’t expect or let your mom make this decision for you!

Commit the time and energy to do this right the first time

It’s inefficient and emotionally draining to have to change specialties in the middle of your residency – even worse after years of practice.