From the Dean: The factors that influence medical students’ specialty choices
This past Wednesday I was invited to participate in a meeting of our Internal Medicine Interest Group, organized and run by medical students interested in that specialty. This session was intended as a subspecialist question-and-answer panel for students interested in the different pathways within internal medicine. As you may know, internal medicine is a wide-ranging specialty, and many certified internal medicine physicians subspecialize in one of many different subspecialties. Residency training for internal medicine typically consists of three years, and subspecialty training typically is also three years. Using me as an example, I am board certified in both internal medicine and cardiovascular diseases (cardiology).
The reason the students held this session was so that they might gain further insight into their career choices within the internal medicine domain, an area of medical practice that is already interesting to them. That domain, as indicated, is wide-ranging, stretching from hospital medicine to subspecialities such as infectious disease, cardiology, and endocrinology. The session went well, and the students asked a lot of good questions.
As I reflected on the meeting, I was reminded of some fairly consistent findings we see when our UND medical students (not to mention medical students from across the country) are queried as to the most important factors in their decision about career choices after graduation from medical school. One of the important sources of information regarding career choices of medical students comes from the annual Graduation Questionnaire (GQ) distributed by the Association of American Medical Colleges. In this annual survey, we see how our students compare with all other medical students in the country. Our students (in synergy with the national sample) consistently identify several factors that are most influential in their career choice; the top factors have remained the same for years. Taking first place is what the GQ calls “fit” – that is, do the characteristics of the career choice match well with the personality, interest, and skills of the student? Does the content of the choice line up well with what the graduate will be doing for the remainder of his or her professional life?
That’s why the session that was held two days ago can be so helpful to students – they can gauge how well a career in cardiology, for example, might match their interests, skills, and values. I was glad to share my thoughts as to why cardiology has been such a rewarding choice for me. For what it’s worth, cardiology was the right choice for me because it allowed me to involve my brain, my hands, and my heart in my profession: my brain, by trying to figure out what ails the patient and how we can help the patient; my hands, through the procedural skills I’ve acquired over the years in the cardiac catheterization laboratory; and my heart, by allowing me the immense satisfaction of helping another human being deal with a trying illness.
By the way, the other high-ranking factors are work/life balance and the impact of mentors. I know for me, one mentor (a cardiologist!) in medical school was especially impactful. That’s why we at the School are so grateful to the legions of physicians in practice across North Dakota who share their time, experiences, and patients with our students.
Work/life balance was not always a top consideration, though. Back when I was in medical school, I think I and my co-students would have said that “balance” is important, but maybe not among the top three factors influencing our choices. In this case, things have changed – for the better!
Also please note what is not among the top considerations for today’s students: income expectations. Yes, students are quite aware of and sensitive to their acquired debt burden from college and medical school. And, yes, students clearly are aware of the income levels of various specialists. So, of course income is involved in their career plans. But for most students, it is not the deciding factor. For most students, it’s “fit,” work/life balance, and mentors. Those top three factors sound about right to me!
Joshua Wynne, MD, MBA, MPH
Vice President for Health Affairs, UND
Dean, UND School of Medicine & Health Sciences
