75% of medical students

1. 75% of medical students Change their minds about their specialty choice from when they enter to their M4 year

2. Careers In Medicine The “Vigilant” Decision Making Process Phase I

3. CiM Four Year Timeline

4. 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

5. 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.

6. 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

7. 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

8. It is- A decision making process A thorough on-going effort Primarily specialty oriented A source of useful information A self-help process It is not- A decision A quick fix Comprehensive career counseling A substitute for your own research A substitute for interpersonal counseling What CiM is and isn’t

9. 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

10. 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

11. 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

12. What do you need to define about yourself? • Interests • Values • Personality and Learning Styles • Skills • Environmental Factors and Practice Needs • Financial Situation • Educational Experience

13. 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

14. 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

15. 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

16. Values • Physician Values in Practice Scales (PVIPS) • Careers Values Checklist • Values Card Sort

17. 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.

18. 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 Critical Factors Checklist

19. 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

20. Environmental • Large or small practice • Level of compensation • Hospital, academic, private practice, etc • Work hours – structured, # of calls, etc. • Rural, suburban, urban, etc.

21. Personality and Lifestyle • Myers-Briggs Type Indicator • Keirsey Temperament Sorter-$14.95

22. Skills • Help determine areas in which you excel. • Assess your adaptive, functional, and specific content skills. • Informal Skills Assessment • Skills Assessment with Feedback

23. 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

24. 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?

25. 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/

26. 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

27. 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/

28. 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 Critical Factors Checklist

29. 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.

30. Resources to help with the process • CiM website • Faculty – • Any of the clerkship directors • Student affairs office • Master Clinicians • Faculty Mentors

31. 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.

32. Exploration • Work in an overseas clinic in a specialty you are considering. • Especially important for those students considering competitive or early match professions

33. 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.