Blog Archives

Something You Probably Haven’t Considered Could Have a Huge Impact on Your Professional Happiness

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. 

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Your Residency Application: Six Factors to Prioritize When Creating your Rank List

Creating your Match rank list can be absolutely agonizing because it feels like so much is at stake. Sometimes it helps to step back and look at the big picture. Below, I briefly note a few important considerations when making your list:

1. Make sure you understand how the NRMP algorithm works. See my previous blog post regarding errors to avoid at all costs. The key is to rank in the order you want – first goes first, second goes second, etc.

2. Consider your happiness and life balance. Blasphemy perhaps, but I would argue that they are more important than the strength of the training program.

3. Reflect on the culture, geography, size, and even maturity/age of the program. Think about whether you will fit in.

4. Consider whether you could spend your whole life at the institution or in that program’s location. It’s a lot to grapple with, but many residents graduate and stay for the rest of their careers.

5. Decide whether you liked the program director, chairperson, and faculty generally. They could make or break your happiness and success.

6. Realize that most programs will train you well if you work hard. Their prestige and quality may be more similar than you think. For that reason, note that your personal preferences and intuitions are paramount.

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Bad Advice Turned on Its Head

The end of the year is a time for reflection and a time to consider what will make you happy in the upcoming twelve months – and beyond.

When I was a medical student applying for emergency medicine residency programs, a well-meaning dean gave me some bad advice: I was determining the order of my rank list and was particularly concerned about one program that had an excellent reputation but was in a city I didn’t like. The dean told me, “You’ll be so busy during residency it won’t matter where you live.” Luckily, the advice rubbed me the wrong way, and I wholeheartedly disregarded it. Where you live for your medical training – medical school, residency, or fellowship – is as important as the quality of your training program! The reasons are several-fold:

1. Medical training is time-consuming, and you want to be in a city you can enjoy fully when you have a few moments to blow off steam.
2. Medical training is extremely stressful, and you want to be in a city where you have social support.
3. Medical training is not completed in a vacuum. Your personal life continues. If you’re single you may meet someone and end up staying in the city where you have trained for the rest of your life (gasp). If you’re in a long-term relationship you may decide to have children or may already have them. Down the road you may not want to relocate your family.

Not everyone gets the opportunity to go to medical school or train in residency and fellowship programs in a city s/he likes. But you can make choices that will increase your chances. Consider these options – and your happiness – as you make professional decisions this coming year.

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About Dr. Michelle Finkel

Dr. Michelle Finkel

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

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