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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
  • 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



Interest Orientation



Outer world of actions, objects, and people

Inner world of ideas and concepts







Immediate reality and direct experience

Inferred meanings and relationships







Reliability of logical order – cause and effect

Priorities based on personal importance and values




Environment Orientation



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

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

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

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


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

Year 4: Getting into Residency

  • Research residency training programs through AMA's FREIDA, AMA's Graduate Medical Education Directory (Green Book), or Osteopathic Opportunities
  • 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


  • Graduate Medical Education Directory

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:
    • 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:


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