Congratulations to all of my clients who will be starting medical school soon. This is a tremendous achievement. For those who hope to matriculate in the next year or two, I might recommend this Varsity Tutors piece that I wrote several years ago and the follow-up article. The “medical school paradox” is a tough one to crack, but if you prepare in advance, you’ll have an excellent head start and a professional advantage.
A recent article in Emergency Medicine News caught my eye. Emergency physician Dr. Tom Belanger conducted a small study (n=573) in which he crafted a nine-question Likert scale survey and then attempted to predict emergency physicians’ employment structures based on respondents’ answers. He used statements like “I am paid fairly,” “I am secure in my career,” and “Emergency medicine is a good career” in his survey.
In medical school and residency, I thought little about employment structure, which can include democratic, hospital employee, contract management, independent or locums, academic, resident, or government systems. As a student, I was so focused on what specialty I would choose and was so influenced by the academicians I worked with that I didn’t even consider that I could choose a field in which I might be happy in one employment structure and discontent in another.
Belanger found that employees of contract management groups (CMGs) tended to be the most negative respondents, and owners of CMGs were not far behind. On the other hand, owners of democratic groups were the most positive in almost every aspect.
In this study, all respondents were in the same specialty and yet, employment structure divided respondents with regard to their career satisfaction. Belanger’s graphs are worth viewing in his piece, but the take-home point for medical students and residents is the importance of the employment structure in which you ultimately work, a topic that may not have even crossed your mind until now.
Here’s an oldie-but-goodie New York Times piece by Dr. Pauline Chen on medical student grades. In reading the article, residency applicants should reflect on how important the content of their letters of recommendation is, especially in the setting of medical school grades that may be inflated or simply inaccurate. The 2020 NRMP Program Director Survey supports the importance of letters, as well, with statistics. Make sure your letters are very strong; remember that mediocre letters should not be a part of your residency package.
For many third-year medical students, this is a challenging time of year: Contemplating an ERAS application can be daunting, but it’s even worse if you don’t know what specialty you want to practice. Here’s a short piece I wrote with my colleague David Presser, MD, MPH called “Choosing a Specialty: The Generalist vs. The Early Committer,” and here’s a complementary (non-medical) New York Times article called “You Don’t Want a Child Prodigy” that’s a great follow-up piece.
When I applied in emergency medicine (EM), I had only two other classmates submitting applications to the field. EM wasn’t a very popular specialty, although that would change as the show ER became hotter. Although enthusiasm for the field has generally increased over my career, medical students’ interest in EM has waxed and waned.
Recently an eight-organization consortium of EM groups analyzed the field’s workforce, demonstrating an oversupply of emergency physicians likely to appear over the next decade. There are a number of reasons proposed, including the proliferation of EM residencies and inappropriate use of physician extenders. Take a look at this piece in ACEP Now for detailed information, especially if you see EM in your future.
Dr. Finkel is a graduate of Stanford University and Harvard Medical School. On completing her residency at Harvard, she was asked to stay on as faculty at Harvard Medical School and spent five years teaching at the world-renowned Massachusetts General Hospital. She was appointed to the Assistant Residency Director position for the Harvard Affiliated Emergency Medicine Residency where she reviewed countless applications, personal statements and resumes. Read more
