75% of medical students
Change their minds about
their specialty choice from
when they enter to their M4
year
Careers In
Medicine
The “Vigilant” Decision Making Process
Phase I
CiM Four Year Timeline
M-1
August
CiM Intro
March
Phase I
Summer
M-2
February
M-3
Fall
M-4
Self Assessment
Shadowing
Research
Volunteer
Phase II
Career Exploration
Alumni Panel Discussion
Clerkships
Student AMA lunches
December
Phase III
Career Day
April
Phase IV
Strolling thru Match
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-
• It is not-
• A decision making
process
• A thorough on-going
effort
• Primarily specialty
oriented
• A source of useful
information
• A self-help process
• 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.