Career coaching, a systematic process for professional development of physicians-in-training, equips students with the tools of self-reflection and lifelong learning.1 It facilitates career exploration, professional identity formation, preparation for medical training, and career advancement while providing the learner with mentoring and advising.2 Important distinctions should be made between a career coach, a mentor, and an advisor.
The classic definition of a coach is someone with an advanced level of expertise who supports the learner in achieving their specific goals.3 This is routinely done by providing training and guidance that is individualized to the learner and what they are trying to accomplish. The relationship involves the coach conducting objective assessments of the learner. The coach and learner must then work together to identify and understand the learner’s areas for improvement. By detailing these knowledge gaps, the learner should work to develop a plan to address them while the coach helps the learner remain accountable.4 At this point in the process, the coach should be taking a hands-off approach and allowing the learner to strengthen their ability to self-monitor.5 It is crucial to note that the coach must be an expert in professional development and not necessarily in the same field as the learner.5
Mentors and advisors should not be confused with career coaches as they have very different, yet important, roles. Mentors are sought-out members of the same field who can listen and offer support to the student about navigating the learning process.6 However, the mentor’s advice is more subjective and based on their own experiences in the same profession, while a career coach can facilitate the learner’s knowledge from a broader, all-encompassing view. Advisors are typically assigned to the learner and informed on the institution-specific protocols needed to help achieve a goal.7 While they are essential, the relationship can often be impersonal. Career coaching works to cultivate meaningful, one-on-one relationships between the learner and the coach. In addition, career coaches work to help learners not only achieve specific personal and professional goals but sustain them.
While we often associate career coaching with disciplines like sports and business, this style of program is a newer concept in medicine. The topic has been studied in faculty development and graduate medical education; however, there is a paucity of research on coaching in undergraduate medical education.8–10 With the growing number of residency applicants compared to residency positions and the increasing competitiveness among specialties, career advising has become more complex but paramount in successful matching. While not formally monitored, career coaching is one strategy currently being implemented by some medical schools to address the increasing complexity of career advising for both advisors and students. To investigate this topic, we conducted a survey assessing the satisfaction of undergraduate medical students taking part in a newly implemented career coaching model at the Geisinger Commonwealth School of Medicine (GCSOM).
The investigators used the conceptual framework of positive psychology coaching for the development of this program.11 This framework provides structure for the coach and learner development, the relationship, and goal setting.10 Review of the literature demonstrates significant potential for this framework to positively impact the individuals and the entire culture of medicine and medical education.7,9 From this foundation, the career coaching model at GCSOM is grounded in the longitudinal relationship between the career coach and the learner. Utilizing the Association of American Medical Colleges’ Careers in Medicine (CiM) (https://www.aamc.org/cim/) with a four-year graduated program, the career coach can provide developmentally appropriate support in assisting the student to identify their career goals and create a plan for meeting these goals. The career coaching program includes required components such as career coach meetings, review of CiM assessments, curriculum vitae (CV) writing workshops and mock interviews, as well as coordination with faculty advisors and mentors. Optional activities include support with personal statement development, creation of the rank order list, and Electronic Residency Application Service (ERAS) review.
GCSOM’s career coaching program officially launched in 2017, and all undergraduate medical students enroll in the program. The school currently has two career coaches who oversee all MD classes from matriculation until graduation. The coaches are members of the Office of Student Affairs with master’s level education who have prior experience working in higher education. The coaches received formal training through the CiM program as well as direct mentoring from the Associate Dean of Student Affairs. In addition, they are required to participate in various professional development activities such as a coaching course or emotional intelligence program. The school assigns specialty-specific mentors so the coaches do not serve dual roles as mentors. Career coaches are required to meet with students at least twice yearly or more frequently depending on student needs. In addition to individualized sessions, career coaches lead on average 2 to 4 group sessions per year about career-related topics for each class year.
To explore program evaluation and impact of the career coaching model, the investigators designed a descriptive study to determine the elements of the career coaching model that students viewed as most helpful. The investigators conducted a literature search prior to survey creation and did not find any surveys applicable to undergraduate medical education coaching. We developed a survey that was separated into 4 domains of the career coaching model: preparation for residency, career exploration, advising and mentoring, and professional identity formation. Using a semi-Likert Scale of 1 to 10 with 10 being the most helpful, students were asked to rate each specific element. The survey consisted of 22 ranked questions (Appendix A), which were reviewed by content experts then pretested with a small group of current undergraduate medical students before distribution to the study population. Demographic data were collected for preferred gender identity, ethnic heritage, race, first-generation college student, and first-generation medical student (Appendix A).
The survey was administered to medical students from GCSOM’s Class of 2020 three months after graduation. Receiving feedback from recent graduates rather than students currently in the program allowed the investigators to explore these questions with the benefit of the respondents’ experience of already transitioning to residency. Although there were two prior graduated classes that had participated in the career coaching program, the class of 2020 was selected as the initial survey group since they had the benefit of the longitudinal aspect of this program.
An email invitation was sent by the investigators to 104 graduates of the GCSOM Class of 2020 to complete an electronic survey. Of the 104 graduates, a total of 44 completed the survey over a 6-week period. Data were collected in Qualtrics and reported using means and standard deviations for all ranked questions. Research participants provided written informed consent. All student responses were anonymous, and no personal identifiers were collected. This study received exempt status from the GCSOM Institutional Review Board.
The investigators reported results of the survey in the 4 domains of the career coaching model studied. Initial analysis of the data included exploration of the range, median and quartile responses for each of the questions in the 4 domains (Appendix B). Through this analysis the investigators determined to utilize a response rate of 7 or greater for further review of items. In the “Preparation for Residency” scale the most impactful areas defined as a 7 or greater on the 1 (minimum) to 10 (maximum) scale were preparation and guidance for securing letters of recommendation (7.11), communication guidelines with residency programs during the interview season (7.02), CV writing (8.45), and guidance and feedback on Electronic Residency Application Service (ERAS) application (including noteworthy characteristics) (7.75) (Figure 1).
The “Career Exploration” scale item that was found as most impactful was individual meetings with career coach during 3rd and 4th years (7.30) (Figure 2). In the “Advising/Mentoring” scale the most impactful areas were supporting your professional identity formation (7.05), determining your competitiveness for your intended specialty (7.14), and residency application preparation (7.40) (Figure 3). Of note, the item for identifying your career choice was lower (5.84). The final scale of “Professional Identity Formation” showed the most impactful areas were supporting your development as a physician (7.05), supporting your development as a person (7.14), and supporting your development as a self-reflective practitioner (7.12) (Figure 4).
Demographic data were also collected for preferred gender identity, ethnic heritage, race, first-generation college student, and first-generation medical student, as literature review has linked these elements as important in career selection.12,13 Most respondents identified as male (55%), not Hispanic or Latino (83%), and white (76%) (Table 1). Most respondents were not first-generation college students (67%) but were first-generation medical students (76%) (Table 1).
The survey data collected in this study provides a baseline measure of the satisfaction of the most recent class of graduating medical students with specific aspects of GCSOM’s newly implemented career coaching model. Using this data, we can preliminarily assess the strengths and weaknesses of required and optional elements of the career coaching model and student engagement. The utility of this instrument to measure satisfaction and efficacy of the four components of the career coaching model will also provide a foundation for program evaluation and further study and for the development of quality improvement initiatives.
Regarding the proposed role of the career coach in the professional development of students, the survey showed high satisfaction in supporting students’ development as physicians, individuals, and self-reflective practitioners. This suggests that the career coaching program directly addresses the institutional goal of supporting the personal and professional development of students. As the literature review demonstrates, these factors are critical in promoting the development of effective, compassionate, and resilient individuals as they transition to residency.9
Higher satisfaction scores were also observed with individual meetings with career coaches during students’ third and fourth years as compared to meetings during their first two years. It is hypothesized that these individual meetings allow for a safe and accessible environment for asking questions about factors related to a student’s application. Developing a deeper understanding of the components of the career coaching-student relationship is an area for future research. The results also suggest that professional expertise and support provided by the career coaches in the logistics of the application process is helpful for students. Several of these items are components of the residency application cycle that change frequently, such as communication guidelines and the ERAS application.
Lower satisfaction responses were observed for preparation for residency interviews. These data demonstrate an opportunity for improvement of the career coaching model in collaboration with specialty mentors and advisors. Creating more opportunities for mock interviews or providing more resources regarding residency interviews might prove useful to increase student satisfaction and lead to greater success of students in matching into their desired residency programs. These results may also suggest that students utilize their relationships with specialty faculty as advisors and mentors to begin their transition of identity from a medical student to a resident in the specialty, as well as for support of the logistics related to application in their selected specialty.
One limitation of the present study is our sample size. While it would be ideal to ascertain satisfaction levels from the entire graduating class, we recognize that the members of our target population are now first-year resident physicians. Furthermore, the COVID-19 pandemic occurring during the administration of the survey may have contributed to a lower response rate. Another limitation is that this study population had the career coaching model implemented during their second year and thus the longitudinal benefit of a 4-year career coach relationship was not able to be assessed. The survey will be repeated annually for each graduating class so we can assess the impact of the career coaching model based on 4 consecutive years of coaching.
Future studies will also aim to investigate relationships between the demographic data collected in this study and satisfaction measures using preferred gender identity, racial identification, ethnic heritage, and whether the student was a first-generation college or medical student. As the literature suggests, a gap exists in knowledge and best practices in career advising and preparation for medical students transitioning to residency.1,11 Exploring the career coaching model in these components will allow for exploration of the factors most critical to certain demographic groups and for the implementation of directed faculty development. The utility of this survey will also allow for more directed allocation of resources to areas most impactful for students.
No funding sources were utilized for this research.
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CREDIT Contributor Roles
Spatz C: Conceptualization, Methodology, Data curation, Interpretation of data [Formal analysis], Writing—original draft, and Writing—review & editing
Romanowksi K: Conceptualization, Writing—original draft, and Writing—reviewing & editing
Wolfheimer J: Conceptualization, Writing—original draft, Writing—review & editing
Adonizio T: Conceptualization, Methodology, Data curation, Writing—original draft and Writing— review & editing
Michelle Schmude, EdD, MBA; Erin Dunleavy, MS, PhD; Linda Learn, MSW, MBA; Julia Kolcharno, MA; Sonia Lobo, PhD.
The authors declare that they have no competing interests.
This work is original and has not been published elsewhere, nor is it currently under consideration for publication elsewhere.
This article was reformatted after publication as part of The Guthrie Journal’s move to a new platform so that all of our articles would have a consistent look. The article was published December 30, 2021, and reformatted in March 2022.