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Case Study: A Midclerkship Crisis—Lessons Learned From Advising a Medical Student With Career Indecision

Levine, Rachel B. MD, MPH; Cayea, Danelle MD, MS; Shochet, Robert B. MD; Wright, Scott M. MD

doi: 10.1097/ACM.0b013e3181d299b7
Case Study

Advising medical students is a challenging task. Faculty who serve as advisors for students require specific skills and knowledge to do their jobs effectively. Career choice is one of the many complex issues about which medical students often seek assistance from a faculty advisor. The authors present a case of a third-year medical student with career indecision, with a focus on the various factors that may be influencing her thinking about career choice. Key advising principles are provided as a framework for the discussion of the case and include reflection, self-disclosure, active listening, support and advocacy, confidentiality, and problem solving. These principles were developed as part of the Advising Case Conference series of the Johns Hopkins University School of Medicine Colleges Advisory Program. Emergent themes from the case included a student's evolving professional identity, a student's distress and burnout, lifestyle considerations, and advisor bias and self-awareness. The authors propose reflective questions to enhance meaningful discussions between the advisor and student and assist in problem solving. Many of these questions, together with the key advising principles, are generalizable to a variety of advising scenarios between advisors and learners at all levels of training.

Dr. Levine is faculty advisor, Colleges Advisory Program, and assistant professor, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Dr. Cayea is internal medicine clerkship director, faculty advisor, Colleges Advisory Program, and assistant professor, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Dr. Shochet is director, Colleges Advisory Program, and assistant professor, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Dr. Wright is professor, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Correspondence should be addressed to Dr. Levine, Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, 5200 Eastern Ave./Mason F. Lord Bldg., Center Tower, Suite 2300, Baltimore, MD 21224; telephone: (410) 550-9875; fax: (410) 550-3403; e-mail: rlevine@jhmi.edu.

Editor's Note: A commentary on this article appears on pages 578–579.

© 2010 Association of American Medical Colleges