Objectives: This study sought to account for trends in medical student specialty choice by examining the importance of lifestyle factors. Emergency medicine (EM) is among several medical specialties classified as having a ''controllable lifestyle.'' The primary objective of this study was to determine if medical students choosing careers in EM have a different profile of influences, values, and expectations from students choosing other specialties or specialty groups. Of secondary interest was how much lifestyle influenced students choosing EM compared to students choosing controllable lifestyle (CL) specialties.Methods: Using data from the 2005 and 2006 Association of American Medical Colleges (AAMC) graduation questionnaire (GQ) supplemental surveys, we grouped responses according to desired specialty choice: EM (n = 963), CL (n = 3,681), primary care (PC; n = 3,191), or surgical specialty (SS; n = 1,694). The survey requires students to rate the influence of nine specific factors in determining their specialty choice: lifestyle, competitiveness, high level of educational debt, mentors and role models, options for fellowship training, salary expectations, length of residency training, family expectations, and medical school career planning activities. Using one-way analysis of variance (ANOVA) and nonparametric statistics, we assessed responses among the four subgroups for differences in the importance attributed to these factors.Results: A total of 13,440 students completed the two supplemental surveys of the GQ. Of these students, 9,529 identified a specialty choice that fell within one of the four comparison groups and were included in the analysis. Compared to other specialty groups, students choosing EM reported lifestyle and length of residency as strong influences, while attributing less influence to mentors and options for fellowship training.Conclusions: Students choosing a career in EM have distinctly different priorities and influences than students entering PC and SS. The profile of students who choose EM is very similar to those choosing traditional CL specialties. A more thorough understanding of the values and priorities that shape medical student career selection may allow educators to provide better career counseling. ACADEMIC EMERGENCY MEDICINE 2009; 16:544-549 ª 2009 by the Society for Academic Emergency MedicineKeywords: emergency medicine, medical education, controllable lifestyle, medical student, career planning, specialty selection W hile the specialty choices of graduating medical students have a profound impact on the physician workforce, the motivations and values that underlie these decisions remain incompletely understood. Much research has been devoted to analyzing and characterizing these values, some within particular fields, 1-4 others between two types of specialties or across the spectrum. 5-8 In 1989, Schwartz et al. 9 proposed a factor to account for some of the then recent trends in medical student specialty choice, the ''controllable lifestyle'' factor. Based...
Over the past two decades, there have been increasing calls for physicians to develop the capabilities to lead health care transformation. Many experts and authors have suggested that leadership education should begin during medical school; however, little information exists regarding the presence or nature of undergraduate medical education leadership curricula in the USA. This study sought to determine the prevalence of formal leadership education in US undergraduate medical schools, as well as the delivery methods and degree of student participation. A web-based survey of medical education deans from US allopathic medical schools (N = 144) was administered from November 2014 to February 2015. The survey included questions on the presence of leadership curricula, delivery format, student participation rates, and forms of recognition. Eighty-eight surveys were completed; the majority (85%) of respondents were associate or assistant deans for medical education. Approximately half (54.5%) of respondents reported leadership curricula within their medical schools. Of those, 34.8% (16/46) were required; 32.6% (15/46) were elective; and 32.6% (15/46) indicated both required and elective components. Of schools with formal leadership curricula (n = 48), the common forms of content delivery were: mentoring programs (65.1%); dual degree programs (54.5%); workshops (48.8%); seminar/lecture series (41.9%); courses (41.9%); or single seminars (18.6%). Nineteen percent of institutions offer longitudinal leadership education throughout medical school. Common forms of recognition for leadership education were: course credit (48.8%); dual degrees (37.2%); certificates of completion (18.6%); and transcript notations (7.0%). This study indicates that formal leadership education exists in more than half of US allopathic medical schools, suggesting it is an educational priority. Program format, student participation, delivery methods, and recognition varied considerably. Further study is needed to identify the optimal content, competencies, and pedagogy for leadership education. Identifying best practices may help guide standards for leadership curricula across UME and fill this educational need.
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