premedpathfinder

Personality Type and Medical Specialty

Here's an online quiz, offered by Peter M. Filsinger, M.D.,

Anita D. Taylor M.Ed., Spencer B. Gay, M.D., and Haiyan He. Taylor authored How to Choose a Medical Specialty. I did not find it helpful, since there's no category for medical informatics and that's what I'm heading toward. Anyway, the results showed that I might be suited for allergy/immunology.

Myers-Brigg Type Indicator

Which personality types settle into which medical specialties? This question has been intensely studied and more studies will come out. Many use the Myers-Brigg Type Indicator. If you don't already know your four-letter symbol, take the free test at:

www.advisorteam.com/user/ktsintro.asp

Holland System

Dr. John Holland theorizes that people and work environments can be loosely classified into six different groups. Different personalities may find different environments suit them best. Check if your college career center can help you determine your two- or three-letter Holland Code for free. The test is offered online for $8.95 at:

www.self-directed-search.com/index.html

The Enneagram

A typology system with a strong spiritual component. Enneagram literature first sparked my interest in medicine. I am a perfectionist, and that's a good thing for doctors to be. But, this system also pointed out negative aspects of perfectionism and recommended I convert these 'vices' to the virtue of serenity through spiritual practices. You can determine your type at the following web site:

www.9types.com/rheti/homepage.actual.html

Recommended books:

The Enneagram Advantage: Putting the Nine Personality Types to Work in the Office, 1997, by Helen Palmer and Paul B. Brown.

The Enneagram in Love & Work: understanding your intimate & business relationships, 1995, by Helen Palmer.

Remember, you don't have to buy into typology! Especially if it's in conflict with your gut feelings or heart's desire. It's just a tool to help you think in a more detailed fashion about which specialty might bring the greatest personal and professional satisfaction.

For a current and extensive list of articles about personality and specialty choice, try a PubMed search using the terms "medical students career choice personality."

MULTIPLE SPECIALTIES

"Who Does What in Medicine," Suzanne Brue, SuccessTypes for Medical Education web site. Available free online, this excellent article is written for the lay person.

"Medical Specialty Choice and Personality," Archives of General Psychiatry, Jan. 1969, pp 89-99.

"Interest and Personality Factors as Related to Choice of Medical Career," Journal of Medical Education, Nov. 1963, pp 932-942.

"Personality Profiles and Specialty Choices of Students from Two Medical School Classes," Academic Medicine, May 1991, pp 283-287.

"Personal Characteristics of Student Choosing Different Types of Medical Careers," Journal of Medical Education, Mar. 1964, pp 278-288.

"New Results Relating the Myers-Brigg Type Indicator and

Medical Specialty Choice," Journal of Medical Education, Apr. 1988, pp 325-327.

Family Practice

"Personality Types of Family Practice Residents as Measured by the Myers-Briggs Type Indicator," Family Medicine, Jan./Feb. 1985, p 8(3).

Physical Medicine

"Physician Personality Types in Physical Medicine and Rehabilitation as Measured by the Myers-Briggs Type Indicator,"

American Journal of Physical Medicine & Rehabilitation, Sept.-Oct. 1994, pp 308-312.

Surgery

"Surgeon's Personalities: the Influence of Medical School,"

Medical Education, July 1993, p 337.

Career Satisfaction: Who Are the Happy Campers

in Medicine?

"Are Younger Physicians Less Unhappy With Medicine? (The changing face of medicine), American Medical News, Jan. 4, 1993, p 27(3). Available on InfoTrac. Summary: Yes, most younger physicians in this survey would choose medicine again.

"For a New Doctor, the Old Dream Lives On," Medical Economics, Oct. 19, 1998, p 251(5). Available on InfoTrac. Shirlene Knudtson Smook tells how she went from being a hospital lab tech to a doctor, while also being a wife and mom to three kids. This is an unvarnished yet inspiring account of her studies, family life, early diagnostic successes and how she begins and ends each day with prayer. She also has a nugget of useful advice when selecting that first professional position: hire a lawyer versed in medical employment.

"Managed care, time pressure, and physician job satisfaction: results from the physician worklife study," Journal of General Internal Medicine, July 2000, pp 517-518. PubMed abstract: OBJECTIVE: To assess the association between HMO practice, time pressure, and physician job satisfaction. DESIGN: National random stratified sample of 5,704 primary care and specialty physicians in the United States. Surveys contained 150 items reflecting 10 facets (components) of satisfaction in addition to global satisfaction with current job, one's career and one's specialty. Linear regression-modeled satisfaction (on 1-5 scale) as a function of specialty, practice setting (solo, small group, large group, academic, or HMO), gender, ethnicity, full-time versus part-time status, and time pressure during office visits. "HMO physicians" (9% of total) were those in group or staff model HMOs with > 50% of patients capitated or in managed care. RESULTS: Of the 2,326 respondents, 735 (32%) were female, 607 (26%) were minority (adjusted response rate 52%). HMO physicians reported significantly higher satisfaction with autonomy and administrative issues when compared with other practice types (moderate to large effect sizes). However, physicians in many other practice settings averaged higher satisfaction than HMO physicians with resources and relationships with staff and community (small to moderate effect sizes). Small and large group practice and academic physicians had higher global job satisfaction scores than HMO physicians (P <.05), and private practice physicians had quarter to half the odds of HMO physicians of intending to leave their current practice within 2 years (P <.05). Time pressure detracted from satisfaction in 7 of 10 satisfaction facets (P <.05) and from job, career, and specialty satisfaction (P <.01). Time allotted for new patients in HMOs (31 min) was less than that allotted in solo (39 min) and academic practices (44 min), while 83% of family physicians in HMOs felt they needed more time than allotted for new patients versus 54% of family physicians in small group practices (P <.05 after Bonferroni's correction). CONCLUSIONS: HMO physicians are generally less satisfied with their jobs and more likely to intend to leave their practices than physicians in many other practice settings. Our data suggest that HMO physicians' satisfaction with staff, community, resources, and the duration of new patient visits should be assessed and optimized. Whether providing more time for patient encounters would improve job satisfaction in HMOs or other practice settings remains to be determined.

"Career Satisfaction of US Women Physicians," Archives of Internal Medicine, July 12, 1999, p 1417. Available on InfoTrac. Summary: A large majority of women physicians are generally satisfied with their careers, but many wish they'd chosen another specialty or that they hadn't gone into medicine at all. Complaints: stress, harassment, lack of control in work environment.

"Primary care physician job satisfaction and turnover," American Journal of Managed Care, July 2001, pp 701-713. PubMed abstract: OBJECTIVE: To examine the relationship of personal characteristics, organizational characteristics, and overall job satisfaction to primary care physician (PCP)

turnover. SUBJECTS AND METHODS: A cohort of 507 postresident, nonfederally employed PCPs younger than 45 years of age, who completed their medical training between 1982 and 1985, participated in national surveys in 1987 and 1991. Psychological, economic, and sociological theories and constructs provided a conceptual framework. Primary care physician personal, organizational, and overall job satisfaction variables from 1987 were considered independent variables. Turnover-related responses from 1991 were dependent variables. Bivariate and multivariate analyses were conducted. RESULTS: More than half (55%) of all PCPs in the cohort left at least 1 practice between 1987 and 1991. Twenty percent of the cohort left 2 employers. PCPs dissatisfied in 1987 were 2.38 times more likely to leave (P < .001). Primary care physicians who believed that third-party payer influence would decrease in 5 years were 1.29 times more likely to leave (P < .03). Non-board certified PCPs were 1.3 times more likely to leave (P < .003). Primary care physicians who believed that standardized protocols were overused were 1.18 times more likely to leave (P < .05). Specialty, gender, age, race, and practice setting were not associated with PCP turnover. CONCLUSIONS: Turnover was an important phenomenon among PCPs in this cohort. The results of this study could enable policy makers, managed care organizations, researchers, and others to better understand the relationship between job satisfaction and turnover.

"Rural general practitioners' experience of the provision of out-of-hours care: a qualitative study," British Journal of General Practice, Apr. 2001, pp 286-290. PubMed abstract: BACKGROUND: Published research into the provision and utilisation of out-of-hours services shows long-term trends towards decreasing personal commitment among general practitioners (GPs). However, the on-call commitments of rural GPs remain especially onerous. There has been little research relating to either rural out-of-hours

services or the implications of such services for the families of the providers. AIM: To explore and describe how rural GPs in Ireland perceive and experience out-of-hours care provision. DESIGN OF STUDY: A qualitative study was conducted with 10 rural GPs and their spouses in their homes or practices using one-to-one in-depth interviews. SETTING: Ten general practices in rural Ireland. METHOD: The interviews were guided by an interview schedule that was based on pertinent themes that had emerged from previous relevant literature. The interviews were audiotaped, transcribed, and analysed for themes and issues. RESULTS: Results indicated that rural GPs experience a wide variety of satisfactions from work related to the provision of out-of-hours care. However, the large proportion of time committed to out-of-hours care greatly infringes on their social and family life. The key stressors identified related to organisational system difficulties, especially with regard to locum cover, and unrealistic patient expectations. The stressors were mainly expressed as lack of time off, restrictions on family life, and interruptions. CONCLUSION: System difficulties, such as difficulty with obtaining locums and rota extension, need to be addressed at an organisational level. Patient expectations of the role of the rural GP have significant implications for practitioners and their families.

"Beyond the malaise of American medicine," Journal of Medical Practice Management," Mar. 2001, pp 227-230. PubMed abstract: Over the past two decades, physicians have suffered declines in real income, community standing, and of collegiality. Physicians must not view themselves solely as victims of the sweeping changes in current medical care delivery. They have both the opportunity and the duty to reassert their true role as compassionate conveyors of the science and the art of medicine. This article explores the historic trends that have led to our current state. It also explores the exciting possibilities open to doctors to assume a renewed elevated status that both they and their patients yearn for.

MCAT Preparation

Which MCAT test prep. materials are the best? To my knowledge, this issue has not been studied scientifically. Even if it has been, well, new editions come out every year. Quality can rise and fall. Conventional wisdom holds that Kaplan and Princeton Review are decent, and test-takers should use more than one brand of prep. materials. Used prep. materials are advertised on eBay and, skipping eBay's fee, Student Doctor Network Lounge.

Kaplan. These folks (Kaplan is a subsidiary of the Washington Post) generally sell MCAT prep. info and materials, but the site does offer free info, like an overview of how the last MCAT went and what was on it. Also has schedules and locations for their cram courses. Premed Pathfinder Commentary: Kaplan, which bills itself as "the experts," ought to include an area on its web site reporting corrections to MCAT prep materials such as its MCAT Workbook, 2nd ed. For example, the drawing for Biological Sciences Test 1 Question 9 is incorrect. The two compounds the answer says are tautomers are not properly drawn. How nice it would be to have a web address on the book to report any errors or check for corrections.

Examkrackers. The former editor of Flowers and Silver MCAT and the ex-National Director of MCAT for Princeton Review team to offer classes and prep. materials. After listening to Audio Osmosis dozens of times during my long commute, I've decided to buy their five-manual prep. package, $150 plus shipping on the company site, but $120 plus shipping on walmart.com. However, when ordering from the Examkrackers site, you'll get a free full-length practice exam. (I'd rather focus on the AAMC practice exams, because they'll be filtered through other mindsets.) I like the Examkrackers focus on the most likely stuff to be tested, basic science concepts, on confidence building and common-sense strategies. For example: Kaplan suggests that during the verbal portion you should bounce around to sections with the most questions. Although K. warns us to be careful about bubbling errors, this still seems an unnecessarily complicated approach to take during this high-stakes test. The Examkrackers guys advise taking the questions as they come, spending only so much time on each one, making your best guess and moving on. You can always go back if you finish early. This approach minimizes the risk of bubbling error. The only other manual I've purchased is Kaplan, but it seems, well, like McKaplan, an average and bland approach to MCAT prep.

The Princeton Review. More MCAT prep. courses and materials.

The Berkeley Review. MCAT prep. courses and home-study packages.

Richardson MCAT. MCAT prep. for Canadian students.

premedonline.com is by a Kaplan instructor named Anthony. Not an official site but a place for his commentary on prep. courses and studying for the MCAT.

Dr. Blank's Review, an in-person course offered to those in the vicinity of Hunter College in Manhattan, Rutgers in New Brunswick or Fairleigh Dickinson in Madison, New Jersey.

Complete Preparation for the MCAT, 2000 Medical College Admission Test, published by Lippincott, Williams & Wilkins (formerly published by Betz), $49.95. ISBN: 0683307797.

Research Skills for Doctors

Recommended Articles

"Medical Informatics and Computer Applications:

Recommended Core Educational Guidelines for Family Practice Residents," Family Practice Management, Sept. 1996. Outlines research skills and knowledge you need to answer questions arising during patient care.

Books: Nontraditional Students

Book Reviews

Nontraditional students

Getting Into Medical School, Sanford J. Brown, M.D., 1997, 8th edition. Commentary: Not a 19-year-old science geek who grinds out a 4.0 GPA? This book's for you! Brown talks generally about preparing for medical school, finding a good premed advisor, the value of having doctors from all walks of life and from widely varying majors--and advises not overloading on extra science courses unless you love science. Brown also is available as a paid consultant for nontraditionals trying to get accepted.

MD/RN: Nurses that Become Doctors, by Neff Rotter. An e-book available free online from Belgrave House. An interesting collection of narratives from women and men who went over to the 'doc' side.

Old Docs Advise New Docs

Physicians for the 21st Century, Lawrence E. Stevens, M.D., 1997. Review:

Reading this short book is like sitting down for a long conversation with a wise, weathered and positive retired surgeon. His common sense sticks in my mind: upholding medicine's noble traditions gives your life meaning, look at medicine realistically, determination to be a physician can be a greater asset than high intelligence, be nice to other health professionals, minimize personal debt, money is a secondary reason to go into medicine, don't have an extramarital affair. He also advises making research a part of any medical career: "I was intrigued by the first successful human kidney transplants as they were reported in the early 1960s," he says. "Scraping together some used surgical equipment and dogs from the local pound, I began transplanting kidneys in dogs, studying how best to preserve these organs before transplanting." He went on initiate kidney, pancreas and liver transplant programs as a surgeon. When this guy states that his "hope is that bold and bright young students" will tune out medicine's naysayers and opt for a career he found intellectually exciting and emotionally rewarding, I want to jump and say "Me, me!" Order from the author at: 2932 St. Mary's Way, SLC, Utah 84108 (801) 583-0719.

What Medical School is Like

Surviving Medical School, Robert Holman Coombs, with insights from medical humanist Bernard Virshup, 1998, 197 pages. Review: I read this book for the down-and-dirty and does it deliver. The title and content make medical school sound like an ordeal only a masochist would undergo. Chapter titles: 1. Anticipation: Are My Expectations Realistic? 2. First Year: Am I Smart Enough? 3. Student Diversity: Who Are All These People? 4. Second Year: Do I Really Want to Do This? 5. Relationships: Am I Married to Medicine? 6. Third Year: Who's the Real Doc Here? 7.

Challenging Issues: What if I Make a Mistake? 8. Fourth Year: Will I Ever Know Enough? 9. Graduation: What Happens Next? Coombs' post at UCLA may color his perceptions. UCLA would be a very competitive school. I hear that smaller, less-prestigious schools have greater cooperation and camaraderie among students. Still, this is a fascinating, detailed and thorough book, based on in-depth interviews with medical students at different levels of training. Coombs has chaired the UCLA med school's Student Affairs Committee and published extensively on physician socialization. He even goes into the sex lives of medical students--many don't have them! "Shortage of leisure time, unpredictable schedules, physical exhaustion and general tension all contribute to a common plight summed up in the term 'deferred sexuality.' " Oh, great. By telling you how bad things might get, this book prepares you mentally. That in itself may make your medical school years less stressful. The late Bernard Virshup's commentaries remind us that doctors are allowed to be human and being a physician is a unique invitation to understanding humanity itself.

The Successful Medical Student: Achieving Your Full Potential, John R. Thornborough, Ph.D., and Hilary Schmidt, Ph.D., 1993. For those that have gotten in and want to be prepared to do their best. This book is basic and blessedly brief at 151 pages. Especially practical are the sections on financial aid (there really is some help, but often it comes with strings) and time management for those married and/or kidded. With good time management, the authors declare,"There is absolutely no reason why a medical student cannot 'have a life'--at least one evening per week to relax, one day per weekend free of academic concerns, and sufficient time to do the laundry, buy groceries, watch TV, exercise, etc."

Chapter titles: 1) What to Expect in Medical School;

2) A Time Line for the Next Five Years;

3) Curricular Content;

4) Financing Your Medical Education;

5) Basic Supplies for Your Study Desk;

6) What to Bring from College;

7) Time Management;

8) Study Management;

9) Getting the Most Out of Your Classes;

10) Knowledge Organization;

11) Stress Management by Janice N. McLean, Ph.D.;

12) The Medical Specialties;

13) Medical Ethics by Rosamond Rhodes, Ph.D.;

14) A Summing Up of Ideas.

This books also recommends D. Shain's Study Skills and Test-Taking Strategies for Medical Students, 1992, as a "detailed treatment of individual differences in personal learning styles." Thornborough and Schmidt also have authored books on preparing for USMLE exams. Highly recommended.

Biographies

My Mother, the Doctor, Joy Daniels Singer, 1970. Review: Singer writes of her extraordinary mother, Anna Kleegman Daniels, who came to the United States as a poor Russian Jew, got into Cornell and became a doctor. More of a story about home life than professional achievements. A fun, fascinating read.

Julie Bolding

EXPERIENCE

Engineering research materials cataloger, November 2001 to present -- currently organizing and cataloging the 10,000+ items in the South Dakota Transportation Department's research engineering library.

Mom, Premed Student, Creator and Webgal for the Premed Pathfinder web site, September 1999-present -- studying chemistry, biology and physics while managing an innovative, free web site for premedicine students that includes an annotated index of premed sites, specialty choice information and other content useful to American and Canadian students interested in regular and osteopathic medical education.

Project Manager, South Dakota Newspaper Project, State Archives, Pierre, SD, June 1994-August 1999 -- established and managed South Dakota's part in the United States Newspaper Program, a National Endowment for the Humanities effort to preserve and provide access to the local history contained in American newspapers. Created original serials catalog records and local data records on OCLC as sole project cataloger. Wrote two successful grant applications covering costs of the inventory and cataloging phases. Hired and trained project assistants. Created multi-table Access 2.0 database for use as project management tool and source of newspaper information after project was done. Participated in the assessment and upgrading of state microfilm unit. Gave talks, papers and wrote press releases and articles promoting South Dakota newspaper preservation. Created text for Newspaper Project's Web page. Handled equipment purchases and hiring of appropriate consultants.

Reference Librarian, South Dakota State Library, Pierre, SD, January-June 1995 -- answered reference questions from walk-in patrons and phone callers using on-line resources, CD-ROM databases, the library catalog and traditional reference tools. Compiled information on academic libraries for federal report. Reviewed library improvement plans for school libraries. This was a temporary position taken while the Newspaper Project awaited grant approval and was not operating.

Practicum, Dayton Daily News, Reference Library, Dayton, OH, July 1993 -- Used Dialog, Lexis/Nexis and DataTimes to answer reporters' questions. Reviewed electronic text of news stories to make sure the database versions were the same as those printed in the newspaper, then enhanced the database records before adding them to the newspaper's database.

Journalist, Argus Leader, Sioux Falls, SD, January 1986 to June 1990 -- gained extensive knowledge of South Dakota issues, businesses, places, people and institutions while covering the South Dakota Legislature, Sioux Falls City Commission, Minnehaha County Commission, political races and environmental matters for state's largest newspaper. Researched government documents for news stories. Wrote in-depth series of stories on threats to the underground water supplies South Dakotans depend on for drinking water and industrial uses. Lobbied for and helped reorganize the neglected newspaper library.

EDUCATION

M.S., Library and Information Science, University of Illinois at Urbana-Champaign, May 1994.

B.A., Mass Communication, University of Wisconsin--Milwaukee, December 1985.

PUBLICATIONS

"Midwestern Transportation Library Consortium," Sci-Tech News, 56/2 (May 2002), p. 49.

"Introducing Otto Doll, State Commissioner of Information," Book Marks, 50/4 (July/August 1999), p. 1.

"In the Internet Age, South Dakota Libraries Can Offer More Than Ever," mbc inews, Jan. 9, 1998.

"Research Instruction for Undergraduate Students," Journalism and Mass Communication Educator, 51/1 (Spring 1996), 15-22.

"U.S. Newspaper Program Toasts a Decade, Plans Project Conclusion," News Library News, 18/1 (Fall 1995), 1.

"News Librarians + New Technologies = New Career Paths," News Library News, 16/1 (Fall 1993), 1.

CONFERENCE PAPERS

"Have You Seen the News? The Newspapers that Link South Dakota Communities from Past to Present," Dakota History Conference, Sioux Falls, SD, May 31, 1996.

"Lost Newspapers of West River, South Dakota," West River History Conference, Keystone, SD, Sept. 13, 1996.

PROFESSIONAL ACTIVITIES