Medical Specialties

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Overview. Introduction: Why Specialties?Looking ahead: Course Goals/ObjectivesCourse ContentResources for Students. Introduction. Why Specialties?. Physician Dissatisfaction:Study in 19971 revealed physicians were less satisfied in every aspect of their professional life compared to 10 years prior.40% of practicing physicians in 2005 would not choose to enter the medical profession if deciding on a career againHigher percentage would not encourage their children or highly qualified c35468

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Medical Specialties

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1. Medical Specialties Xochilt Borja PCPR August 28, 2008

2. Overview Introduction: Why Specialties? Looking ahead: Course Goals/Objectives Course Content Resources for Students

3. Introduction

4. Why Specialties? Physician Dissatisfaction: Study in 19971 revealed physicians were less satisfied in every aspect of their professional life compared to 10 years prior. 40% of practicing physicians in 2005 would not choose to enter the medical profession if deciding on a career again Higher percentage would not encourage their children or highly qualified college graduates to pursue medicine

5. Introduction (Cont.) Dissatisfaction has been reported in diverse groups of physician1 Primary care Surgery Infectious disease Anesthesiology Large study3 revealed lowest dissatisfaction in primary care sub-specialists and highest in surgical subspecialties such as gynecology, ENT, and plastic surgery Steep reduction in income and job availability due to managed care Escalating malpractice rates

6. Introduction (Cont.) Increasing unhappiness among physicians has led to job changes, non-clinical work and early retirement1

7. Looking Ahead

8. Course Goals/Objectives 2006 survey of final year medical residents by Merritt, Hawkins & Associates 285 residents completing final year of residency 25 different medical specialties 38% primary care (FP, IM and pediatrics) 50% surgical specialists or IM sub-specialists 12% hospital based specialists (anesthesiologists, radiologists, pathologists, hospitalists or emergency medicine)

9. Residents “As you consider entering a professional practice, do any of the following cause you a significant level of concern?” Ability to find a job 83% Earning a good income 74% Availability of free time 63% In 1999: 13% Malpractice 32% Educational debt 19% Dealing with managed care 15% Insufficient practice management knowledge 12% Dealing with patients 4% Insufficient medical knowledge 3%

10. Residents “Other than quality of care considerations, what are your top considerations as you look at selecting a medical practice job opportunity?” Geographic location/lifestyle 79% Usually close to where they trained or grew up Good Financial Package 68% Increased from 43% in 2001 Adequate Call/Coverage 44% Loan Forgiveness 19% Specialty Support 8% Low Malpractice 6% Good Medical Facilities/Equipment 9%

11. Residents “If you were to begin your education again, would you study medicine or would you select another field?” Medicine 76% Another field 24% (highest rate in 15 years of surveys) NOTE: Shows that further consideration of the medical career pathways and desired lifestyle is very important to considerNOTE: Shows that further consideration of the medical career pathways and desired lifestyle is very important to consider

12. Course Goals/Objectives Goal Every student be exposed to the broad spectrum of pathways in medicine, gain awareness of what a career in medicine is as a whole, and have the opportunity to assess which career path best suits their personal interests and life goals.

13. Course Goals/Objectives Focus: Reflection on what type of lifestyle they want to live as medical professionals Salaries Employment (getting a job, types of jobs available) Objectives (in progress): Students will know the specialties recognized by the American Board of Medical Specialties, including the salaries, competitiveness of residency programs and employment opportunities. Students will complete a specialty-personality assessment test (i.e. Myers-Briggs) Students will reflect upon what lifestyle they would prefer as a medical professional.

14. Course Content

15. Specialties Allergy and immunology Anesthesiology Colon and rectal surgery Dermatology Emergency medicine Family practice Internal medicine Medical genetics Neurological surgery Nuclear medicine Obstetrics and gynecology Ophthalmology Orthopedic surgery Otolaryngology Pathology Pediatrics Physical medicine and rehabilitation Plastic surgery Preventive medicine Psychiatry and neurology Radiology Surgery Thoracic surgery Urology

16. Competitiveness Extremely competitive Plastic Surgery (37.8) Dermatology (27.0) Urology (23.0) Otolaryngology (16.5) Radiation Oncology (15.6) Very Competitive General surgery (13.9) Orthopedic surgery (12.9) Neurosurgery (12.0) Ophthalmology (12.0) Anesthesiology (10.0) Competitive Physical medicine and rehabilitation (8.1) Neurology Obstetrics- gynecology (7.0) Pathology (5.0) Emergency medicine (4.5) Less competitive Radiology (3.6) Psychiatry (2.7) Pediatrics (2.6) Internal Medicine (2.5) Family Medicine (1.9)

17. Salaries

18. Personality Factors McManus1: 1,668 medical graduates Correlation between physicians’ perceptions of workplace to differences in personality Attitudes were evident in medical school and remained stable when measured again in the final year at medical school and five years later in working doctors Stress and burnout correlate with personality traits measured five years earlier We can select happier doctors by assessing personality profiles and learning styles at entry to medical school

19. Personality Factors Myers-Briggs Myers-Briggs Type Indicator (MBTI) Concerned with the differences that result from the way people perceive information and prefer to use that information Based on work of C.G. Jung Four Dimensions measured by MBTI

20. Personality Factors Myers-Briggs Four MBTI Dimensions Extraversion or Introversion (E-I) Sensing or Intuition (S-N) Thinking or Feeling (T-F) Judging or Perceiving (J-P)

21. Personality Factors Myers-Briggs Extraversion or Introversion (E-I) Extraverts: focus on the outer world of action, objects, and persons. Introverts: focus on inner world of concepts and ideas. Sensing or Intuition (S-N) Sensing: collects information from the immediate, real, practical facts of life. Intuitive: sees the possibilities, the relationships, and the meaning of experience.

22. Personality Factors Myers-Briggs Thinking or Feeling (T-F) Thinker: makes judgments objectively and impersonally, considering the causes of events and where decisions may lead. Feeler: makes judgments subjectively and personally, weighing values of juices and how they affect others. Judging or Perceiving (J-P) Judger: prefers to live in a decisive, planned, and orderly way so as to regulate and control events. Perceiver: lives in a spontaneous, flexible way, aiming to understand life and adapt to it.

23. Personality Factors Myers-Briggs Introverted-Sensing-Feeling-Perceptive (ISFP) Anesthesiology Urology Family practice Thoracic surgery General Practice Extroverted-Sensing-Thinking-Judging (ESTJ) Obstetrics and Gynecology General practice General surgery Orthopedic surgery Pediatrics

24. Alternative Careers Dual Degrees International/ Global Health Academic Medicine Administration

25. Student Resources CareerMD- www.careermd.com Fellowship and Residency Electronic Interactive Database (FREIDA)- www.ama-assn.org/go/freida Internship and Resident Information Site (IRIS)- www.i-r-i-s.com MedCAREERS www.aamc.org/medcareers Physician’s Guide to the internet- www.physiciansguide.com ResidentWeb- www.residentweb.com Scutwork.com (residency program reviews)- www.scutwork.com The Student-Doctor Network- www.studentdoctor.net

26. Conclusion The next phase Premed perceptions of being in a specialty Closer look at what specialties are most preferred by medical students and why Environment of specialties CiM

27. Thank You

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