Medical schools should require a track in professional wellbeing and career satisfaction

The traditional medical school curriculum includes courses in basic science and clinical rotations to develop and demonstrate care delivery competencies. Some schools have introduced additional tracks in data analytics, engineering, and artificial intelligence.

The increased attention that “medical professionalism” has lately exposed the deficit in our educational system and indicates the need for more work to be done to ensure an effective teaching and assessment of this competency. The concerted efforts made by many reputable organizations are great steps in the right direction. Nonetheless, many medical schools are still lagging behind. Literature has been clear about the importance of formal teaching in establishing professional behaviors in the medical school graduates; failing in this regard is certain to have unfavorable outcomes. Furthermore, current literature suggests many teaching strategies and assessment tools that can help in achieving this goal. However, many inadequacies are still there.

Teaching professionalism requires, in addition to an explicit core curriculum that spans the continuum of medical education, special efforts in terms of imparting the non-cognitive skills as well. Respectable role-models play a major part in this process. Helping students to reflect on the real-life encounters in a safe environment is, probably, one of the most effective tools at our disposal. Many obstacles that may hinder this educational endeavor have been described in the literature. Negative role models and the “hidden curriculum” are among the most dreaded ones, and they deserve an extra effort to overcome.

For example, the following professionalism principles must be met in order for a student to qualify for conferral of the MD degree from the Stanford University School of Medicine.

Professionalism comprises those attributes and behaviors that serve to maintain patient interests above physician self-interest. However, we cannot ignore the fact that professional self-interest in the form of career satisfaction and success, financial security, safety, and other needs strongly informs professionalism.

Grumpy, unhappy, dissatisfied students and graduates make grumpy patients, commit more errors, make bad decisions sometimes out of self-interest, and demonstrate harmful behavioral health habits and drop out early in their careers. The dynamic contributes to the "doctor shortage", unprofessional conduct, and professional suffering.

From 2022 to 2023, 35.7% of doctors said they had a moderate interest in leaving their current jobs within the next two years, or that they would like to or definitely would leave in that time period, says the national physician comparison report.

Though that figure is down from 39.3% in 2022, intent to leave was highest among physicians who were 20 or more years out of training, at 40.8%. Among part-time physicians, 39.1% reported intention to leave their current position, compared to 34.9% of full-time physicians. Among male physicians, 35.9% reported planning to depart, compared to 33.2% of women.

The physician specialties with the highest intent to leave were:

• Internal medicine: 39.1%.
• Family medicine: 37.3%.
• Obstetrics and gynecology: 34%.
• Hospitalist medicine: 32.9%.
• Emergency medicine: 32.3%.
• Pediatrics: 30.2%.

Medical schools and graduate education training programs should address the yawning gaps in professional career satisfaction by adding an education and training wellbeing and career satisfaction track.

The track would attempt to PISS on dropout and include:

1. Prevention: It's been demonstrated that burnout prevention interventions work best when there are personal and organizational tools brought to bear. However, the outcomes fatigue so it takes ongoing vigilance and monitoring. Changing the warrior mentality of medical workers would also help but that means changing the culture of medical education and training. Researchers have identified three types of burnout:?overload, under-challenged, and neglect — and provides readers with signs to watch out for, and tips on how to overcome each type.

We also need to give medical students and residents an adequate job preview and the KSAs and the hidden curriculum they will not learn during their formal training to insure Physician Information about career Success and Satisfaction.

2. Innovative ways to detect and treat burnout. Some have hired in-house corporate chaplains or counselors , use behavioral health apps or telepsychiatry. A new AI tool from Washington University in St. Louis researchers aims to help identify burnout among physicians and could potentially prevent it in the future.

3. Surveillance. Self-reporting does not work. Snitching does not work either. We need better ways to keep track of who is in trouble or likely to be and a way to measure the burnout impact factor of organizations.

4. Stewardship. Stop piling on administrivia, rules, regulations, red tape and bad bosses who simply get between the patient and their doctors and add little or no value to patients.

People analytics using AI tools might be helpful to identify those at risk, and using predictive analytics, recommend some prescriptive remedies.

Those remedies might include exit ramps, career planning and transitioning, mentoring interventions, financial planning assistance, addressing the unique needs of first generation to medical school, education and training in the business of medicine, innovation and entrepreneurship and targeting highest risk students. But here is the problem with measuring happiness.

One of the strongest human motivators is self-interest. In the case of doctors, they are held to a standard of placing the patient's interest first and managing and mitigating conflicting interests.

Having a sense of purpose, meaning, career satisfaction and happiness is foundational to professionalism. Not addressing those needs is treating the symptoms and not the disease.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs on Substack