Monday, May 01, 2006

Career Planning in Medicine

Career Planning in Medicine: "What to Be or Not to Be, That's the Question. When I graduated from medical school nearly 40 years ago, career 'planning' was virtually unheard of. Oh, I remember one of my classmates who did plan, from even before medical school, to become a cardiac surgeon; he never wavered and ended up doing just that. But for the rest of us, at least most of the rest of us, the careers we ended up in were less a matter of precise planning than of hopeful hunching. Few medical students in those days had access to formal career counseling. We formed our opinions about suitable careers from informal corridor conversations with our attendings, or from our distorted glimpses of what made up their professional lives, or from the stereotypic comments of residents or fellow students who were as poorly informed as we were. As for tailoring our career choices to some objective assessment of our innate talents, forget it.

But the stakes back then were much different from what they are now, and the risks of going with one's hunches rather than following a planned pathway were small. With the exception of the few who chose academic medicine or the military, medical students in my generation were faced with a pretty simple set of choices. One had to select a medical specialty from a list less than half as long as currently exists; one had to decide whether to do solo practice or join a group; and one had to pick where in the country one wanted to live. Have an MD degree was, quite literally, to have a ticket to certain prosperity in whatever specialty one picked, in whatever company one wanted to keep, and in whatever community one chose to settle.

To observe that a lot has changed since then would be to abuse understatement. Today's medical students face a virtual cacophony of choices, and the risks of making the 'wrong' choice can be very costly indeed. Not only have scores of new medical subspecialties sprung into existence over the last few decades, a wide variety of new modes of practice are available to choose among. Although solo practice may have gone the way of the passenger pigeon, many other possibilities offer viable alternatives. Group practice, academic medicine, and the military remain realistic choices. But how about employment in a managed care organization, or in the burgeoning biotechnology field, or as a 'hospitalist,' or in a pharmaceutical company, or with an international relief agency? All are among the tantalizing possibilities clamoring for students' attention."

A useful guide for the perplexed medical student !

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