New education method or tool
Open Access

Podcasting as an Innovative Approach to Enhance Career Counseling in Canadian Undergraduate Medical Education

Anthony Vo[1]

Institution: 1. University of Alberta
Corresponding Author: Dr Anthony Vo ([email protected])
Categories: Students/Trainees, Teaching and Learning, Technology
Published Date: 09/05/2018

Abstract

In a 2012 Royal College of Canada survey of newly trained physicians, 53% did not receive career counseling while in medical school. The purpose of this initiative was to produce a podcast series designed to inform students of the different specialties. The podcast series featured 8 prominent physicians with long-standing experience in their specialty.  The series provides students with an archive of podcasts to help them make informed career decisions. The opportunity to intimately learn about a specialty through the eyes of a physician and the flexibility podcasting offers makes this innovation a valuable and insightful resource for medical students.

Keywords: podcast; medical education; career counseling; medical specialty; undergraduate

Background

The current Canadian undergraduate medical curriculum was designed to graduate medical students after 3 to 4 years of training, depending on the medical school. During the later half of the curriculum, students are placed in clinical settings where they rotate through the different medical specialties. This is usually where students develop an initial understanding of each specialty and decide which specialty they would like to pursue. In their final year of training, students apply to their specialty of interest using the Canadian Resident Matching Service (CaRMS). In order to be a competitive applicant, students need to prepare a strong application that depicts their interest and commitment to the specialty. From the time medical school starts, students have a maximum of 2.5-3.5 years to prepare this application.

For applicants interested in highly-sought specialties, the application process can be very competitive. In 2013, the percent of medical students who matched to their first-choice surgical specialty was significantly lower than non-surgical specialties. For example, only 52% of medical students interested in plastic surgery successfully matched to their first choice discipline in the first iteration compared to 95% for internal medicine or 97% for family medicine (Canadian Federation of Medical Students, 2013). Therefore, students are often pressured to determine their specialty early in their training so that they can prepare a more competitive application. However, choosing a specialty is often made with limited knowledge, exposure and understanding. As a result, students may commit to a specialty for which they later find that they have no interest or satisfaction. Furthermore this can lead students to entering a specialty for which there is no job market or even switching to another residency training program. In a study done by Medscape, only 41% of physicians would choose the same specialty again (Crane, 2012).

This is compounded by the lack of formal opportunities, career counseling services and resources in Canada to help students explore specialties early in their training. In 2011 and 2012, 62% and 53% of newly trained Canadian medical graduates respectively, did not receive any career counseling while in medical school. Of the career counseling provided, only 4.1% addressed the career paths available for a specialty and only 9% were satisfied with career counseling (Frechette, 2013). Canadian services and resources available provide students with a superficial understanding of a specialty, rather than an in-depth, first-hand and intimate apprehension that is necessary to make life-long career decisions. Therefore, it is essential to ensure students are given opportunities to develop an understanding of the different specialties from physicians in their respective field, especially in an era where technology is vastly available, so that they can make informed career decisions.

Developing An Innovation

It is important that when implementing an innovation, that it addresses and is easily consumable by the population it is targeting. Podcasting is a recent innovation that is extensively used and studied for educational purposes. It allows rapid and inexpensive delivery of media contents, known as podcasts, to users through a desktop or mobile platform (Boulos, 2006). Many medical students are familiar with podcasts and how they work. In one study surveying 593 medical students they found that only 2.2% were not familiar with podcasts.  They also found that 79.8% of the students own an MP3 or digital media player that allowed them to listen to podcasts (Sandars, 2007). Therefore utilizing podcasting to target medical students is an ideal approach. 

The purpose of this initiative was to design and produce a podcast series, Leaders in Medicine (LIM), to provide medical students with an in-depth understanding of the different specialties, in order for students to make informed career decisions.

Podcast Series Production

A podcast server was produced with a user-friendly interface for the desktop (see Figure 1) and mobile platform (Figure 2 A and B) with the help of Medtech (Information Management Services) from the Faculty of Medicine, University of Ottawa. Physicians with longstanding experience in their specialty, for example Division Chairs and Residency Program Directors, were invited to participate. The format of the podcast was unstructured in order to allow physicians the ability to talk freely about their specialty. However, prior to each podcast, physicians were asked to emphasize on key topics such as their view of their specialty, advantages and disadvantages, advice, residency application process, how residency programs select students and etc. Physicians were especially encouraged to be open about their specialty and career path, such as any personal regrets and what they wish they had known as a medical student. They also answered commonly asked questions from medical students, including the importance of research when applying and employment.

Several measures were implemented to help make the initiative friendly to physicians who participated. Podcasts were recorded using portable high-quality voice recorders with noise cancellation features (Sony 4GB Digital Voice Recorder ICDPX333). This allowed recordings to be done at any location convenient to them. Editing of the podcast was done using Garage Band 11 (version 6.0.5, Apple Inc.). Once edited, physicians were given the opportunity to review their podcast and further edits were made before distribution. The podcasts were hosted on a password-protected media server to encourage physicians to be more open about their specialty without possible repercussions, such as regrets physicians may have or personal advices. LIM consisted of 8 podcasts, each featuring a unique perspective of the specialty from a distinguished physician (general surgery, obstetrics and gynecology, plastic surgery, endocrinology, hematology, geriatric medicine, family medicine, and ophthalmology). The length of the podcasts ranged from 7 to 48 minutes. They were archived so that all future medical students have access to these from the day they start medical school.

 

Figure 1. Desktop user interface for Leaders in Medicine Podcast Series.

 

Figure 2. Mobile user interface for Leaders in Medicine Podcast Series showing the homepage(A) and podcast player(B).

 

Discussion

Medical students are pressured to choose their specialty of interest early in their medical training in order to prepare a competitive application for CaRMS. This is compounded by the lack of career counseling available to students in undergraduate medical training and formal exposure to specialties in the later half of their training. Therefore students often make decisions based on limited knowledge and exposure. The purpose of this initiative was to produce an innovative podcast series, LIM, to provide students with an early and an in-depth exposure to the specialties, to allow students to make informed career decisions.

 In order to successfully implement an innovation, it needs to be able to address the population it is targeting using means familiar and popular with them. For medical students, producing an innovative resource that can accommodate their schedule is crucial. Podcasting allows students to consume the resource according to their schedule. With mobile devices, such as cell phones and tablets, being more prominent among medical students today, they allow students the opportunity to listen to podcasts wherever they are.  In several past studies, medical students have commented that podcasting provide students with the flexibility to be able to listen when, where, and how they want which is ideal for their busy schedule (Schreiber, 2010). In a 2008 study, one quarter of medical students reported listening to podcasts while traveling (Evans, 2008).

Canadian resources such as the Canadian Medical Association Specialty Profiles provide general overview of medical specialties, discussing topics such as the average salary, satisfaction, and scope of practice (Canadian Medical Association, 2014). However these resources lack the in-depth details about the specialties that are needed for students to make an informed career decision, such as the nuances physicians find about their specialty, how physician picked their career path and the thought process they went through during medical school. For example, one surgeon reflected on his last day of his surgery rotation as a medical student pursuing internal medicine and stated “this is the last time I’m scrubbing in and putting on the gown, but I should’ve known that I wouldn’t be happy in my career without that feeling again.” Another surgeon discussed the poor employment opportunities available to recent surgical graduates, but stated “you can’t predict who’s going to make money tomorrow based on today, just find something you like to do.”

To ensure physicians participate and be open about their specialty, numerous considerations needed to be addressed. Firstly, it was important to make it convenient for physicians to participate at locations convenient to them, which was addressed using portable high-quality voice recorders. Secondly the option of allowing the physician to listen and edit their podcasts and by limiting access to medical students only by using a password-protected server, addressed some of the concerns they had about the possible repercussions from being open and voicing their thoughts about their specialty.  As a result of addressing these considerations, all physicians who were asked were willing to participate in this initiative.

Conclusion

A successful medical education innovation must address the students by using what is familiar and popular among students. Podcasting provides students with an archive of podcasts to help them make informed life-long career decisions. The opportunity to intimately learn about a specialty through the eyes of a physician and the flexibility podcasting offer makes this innovation a valuable and insightful resource for medical students.

Take Home Messages

1. Career counseling is lacking in the Canadian undergraduate medical curriculum.

2. The flexibility podcasting offer makes it a valuable and insightful resource for medical students.

Notes On Contributors

Anthony Vo, MD- a Diagnostic Radiology resident at the University of Alberta, Canada. He has a strong interest in medical education and using innovative approaches to enhance the learning experience of medical trainees.

Acknowledgements

The author would like to thank Dr. Alireza Jalali and Jean-Ray Arseneau for their technological expertise. This initiative was financially supported by the Ontario Medical Students Association (OMSA) Innovator Grant.

Bibliography/References

Boulos MNK, Maramba I, Wheeler S. (2006). Wikis, blogs and podcasts: a new generation of Web-based tools for virtual collaborative clinical practice and education. BMC Medical Education;6:41.

https://doi.org/10.1186/1472-6920-6-41   

Canadian Federation of Medical Students. (2013). The Match Book: An annual review of the CaRMS match. CFMS, 2013. Retrieved March 23, 2014 Available from:   https://www.cfms.org/files/matchbook/matchbook2013-2014.pdf

Canadian Medical Association. (2014). Becoming a physician. Canadian Medical Association. Retrieved March 23, 2014. Available from: https://www.cma.ca/En/Pages/becoming-a-physician.aspx

Crane M. (2012). Physician Fustration Grows, Income Falls—But a Ray of Hope. Medscape. Retrieved March 23, 2014. Available from: http://www.medscape.com/viewarticle/761870_4   

Evans C. (2008). The effectiveness of m-learning in the form of podcast revision lectures in higher education. Computers & Education;50:491-98

https://doi.org/10.1016/j.compedu.2007.09.016   

Frechette D, Hollenberg D, Shrichand A, Jacob C, Datta I. (2013). What's really behind Canada's unemployed specialists? Royal College of Physicians and Surgeons of Canada. Retrieved March 23, 2014. Available from: http://www.royalcollege.ca/portal/page/portal/rc/common/documents/policy/employment_report_2013_e.pdf 

Sandars J, Schroter S. (2007). Web 2.0 technologies for undergraduate and postgraduate medical education: an online survey. Postgrad Med J.;83:759-62

https://doi.org/10.1136/pgmj.2007.063123   

Schreiber BE, Fukuta J, Gordon F. (2010). Live lecture versus video podcast in undergraduate medical education: A randomized controlled trial. BMC Medical Education;10:68.

https://doi.org/10.1186/1472-6920-10-68

Appendices

Declarations

There are no conflicts of interest.
This has been published under Creative Commons "CC BY-SA 4.0" (https://creativecommons.org/licenses/by-sa/4.0/)

Reviews

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Ken Masters - (13/05/2019) Panel Member Icon
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The paper deals with the use of podcasting to enhance career counselling in Canadian undergraduate medical education. The author succinctly explains the problem: in high-demand specialties, students have a low success rate of being accepted into their first choice, so are encouraged to prepare for their first choice application as early as possible in their medical training; at that stage in their training, however, they do not have enough knowledge about the specialities to make a properly informed choice, and only around half of them receive career counselling. In response, the institution developed a series of podcasts to enlighten students.

The research has several strengths, including ensuring balanced information from experts, high technical quality of the podcasts, and post-editing review by the experts.

The main problem with the paper is that it has been published far too soon, before there is really something of value to report. I understand that the paper is categorised as “New education method or tool”, but this is really far too soon to be reporting on this project.
• There are only eight podcasts. This is a good start, but it is a start only. At best, this is a pilot. To be of value, the service should have podcasts from:
o all (or at least most) specialities;
o several sub-specialties, and
o more than one person in each specialty / sub-specialty.

• There has been no evaluation of any kind. I am not suggesting a full longitudinal evaluation (which may be done in a few years’ time), but, at the very least:
o a simple online form in which those students who listened to the podcast report their impressions, and
o usage statistics, showing downloads/accesses, full listening, etc.

This is especially important given the small number of podcasts, and that at least one of them was only seven minutes in length.

So, I think that the project is a good idea, and I wish it every success, but, at this stage, it is simply far to early to report on it to have great value to the readers. I look forward to another article on the project, perhaps a year or two away, in which the author reports more comprehensively.
Ariela Marshall - (20/08/2018) Panel Member Icon
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This is a fantastic educational innovation that really targets the Millennial learner! I commend the author and his coworkers for their novel approach to allow medical students the opportunity for increased exposure to several specialties via Podcast. Having experts in the field discuss why they chose their specialty and their individual career paths as well as regrets allows a “personal” exposure to these fields and will be especially helpful for fields that are less common/more difficult for medical students to rotate through.
I agree with the first reviewer that some measure of outcome would add to the project. Does the author know how many students accessed the Podcasts and what year the students were in when they listened? This information may be very helpful. Also a survey of student users may help assess what additional fields could be added to the existing Podcast library (orthopedics, pediatrics, and so on?). Finally it would be nice for the author to address “next steps” in his project – plan to create more Podcasts in other specialties, plan to focus on distributing what already exists to more medical students, plan to work with medical schools to “get the word out” etc?
Overall this is a very exciting project and I look forward to future follow-up about its success!
Sateesh Babu Arja - (18/05/2018)
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Very thoughtful paper and is easily understandable. Thank you for providing the thoughts and innovative methods to provide career counseling to the medical students. Career counseling is the one area where generally students are dissatisfied with most of the medical schools. Even when institutions conduct surveys among the graduates as part of the self-evaluation process, the results for career counseling are not encouraging.

It can be easier to make their minds for medical students in the third and fourth year of the program where they are exposed to different clinical rotations and specialties. At our institution, we start career counseling early in the first semester itself where students are assigned to their mentors. These mentors are medical doctors who are involved in the teaching program in the early part of the curriculum and the career counseling will be continued until the 4th year. But still, students are not satisfied. It seems that this paper and using podcasting services might be a reasonable solution for these kinds of problems in career counseling. The advantages of using podcasting services are students can listen to them at their convenient time and using them is very easy for students. And also it is very convenient to the faculty members and specialists to be recorded rather than face-to-face counseling sessions which require a lot of time.

This paper definitely adds to the existing literature on career counseling. This is very useful for the faculty mentors and academic administrators who are involved with student support services. But I would like to add one comment that it would be nice to see the satisfaction of students after introducing podcasting services for counseling. Students did mention that 53% did not receive career counseling while in medical school and I would like to see the response rate after implementing the podcasting services.