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Featured Faculty

Personality, Interests, and Values

By Susan Green

Geisel's new chair of medical education wants to keep medical students, residents, physicians, and faculty satisfied with choosing the profession of medicine.

What influences the career choices people make? And, when faced with evidence of not having made the best choice, how do people successfully navigate those changes?

The practice of medicine is filled with a plethora of choices—and important decisions. Choosing a medical specialty is one of the most significant decisions medical students need to make. Luckily, medical schools do an excellent job of helping them navigate choosing a specialty well before the all-important residency match process. But once that career-making decision is made, residents and practicing physicians need continued guidance and support in making informed choices about how they want to practice medicine, achieve career satisfaction, and remain active and engaged in the profession.

Guiding medical students toward informed career decisions motivates Nicole Borges, PhD.

As a counseling psychologist, her expertise gives her insight into the cognitive and noncognitive factors contributing to student success and the ways medical students, residents, and practicing physicians make career choices. Three factors in choice: personality, interests, and values drive her research.

"These factors have all been well studied in vocational guidance literature within counseling psychology. While there has been an emphasis on specialty choice in medical education, it is important for these two worlds to come together," Borges says. "My research explores how to use information about factors associated with medical specialty choice to help students and physicians make more informed choices about what they want to do with their careers."

My research explores how to use information about factors associated with medical specialty choice to help students and physicians make more informed choices about what they want to do with their careers.

Borges' interest in medical education began while earning her doctorate in counseling psychology—her dissertation on personality and medical specialty choice was published in 2001 in the Journal of Vocational Behavior. From there, her research broadly included physician career development and the study of cognitive and non-cognitive factors influencing medical students' choice of a specialty within theoccupation of medicine.

Her research aligns with the Association of American Medical Colleges Careers in Medicine® program that offers information and tools to help medical students assess their interests, values, personality, and skills in order to help them choose specialties that best fit their attributes. For nearly 20 years medical schools have been utilizing vocational psychology in their career advising programs to guide medical students to learn more about themselves before choosing a specialty.

"What's interesting to me about choice is when people are foreclosed on what they think they want to do—we can play a role in helping them realize it may not be the best option for them by increasing their awareness of the host of factors influencing their choice," she explains.

"Specialty choice can be very complex for some folks and practicing as a physician can be complex as well. Medical schools do a good job of having conversations with students when they are deciding on a specialty. But these conversations need to continue at the residency level and throughout one's career as a physician. It becomes more challenging when a physician within the hospital environment is no longer satisfied. Decision making doesn't end with residency, it continues throughout a medical career. I think we can help with that."

Speaking as a psychologist, Borges says she would like to see more formalized programs established to meet the career and decision-making needs beyond medical school for residents and physicians thinking about how they want to practice medicine. "There are a number of very important decisions that need to be made. Such as, 'Am I going to do a fellowship?' 'What type of environment do I want to practice in—an academic health center or follow a non-traditional pathway?' 'What kind of life do I want as a physician?'"

As chair of Geisel's Department of Medical Education, Borges herself has similar decisions to make regarding the department's future. She leads an academically diverse group of educators and researchers who enthusiastically embrace innovation and excellence in delivering undergraduate medical education. Moving forward, she plans on tapping her expertise in career development to advance faculty careers and strengthen faculty development emphasizing scholarly productivity in medical education, which in turn will accelerate excellence in teaching.

"Having a strong curriculum along with faculty who are avid teachers but also scholars in medical education gives us a strong foundation on which to build an exemplary medical education department. With that," she proudly says, "we are poised to become a leader inmedical education."

If you'd like to offer feedback about this article, we'd welcome getting your comments at DartMed@Dartmouth.edu.

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