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 M-1AugustCiM Intro MarchPhase ISelf Assessment SummerShadowing Research Volunteer M-2FebruaryPhase IICareer Exploration M-3FallAlumni Panel Discussion Clerkships Student AMA lunches DecemberPhase IIICareer Day AprilPhase IVStrolling thru Match M-4FallERAS Dean’s Letter

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. What CiM is and isn’t 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

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. Critical Factors Checklist 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

19. Considerations in “Working” the Critical Factors What I wantvs.What I want to avoid Selfvs.Others Short Termvs.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. Critical Factors Checklist 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

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.