Letters to the Editor
To the Editor:
Forty percent of young physicians report that they would not go to medical school if given the choice again.1 Twenty percent of physicians are dissatisfied with their careers,2 while 34% meet criteria for burnout.3 An explanation for these staggering numbers may be found in a study revealing that those who spend less than 20% of their time on their most meaningful activity (i.e., patient care, research, or education) have significantly higher rates of burnout than do physicians who focus on their most meaningful areas.3 This suggests that optimizing career fit would substantially increase physician satisfaction. Since medical school is often the first opportunity for future physicians both to explore the various career tracks within medicine and also to experience burnout, it would be an ideal place for medical students to pursue their unique interests to ensure a good fit.
The creation of individualized tracks as a supplement to a standard medical education would allow students to self-select the area most in line with their particular strengths and interests. Students in the research track could be exposed to biostatistics and clinical trial design and work individually with a faculty mentor on a structured research project. Those in the education track would have the opportunity to help develop the medical curriculum for students under the guidance of clinician–educators. Finally, the majority of students would be in the clinical care track, which would feature added elective time in community-based settings and also allow students to learn about the business aspects that drive medicine. Important components of this educational prototype would be strong faculty advising and the flexibility to change tracks, such that students could make informed decisions and navigate their paths as they recognize changing interests.
This approach would enhance the current paradigm in which we teach medicine. The current medical education system focuses the vast majority of its time teaching students about the various fields within medicine, but fails to encourage students to discover the environment within which they would like to practice medicine. A large part of medical school is about students discovering their interests, yet, too often, students have limited opportunities to see which culture of medicine fits them best. The individualized track model we propose would allow students to see which area of medicine most corresponds to their unique strengths and interests. Just as important, students might discover areas they find particularly unsatisfying. These experiences would enable students to make better decisions when considering which residency programs best align with their interests. It is our hope that early exposure to the different aspects of medicine might also save students from facing burnout later on in their careers.
Shawn G. Kwatra, MD
Resident, Department of Internal Medicine, Saint Joseph Hospital, Chicago, Illinois; firstname.lastname@example.org.
Lauren P. Rimoin, MD
Resident, Department of Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, California.
1. Brown S, Gunderman RB. Viewpoint: Enhancing the professional fulfillment of physicians. Acad Med. 2006;81:577–582
2. Buchbinder SB, Wilson M, Melick CF, Powe NR. Primary care physician job satisfaction and turnover. Am J Manag Care. 2001;7:701–713
3. Shanafelt TD, West CP, Sloan JA, et al. Career fit and burnout among academic faculty. Arch Intern Med. 2009;169:990–995