Introduction to Osteopathic Medicine Ronald Januchowski, D.O. Associate Dean, VCOM.
John Graneto, D.O., M.Ed. Professor and Associate Dean · Electives and Career Planning John...
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Electives and Career Planning John Graneto, D.O., M.Ed. Professor and Associate Dean
Transcript of John Graneto, D.O., M.Ed. Professor and Associate Dean · Electives and Career Planning John...
Electives and Career Planning
John Graneto, D.O., M.Ed.
Professor and Associate Dean
Disclosure
• This study was supported by a grant from the American Association of Colleges of Osteopathic Medicine and the Osteopathic Heritage Foundation.
IRB
• This study was reviewed by the IRB at Midwestern University, Downers Grove IL.
Acknowledgements
• Statistical Support provided by:
• Matthew S. Mayo, Ph.D., MBA
• Founding Chair and Professor, Department of Biostatistics
• KU Medical Center, Kansas City
Introduction
• Osteopathic medical students face decisions such as “should they enter primary care or a specialty field?”
• Factors that ultimately influence an individual medical student’s specialty choice are also varied. 1,2
• What is less well described are the rotation elective choices students make based on entering these specialties.
• The objective for this study is to compare the elective choices that students make.
Background
• Medical school curricula, generally consist of earlier years of foundational teachings in the science-based disciplines or systems and during the later years more clinically focused rotation-based bedside patient encounters with physician preceptors.6,7
• Every year thousands of osteopathic medical students throughout the country make the transition from these pre-clinical classroom years to the rotation-based clinical experiences.8,9
Background
• Each student may have limited number of electives
• Perceived lifestyle of that career choice is cited as one factor that influences students’ decisions to match in a particular area such as EM.13
• Earlier exposure to a specific specialty may in fact make a student’s choice of matching in that specialty more desirable.4,14,15
Background
• Clinical rotation requirements are generally include several electives available at the student’s discretion.20
• Students may seek the advice of faculty and staff as to which rotation electives to choose.21 These decisions are sometimes based on an individual student’s general interest in the specific elective rotation or
• they may be based on the specialty being sought for residency training and the students need to audition for their desired career choice.22-24
Methods
• A retrospective records review of students who attended Chicago College of Osteopathic Medicine from 2008 through 2012. Approval from the IRB at Midwestern University was attained. Data was obtained through the office of Clinical Education and entered into spreadsheet.
• Analysis of data findings was conducted by separate individuals after specific identifying information had been removed from the spreadsheet data.
746 records were reviewed
• Retrospective Review
• Class of 2008, 09, 10, 11, 12
• After all NMS, NRMP, secondary match, scramble and SOAP
Top Choices for Careers
• Family 27%
• Internal 22%
• Emergency 11%
• Pediatrics 7%
• Radiology 3%
• Surgery 3%
Definitions
• Auditions or Sub-I (in the same specialty)
• Other electives as follows….
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30
0
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90
Radiology Hospice PM&R
Family - 201 Students
78
6357
0
10
20
30
40
50
60
70
80
90
Radiology Nephrology Cardiology
Internal Medicine - 167 Students
39
31
19
0
5
10
15
20
25
30
35
40
45
Radiology Family Anesthesiology
Emergency - 81 Students
2119
15
0
5
10
15
20
25
Neonatology Radiology Ped/GI
Pediatrics - 49 Students
7
5 5
0
1
2
3
4
5
6
7
8
Family Pathology Internal Medicine
Radiology -24 Students
11 11
7
0
2
4
6
8
10
12
Radiology Plastics Ortho
General Surgery - 23 Students
1110
4
0
2
4
6
8
10
12
Family Radiology Neurology
PSYCH - 22 Students
11
7
0
2
4
6
8
10
12
Neurology Ped Neurology
ENT - 21 Students
7 65
0
1
2
3
4
5
6
7
8
Family Radiology EmergencyMedicine
Orthopedics - 19 Students
8 8
5
0
1
2
3
4
5
6
7
8
9
Radiology Family Neurology
PM&R - 19 Students
15
9
3 30
2
4
6
8
10
12
14
16
PM&R Radiology Ortho Critical Care
Anesthesiology - 18 Students
10
6
4
0
2
4
6
8
10
12
Maternal Fetal Radiology Research
OB/GYN - 17 Students
6
4
3 3 3
0
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2
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6
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Radiology Family Psych Critical Care Neuro Surg
Neurology - 11 Students
Clinical Rotations
• Conclusions
References• 1. Kiolbassa K, Miksch A, Hermann K, et al. Becoming a general practitioner--which factors have most impact on career choice of medical
students? BMC Fam Pract. 2011;12:25.
• 2.Love JN, Howell JM, Hegarty CB, et al. Factors that influence medical student selection of an emergency medicine residency program: implications for training programs. Acad Emerg Med. 2012;19(4):455-460.
• 3.Gill H, McLeod S, Duerksen K, Szafran O. Factors influencing medical students' choice of family medicine: effects of rural versus urban background. Can Fam Physician. 2012;58(11):e649-657.
• 4.Zun LS, Downey L. Is a third year clerkship in emergency medicine correlated with a career choice in emergency medicine? Teach Learn Med. 2004;16(1):14-17.
• 5.Carraccio CL, Englander R. From flexner to competencies: reflections on a decade and the journey ahead. Acad Med. 2013;88(8):1067-1073.
• 6.Duffy TP. The Flexner Report--100 years later. Yale J Biol Med. 2011;84(3):269-276.
• 7. Ludmerer KM. Abraham Flexner and medical education. Perspect Biol Med. 2011;54(1):8-16.
• 8.Levitan T. AACOM projections for growth through 2012: results of a 2007 survey of US Colleges of Osteopathic Medicine. J Am Osteopath Assoc. 2008;108(3):116-120.
• 9.O'Brien BC, Poncelet AN. Transition to clerkship courses: preparing students to enter the workplace. Acad Med. 2010;85(12):1862-1869.
• 10. Terry R, Hill F. Analysis of AOA/ACGME accredited family medicine residency programs. Fam Med. 2011;43(6):387-391.
• 11. Jolly P, Boulet J, Garrison G, Signer MM. Participation in U.S. graduate medical education by graduates of international medical schools. AcadMed. 2011;86(5):559-564.
• 12. Fabri PJ, Powell DL, Cupps NB. Is there value in audition extramurals? Am J Surg. 1995;169(3):338-340.
References• 13. Boyd JS, Clyne B, Reinert SE, Zink BJ. Emergency medicine career choice: a profile of factors and influences from the Association of American
Medical Colleges (AAMC) graduation questionnaires. Acad Emerg Med. 2009;16(6):544-549.
• 14. Colwill JM, Cultice JM. The future supply of family physicians: implications for rural America. Health Aff (Millwood). 2003;22(1):190-198.
• 15. Cummings M, Dobbs KJ. The irony of osteopathic medicine and primary care. Acad Med. 2005;80(7):702-705.
• 16. Tong ST, Phillips RL, Berman R. Is exposure to a student-run clinic associated with future primary care practice? Fam Med. 2012;44(8):579-581.
• 17. Clinite KL, Reddy ST, Kazantsev SM, et al. Primary Care, the ROAD Less Traveled: What First-Year Medical Students Want in a Specialty. AcadMed. 2013.
• 18. Penciner R. Emergency medicine preclerkship observerships: evaluation of a structured experience. CJEM. 2009;11(3):235-239.
• 19. Heidelbaugh J, Cooke J, Wimsatt L. Opportunities for medical student engagement with family medicine. Fam Med. 2013;45(7):484-491.
• 20. Mueller PS, McConahey LL, Orvidas LJ, et al. Visiting medical student elective and clerkship programs: a survey of US and Puerto Rico allopathic medical schools. BMC Med Educ. 2010;10:41.
• 21. Miller JB, Koehn NN, Schaad DC, Crittenden RA, Oriol NE. The departmental advisor's effect on medical students' confidence when the advisor evaluates or recruits for their own program during the match. Teach Learn Med. 2004;16(3):290-295.
• 22. Goldacre MJ, Goldacre R, Lambert TW. Doctors who considered but did not pursue specific clinical specialties as careers: questionnaire surveys. J R Soc Med. 2012;105(4):166-176.
• 23. Hobbs J, Rosenthal TC, Newton WP, Medicine AoDoF. Difficult choices in medical student education. Ann Fam Med. 2006;4(6):564-565.
• 24. Bahn TJ, Cronau HR, Way DP. A comparison of family medicine and internal medicine experiences in a combined clerkship. Fam Med. 2003;35(7):499-503.
Thanks
Alternative Specialty Choices
• What is my Back Up Plan?
Alternative Specialty Choices
What is my Back Up Plan?
Alternative Specialty Choices
What if specialty X didn’t exist? What would you suggest your classmate do?
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0
5
10
15
20
25
30
Anesthesia
Radiology
45
19
0
5
10
15
20
25
30
35
40
45
50
Plastic Ophthalmology
Dermatology
38
17
0
5
10
15
20
25
30
35
40
General Surgery Anesthesia
Emergency
92
24
0
10
20
30
40
50
60
70
80
90
100
Ophthalmology Plastic
ENT
128
108
69
57
3632 31
0
20
40
60
80
100
120
140
Internal Pediatrics Psychiatry OB/GYN PM&R Emergency Dermatology
Family
6058
53 53
35
2422
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0
10
20
30
40
50
60
70
Neurosurgery Orthopedics OB/GYN Plastic Urology Emergency Anesthesia ENT
General Surgery
104
42 41
120
20
40
60
80
100
120
Family Emergency Neurology ENT
Internal Medicine
28
0
5
10
15
20
25
30
Nephrology
Urology
42 41
11
0
5
10
15
20
25
30
35
40
45
Neurosurgery Psychiatry Ophthalmology
Neurology
15
0
2
4
6
8
10
12
14
16Neurosurgery
Neurology
42
36
27
0
5
10
15
20
25
30
35
40
45
Urology General Surgery Pediatrics
OB/GYN
47
0
10
20
30
40
50Ophthalmology
ENT
51
22
0
10
20
30
40
50
60
PM&R General Surgery
Orthopedics
80
0
10
20
30
40
50
60
70
80
90Pathology
Radiology
30
0
5
10
15
20
25
30
35
Pediatrics
OB/GYN
29
22
0
5
10
15
20
25
30
35
Dermatology ENT
Plastics
39
0
10
20
30
40
50PM&R
Orthopedics
53
0
10
20
30
40
50
60Psychiatry
Neurology
102
49
0
20
40
60
80
100
120
Pathology Anesthesia
Radiology
24
0
5
10
15
20
25
30Sports Medicine
Orthopedics
1010
0
2
4
6
8
10
12
OB/GYNGeneral Surgery
Urology
Thanks
