MedCAREERS Choosing the Right Career Dr. Teri Stuckless, MD, FRCPC Director, MedCAREERS Faculty of Medicine, MUN MedCAREERS Choosing the Right Career October 7, 2016

OBJECTIVES Review the role of MedCAREERS in career planning Discuss determinants of physician job satisfaction Identify resources available that can help in career planning Introduce you to CaRMS

Career Options Applying to Residency Year 1 Year 2 Year 3 Year 4 MedCAREERS_I Clerkship Preparation Course Choosing the Right Career CaRMS Document Preparation MedCAREERS_II Succeeding on the Wards Early Prep for THE MATCH Shadowing Orientation OR Scrub Course Year 1 Year 2 Year 3 Year 4 Phase 1 Phase 2 Phase 3 Phase 4 If we look at our curriculum, you can see this lecture fits in to the early part of phase 1 Pre-core Electives Discussion (including international electives) Elective/Selective Advice (& introduction to online portal) Choosing Electives

MedCAREERS Phase 1 Phase 2 Phase 3 Phase 4 Understanding Exploring Yourself Exploring Options Choosing a Specialty Getting into Residency Right now, most of you should be thinking about “what makes you tick” and, in general, what kind of pratice you picture yourself in when you are done. Do you like working along, or in a group? Do you like urban vs rural living? Do you need to make a lot of money? Do you like to ruminate over theories, or get your hands dirty? At the same time, you should be exploring the many options that are open to you right now. You can be anything from a neurosurgeon to a geriatrician to a labortaory medicine expert. Many of you are probably not aware of all the options. *modelled after Careers in Medicine

MedCAREERS Support Finding and understanding meaningful experiences. Developing career management skills. The MedCAREERS program aims to help you through this process. We want to help you find yourself and meaningful clinical experiences. We also aim to give you some of the practical skills you will need to get throught the CaRMS match and into residency.

Choosing the right career Ultimately, planning your career is your responsibility. We will guide you. Career advisors Faculty members Staff Residents, students Lectures, shadowing, specialty night, electives, counselling, on-line resources, etc…

? Medical School Residency Career (Fellowship) Remember, this is just the first step. We are focusing on your journey through medical school. Some of you may decide very early on what you want to do, while others may find it a difficult decision. Ultimately, you need to stay focused and have direction, but also reserve the right to change your mind. As students move through medical school, residency, and into fellowship, they may change direction or even take a break from medicine. Some of you may elect to re-train after a time in the work force. So, don’t be anxious if you do not follow the straight line path. If you path looks like an S turn, the important thing is that you move through with purpose and direction. Career

MedCAREERS Career Counselling Exploring your options -early clinical experience -academic content -physician shadowing -specialty night -talking with faculty -electives/selectives Choosing a specialty -electives/selectives -lifestyle factors -family commitments -geographic considerations -remuneration -job availability Applying to residency -CV preparation -CaRMS application -Understanding the match -Reference letters -Dean’s letter

What do you want to be? When you try to picture where you will end up, what are the things that you think are important to having a satisfying career?

CMA Specialty Profiles https://www.cma.ca/En/Pages/specialty-profiles.aspx

Determinants of physician satisfaction Hours worked per week On call requirements Academic involvement Practice population, geography Remuneration Collegiality Autonomy/control EMR use Work – life balance

Hours worked per week Varies by specialty, depending on your type and location of practice Salary vs fee-for-service Group vs solo practice

On call requirements None All Group Private practice, not affiliated with an institution/group. All Rural GP working alone without local supports. Group Shared with colleagues Right now, there are a lot of GPs in the metro area who don’t do call. If a patient has an after hours emergency, they can simple go to the ER. Some GPs may offer on call services, especially if they are in a group practice where they can share the schedule. However, the remuneration from MCP is probably not adequate for the service that is provided. In a smaller community, the GP may have no choice but to be effectively “on call” every night. I understand the government recognizes that patients are probably best managed by their primary care provider and I hope that means that there will be changes in the fee schedules to properly compensate GPs so that they might be more able to participate in after hours care.

Academic involvement Most academic institutions employ most specialties. Competitve Expectations Teaching Research Policy development Guideline development If you want academic fulfillment, you might be happier in a larger academic institution, but if you are an independent worker who doesn’t need a lot of support, you might be able to fulfill this need in a smaller, rural environment.

Practice population Urban GPs report better satisfaction than rural GPs Why? Isolation Community expectations On call Privacy __________

Remuneration

Remuneration, might influence not just your ultimate career choice, but also where you choose to do residencey. There are some significant differences in resident salary, depending on the province you are in.

CMA, Physician Data Centre: Canadian physician statistics, 2013-14 Fee for service billings, average

Determinants of physician satisfaction Collegiality Autonomy/control EMR use Work – life balance

What is most important to you? For me to be happy, really I need to have time for my family, I need to have time to stay fit and I need to work with people who I like. All of the medical professions are important, so for me, I think I could probably be satisfied doing anything as long as these criteria are met.

Personal factors Health limitations Spousal support Children/family Physical Mental Spousal support Children/family Don’t forget to think about your own personal priorities or concerns.

Brown – happy Green – less happy At the end of the day, most of us are happy most of the time. There is probably more than one thing that will make you happy. So, while you want to be thinking about career planning as you go through your studies, try not to stress yourself out over it. Source: 2004 CFPC/CMA/RCPSC National Physician Survey. *Includes CCFP and non-CCFP family physicians.

CaRMS Because many of you want to know now….

Canadian Residency Matching Service “The Canadian Resident Matching Service (CaRMS) is a national, independent, not-for-profit, fee-for-service organization that provides a fair, objective and transparent application and matching service for medical training throughout Canada.” http://www.carms.ca

Discuss changes in ratio of grads to funded positions

Common myths about the residency matching process: https://www. afmc

Thank you! Questions?