Choosing a Career

by Maxine Papadakis, M.D., Associate Dean for Student Affairs

"If you don’t know where you’re going, you’re likely to end up somewhere else." -Lawrence J. Peter

For some, deciding on a career is simple. For most of us, though, this decision is difficult and anxiety producing. One of the major problems is figuring out how to approach the decision-making process. You may feel that you are the only one who can’t decide between two specialties. Or, you may feel that you just don’t have enough experience in any one field to make a choice. With that in mind it is important to have a systematic approach to gathering and evaluating information about specialties.

First- and second-year students can begin by reviewing the self-assessment exercises available through Careers in Medicine, a career advising program sponsored by the Association of American Medical Colleges. Also, acquaint yourself with what happens in special interest groups and attend their events.

Third-year students should use the clerkships as an opportunity to "try on" that specialty as a career. Think about what role critical factors such as continuity of care, presence of manual procedures, types of illnesses, intellectual content and family leisure time have in each specialty as you move through clerkships and electives.

When you are thinking about these critical factors, it is important to think about what you want in a career as well as what you want to avoid. Tease out needs and desires from what others close to you may want, such as partners or other family members. Examine critical factors in the short term, that is, during the residency, as well as for the duration of your professional career. Acknowledge the uncertain environment of health care and be flexible in your career expectations.

Many people will spend more time researching their decision to buy a car than they will on their career. It is important to have a good decision-making process and to work through this process carefully. It is also important to remember that this type of process is circular, not linear. When you come across new information or insights that make you to re-evaluated your career, don’t be afraid to go back to earlier steps in the decision-making process.

The Vigilant Decision-Making Process

1. Appraise the challenge.

• Acknowledge the advantage of making a proactive decision instead of a passive one.

2. Assess yourself.

• Undergo a thorough self-analysis.

3. Survey alternatives.

• Stay open to many possibilities.

4. Evaluate the alternatives.

• Match your self-assessment with the specialties.
• Be sure to look at both positive and negative consequences for each alternative.

5. Achieve commitment

• Determine the best course of action and make a plan to get there.
• Be sure to use both objective and subjective information.

With a process in place, don’t forget to listen to your gut, but make sure it’s an "informed gut." Maintain flexibility and an open mind about your possibilities. Don’t bury the negatives of your career choice. Thinking about the negative aspects of your decision will help you to cope with any negative feedback you receive from others and thus increase your ability to stick by your choice when the going gets tough. Finally, take total responsibility for your career decision. This decision cannot be delegated.

From Circulation: Volume 14, Number 4, Winter II, February 18, 2000