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Professional Development Series . Part 1. What will I be when I grow up?. The answer is no longer just “doctor”. The Big Decision. Most med students spend more time deciding what car to buy than on selecting a career. Little thought goes into a lifelong decision.

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what will i be when i grow up
What will I be when I grow up?

The answer is no longer just “doctor”

the big decision
The Big Decision
  • Most med students spend more time deciding what car to buy than on selecting a career.
  • Little thought goes into a lifelong decision.
  • Hasty decisions can lead to burnout, changing residency programs, an unhappy career.
statistics job satisfaction
Statistics/Job Satisfaction
  • 40% of physicians report being very satisfied
  • 20% of physicians report complete dissatisfaction
  • The rest are somewhere in between
pitfalls to choosing a specialty
Pitfalls to Choosing a Specialty:
  • Anxiety over exams/grades detracts from focusing on the merits of the specialty
  • Subjective grades can influence final impressions
  • Bitter residents and attendings/personality conflicts
  • One bad rotation does not preclude one from choosing that specialty
  • Lack of participation
  • Lack of “nittygritty”outpatient experience
  • Not enough time to look at every specialty in 1 year
  • Lack of guidance resources/lack of time
over 60 specialties and subspecialties
Over 60 Specialties and Subspecialties
  • Allergy and Immunology Anesthesiology
  • Cardiology Colon and Rectal Sx
  • Dermatology Emergency Med
  • Family Practice General Sx
  • Genetics Infectious Disease
  • Internal Medicine Neurology
  • Neurosurgery Nuclear Medicine
  • OBGYN Oncology
  • Ophthalmology Orthopedic Surgery
  • Otolaryngology Pain Management
  • Pathology Pediatrics
  • Physical Med/Rehab Plastic Sx
  • Preventive Med Psychiatry
  • Radiology Rheumatology
  • Thoracic/CV Sx Urology
sample specialty divisions
Sample Specialty Divisions

Hospital Based Specialties:

Radiology, Pathology, Emergency, Surgery

Comprehensive care for one population:

Pediatrics, OBGYN

Primary Care:

Family Practice, Internal Medicine, Pediatrics

Tertiary Care/Referral-Based/One Organ System:

GI, Dermatology, Urology, Neurology, Cardiology

myths and folklore or truth
Myths and folklore or truth??
  • All orthopods are jocks.
  • Gynecologists have the worst sex lives of all doctors
  • Pathologists are socially inept.
  • You should be a surgeon like your father.
  • Psychiatrists are crazy!
  • Dermatology is good money and short hours.
  • General surgeons do all the work with little pay.
  • ER docs are adrenaline addicts.
  • Internists are nerds.
four domains of career assessment
Four Domains of Career Assessment
  • Personal Values – what is important to you
    • Physician Values in Practice Scale
  • Interests – what you like
    • Medical Specialty Preference Inventory
  • Personality – what are you like?
    • Myers-Briggs Type Indicator
  • Skills – what you can do and do well
    • Experience on clinical rotations
personal values
Personal Values:
  • Hours
  • Income
  • Intellectual Stimulation
  • Type of Patient Population
  • Generalist vs Specialist
  • Work Environment
  • Patient Contact
  • Social Status
other considerations
Other considerations:
  • Paperwork/Managed Care
  • Job Opportunities
  • Length of Training
  • Academic Competitiveness
  • Malpractice/Litigation
personality what are you like
Personality: What are you like?

Results of multiple studies:

Surgeons: extroverted, practical, social, less creative, competitive, structured

Controllable lifestyle specialists: withdrawn and rebellious

Hospital-based specialties: low tolerance for ambiguity, desire high structure

OBGYN: warm and helpful

Primary care: desired long term patient relationships

Action oriented people who desire immediate gratification: sought out ER, surgery, anesthesiology

myer briggs personality type indicator mbpti
Myer-Briggs Personality Type IndicatorMBPTI
  • Developed in the 1950’s
  • Used in medical schools across the country
  • Helps guide specialty selection by determining personality and temperament
  • Identify strengths and weaknesses
  • Take each year for best results
  • www.capt.org for a fee can get expert feedback
mbti four dimensions of personality yield 16 different personality types
MBTI: Four dimensions of personality yield 16 different personality types
  • Extroversion (E) vs Introversion (I): How we interact with the world and where we direct our energy
  • Sensing (S) vs Intuition (I): The kind of information we naturally notice
  • Thinking (T) vs Feeling (F): How we make decisions
  • Judgment (J) vs Perception (P): Whether we prefer to live in a more structured way or a more spontaneous way
slide16

Extraversion

Introversion

Interest Orientation

E

I

Outer world of actions, objects, and people

Inner world of ideas and concepts

slide17

Sensing

Intuition

Perception

S

N

Immediate reality and direct experience

Inferred meanings and relationships

slide18

Thinking

Feeling

Judgment

T

F

Reliability of logical order – cause and effect

Priorities based on personal importance and values

slide19

Judgment

Perception

Environment Orientation

J

P

Judging attitude – Control of events and systematic planning

Spontaneity – Curious, awaiting events and adapting to them

choosing your specialty
Choosing Your Specialty
  • Step 1: Select specialties of interest
  • Step 2: Select factors important to you
  • Step 3: Rate your specialties
glaxo pathway evaluation program
Glaxo Pathway Evaluation Program

http://www.smbs.buffalo.edu/RESIDENT/CareerCounseling/interior.htm?self-assessment.htm

Self assessment will rate medical specialties according to compatability

Co-sponsored by Duke University

glaxo critical factors
Glaxo Critical Factors
  • Caring for Patients
  • Continuity of Care
  • Autonomy
  • Diversity
  • Personal Time
  • Expertise
  • Income Satisfaction
  • Creativity
  • Certainty of Outcomes
  • Clinical Decision Making
  • Patient Decision Making
  • Interacting with Other Physicians/ Members of Health-care Team
  • Manual /Mechanical Activities
  • Pressure
  • Responsibility
  • Schedule
  • Security
  • Sense of Accomplishment
slide28

Year 1

  •   Orientation to Careers in Medicine
  • Seek out an advisor or mentor
  • Understanding Yourself
  • Complete the Specialty Indecision Scale for personalized guidance on your career concerns.
  • Attend CiM workshops
  • Begin completing self-assessment exercises
slide29

Year 2

* Continue self-assessment

* Complete self-assessment exercises

* Review completed Personal Profile with advisor

Exploring Options

* Begin gathering basic information about specialties of interest through CiM Specialty Pages, other online sites, and library research

* Attend Specialty Panel and Information Group sessions provided by your school

* Compare your self-assessment information to the information you have gathered about specialties. Narrow down your specialty interests to 3-4 top choices

* Plan your 3rd year schedule

* Take Boards Step 1

slide30

Year 3

  • Begin clinical rotations
  • Review the Charting Outcomes in the Match report to assess qualifications and competitiveness for different specialties 
  • Conduct informational interviews and/or participate in preceptorships
  • Contact associations and specialty organizations
  • Meet with your advisor to discuss your top choices
  • Complete the "Choosing Your Specialty" exercise
slide31

Year 4: Getting into Residency

  • Research residency training programs through AMA\'s FREIDA, AMA\'s Graduate Medical Education Directory (Green Book), or Osteopathic Opportunities http://opportunities.osteopathic.org/
  • Complete the Residency Preference Exercise
  • Begin reviewing and comparing residency programs
  • Begin preparing residency applications.
  • Complete applications and designate programs to which your materials will be submitted
  • Take Boards Step 2
  • Interview with residency programs
  • Complete the Residency Program Evaluation Guide
sources for researching residency training programs
Sources for Researching Residency Training Programs
  • CiM specialty pages

http://www.aamc.org/students/cim/start.htm

  • AMA’s FREIDA

http://www.ama-assn.org/ama/pub/education-careers/graduate-medical-education/freida-online.shtml

  • Graduate Medical Education Directory

http://opportunities.osteopathic.org/

what do i do now
What Do I Do Now?
  • Excel in your clinical clerkships
    • Program directors like to see as many clerkships with Honors as possible – especially in specialty of choice
  • Explore extramural elective opportunities:
    • http://www.aamc.org/students/medstudents/electives/start.htm
    • Shadow drs on breaks and holidays, engage in research projects
    • Summer between 1st and 2nd year: National Health Service Corps, AMSA/SALUD
  • Participate in CiM self-assessment and Glaxo Pathway Program
  • Explore specialties through personal experience, talking to others, CiM, Glaxo, and other resources
session 3 getting into residency
Session 3: Getting Into Residency
  • Applying for residency
  • Writing a CV and personal statement
  • Getting letters of recommendation
  • Residency interviewing
choosing a career in medicine
Choosing a Career in Medicine:

Sources:

1. The Ultimate Guide to Choosing a Medical Specialty, second edition

by Brian Freeman, MD

  • Ren Stinson / University of Iowa

3. Michael G. Kavan, Ph.D

Associate Dean for Student Affairs

Creighton University School of Medicine

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