Trajectory of a medical career: a perspective regarding a proposed model

A career as a physician offers so many options-clinical care, research, education, leadership, etc. Still, a general trajectory of a medical career can be usefully modelled. Based on a USA-centric lens, this proposed model-which is based on a personal reflection and conversation with colleagues-consists of an initial two-component linear phase, followed later by a non-linear phase. The linear phase requires mastery of a large body of knowledge, acquiring cognitive and technical skills, and achieving prescribed milestones. Two components of the linear trajectory are early education through medical school, and then graduate medical education through the initial career path. A non-linear phase follows, characteristically beginning after graduate medical training and the initial 'hitting stride' in the first post-training position.At this point, the physician's choices regarding career direction are wide open. Yet, the intense focus needed to master the prolonged linear phase of the physician's career can exert opposing effects on preparedness for the subsequent non-linear phase; years of satisfying prescribed curricula and examinations may blunt the self-directed learning and intrinsic motivation needed for the non-linear phase while also stimulating the appetite to get beyond the guardrails of the linear phase.This model has implications for early training, namely encouraging a focus on mindfulness and introducing this model as part of professional identity formation. Given differences in medical training across the globe, generalisability of the model to settings outside the United States would require validation by others.