Careers in Medicine: The U.S. Approach to Career Planning in Medical School. George V. Richard, Ph.D. Director, Careers in Medicine Program

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1 Careers in Medicine: The U.S. Approach to Career Planning in Medical School George V. Richard, Ph.D. Director, Careers in Medicine Program January 18, 2007

2 The Structure of U.S. Medical Education Baccalaureate degree required to enter medical school Some BS-MD programs exist Medical school 125 allopathic medical schools 2 years basic science training 2 years clinical training in affiliated school hospitals Specialty decisions usually by the beginning to middle of 4 th year Graduate Medical Education - Residency ~ 1,500 institutions and teaching hospitals ~ 8,500 training programs

3 Residency Training Paths Year 1 Year 2 Year 3 Year 4 Year 5 Years 6-7 FAMILY PRACTICE EMERGENCY MEDICINE PEDIATRICS SUBSPECIALTIES INTERNAL MEDICINE SUBSPECIALTIES OBSTETRICS/GYNECOLOGY PREVENTIVE MEDICINE SUBSPECIALTIES PATHOLOGY GENERAL SUBSPECIALTIES SURGERY NEUROLOGICAL SURGERY ORTHOPAEDIC SURGERY OTOLARYNGOLOGY UROLOGY TRANSITIONAL or PRELIM MEDICINE or PRELIM SURGERY ANESTHESIOLOGY DERMATOLOGY NEUROLOGY NUCLEAR MEDICINE OPHTHALMOLOGY PHYSICAL MEDICINE PSYCHIATRY RADIOLOGY - DIAGNOSTIC RADIATION ONCOLOGY

4 Percent of students, residents and physicians who make major specialty changes Beginning of medical school Overall: 30%-70% Specialty Specific Internal Medicine: 60% Family Medicine: 61% Pediatrics: 78% Obstetrics & Gynecology: 80% Residents: Overall: 10-15% Specialty Specific: Primary Care: 26% At end of 2nd year Overall: 31% Specialty Specific Internal Medicine: 50% Family Medicine: 63% Pediatrics: 31% Specialty Specific: Physicians Primary Care: 22% Surgery: 12% Controllable Lifestyle Specialties: 9%

5 Growth of Career Planning Services GlaxoWellcome finds strong need for career guidance and information 1987 AAMC GQ reports low satisfaction levels in medical school career planning services Little or no formal career planning services 1989 GlaxoWellcome creates Pathway Program for Medical Professionals AAMC establishes Careers in Medicine Program

6 Challenges Variations in provision of school career planning services (if provided) If you ve seen one medical school Lack of career development expertise in medical school staff Student variations in approach to decision-making Little or no career development resources for professional levels Theory focused on secondary and post secondary education not postgraduate level (e.g.., engineering, psychology, medicine)

7 Program Development Considerations To build a sound career planning service the following needs were addressed A career development model Career planning resources Staff with career development expertise

8 The Model Trait/Factor Theory Person/environment fit The closer the match between your personal characteristics and the chosen career, the more satisfied, productive, and effective you will likely be Careers in Medicine follows this paradigm in four phases: Understanding yourself Exploring options Choosing a specialty Getting into residency Designed to maximize the decision-making process, minimize time away from medical school responsibilities and help students make life and career decisions

9 Program Structure - AAMC CiM Office Develops national program and resources, password protected Web site, print and marketing materials Provides training and development opportunities to medical school personnel Supports school implementation

10 Program Structure - Medical schools Develop localized resources Integration of institutional and AAMC-provided services and resources Coordinate CiM program CiM Liaisons Coordinate program implementation at medical schools Provide access to AAMC CiM products and other resources Recruit and prepare advisors Communicate with AAMC staff Provide direct career guidance services to medical students Offer individual and group advising, workshops, and courses Coordinate development local web-based and physical resources Advisors Provide direct career guidance services to medical students

11 CiM Resources Complete program available online Online career assessment instruments and other decision-making tools Detailed Specialty Pages Confidential Personal Profile Student Guides Free to all incoming students General CiM overview and guide Advisor Resources Online materials, manuals, presentations, and relevant advisor instructions Counseling and career advising skills Guidelines, handouts, and outlines for career planning workshops Program implementation guidance CiM list serve for liaisons, advisors and faculty Regional training workshops for CIM liaisons, advisors, and faculty

12 Career Assessment Resources Information Introduction to self-assessment Using assessment information Tools CiM developed assessment inventories: Medical Specialty Preference Inventory Physician Values in Practice Scale Specialty Indecision Scale

13 Exploring Options Gather information about career options Career exploration activities to include Online and library-based research School-organized specialty seminar programs Informational Interviewing and job shadowing -Use your mentors and advisors Networking with local medical societies, alumni organizations, and specialty associations Clinical clerkships

14 Resources for Exploring Options Information Exploring options and researching specialties Conducting in-depth specialty exploration USMLE Alternatives to traditional clinical practice Academic medicine Using your summer experience Budgeting and financial management Tools Informational interview questions Summer reflections Resources CiM Specialty Pages 112 specialties and subspecialties Nature of the work, personal characteristics, training requirements, match statistics, workforce statistics, compensation, links to specialty societies and online journals

15 Choosing a Specialty Information Making good decisions Residency training paths Researching residency training programs Tools Specialty choice exercise Residency training program selection exercise

16 Getting into residency Information Planning your 4th year Applying for residency Writing a curriculum vitae (CV) Writing a personal statement Getting letters of recommendation Residency interview basics Acing the interview Going through the match Planning for the future The USMLE and me Budgeting and financial management Tools Match timeline Frequently asked interview questions Residency program evaluation guide Budgeting worksheet

17 Program Timeline Medical School Year 1 Year 2 Year 3 Year 4 Understanding yourself Exploring options Choosing a specialty Getting into residency

18 Program Success Growth of CiM Services in Schools (92 US schools - 74% response rate) Conduct individual career advising: 94% of schools Use of Web site: 91% Distribution of Student Manuals: 79% Conduct CiM Workshops: 53% All showing signs of growth over time CiM Impact Improved ratings of student satisfaction with schools career planning services Regional training programs well attended and highly evaluated Regular CiM programming at regional and annual meetings Positive student ratings of web site usefulness

19 Current Barriers Curriculum/schedule constraints Availability of trained clinical advisors Development of assessment products incomplete Staff availability and interest Student interest and involvement Institutional leadership

20

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