Resident career planning needs in internal medicine: a qualitative assessment

Few residency programs have centralized resources for career planning. As a consequence, little is known about residents' informational needs regarding career planning.

To examine career preparation stressors, practical needs, and information that residents wished they were privy to when applying.

In 2007 and 2008, we surveyed 163 recent graduates or graduating residents from 10 Yale-based and Yale-affiliated hospitals' internal medicine programs regarding their experiences with applying for positions after residency. We included questions about demographics, mentorship, stress of finding a job or fellowship, and open-ended questions to assess barriers and frustrations. Qualitative data were coded independently and a classification scheme was negotiated by consensus.

A total of 89 residents or recent graduates responded, and 75% of them found career planning during residency training at least somewhat stressful. Themes regarding the application process included (1) knowledge about the process, (2) knowledge about career paths and opportunities, (3) time factors, (4) importance of adequate personal guidance and mentorship, and (5) self-knowledge regarding priorities and the desired outcome. Residents identified the following advice as most important: (1) start the process as early as possible and with a clear knowledge of the process timeline, (2) be clear about personal goals and priorities, and (3) be well-informed about a prospective employer and what that employer is looking for. Most residents felt career planning should be structured into the curriculum and should occur in the first year or throughout residency.

This study highlights residents' desire for structured dissemination of information and counseling with regard to career planning during residency. Our data suggest that exposure to such resources may be beneficial as early as the first year of training.