Serendipitous Moments in Academic Medicine Careers: Should We Leave as Much to Chance as We Do?

By Anita Navarro

Before joining the AAMC, I was on the faculty at the Virginia Commonwealth University School of Medicine. During an annual medical school admissions committee retreat, the dean asked whether it was possible to identify those who might consider careers in academic medicine as early as the admissions process. Intrigued by the dean’s question, one of the committee members pulled together a team to attempt to answer it. I was one of the members of this team, which studied how, why, and when physicians choose academic medicine as a practice option (insert link?). One of the things we found is that gender differences play a role in the decision, and we went on to investigate factors that influence women physicians specifically to choose academia. Our findings were published in the January 2012 issue of Academic Medicine.

One of the participants I interviewed related growing up with a father who was a professor, and how experiencing the life of an academic through him had a strong influence on her career considerations. Her experience, however, was more the exception than the rule, as most of our participants were the first in their families to become academic physicians.

During many of our other interviews, an unexpected theme emerged. Serendipity frequently played a major role in our participants’ career paths. The chance meeting of a role model or mentor, or being offered a research opportunity because they just happened to be at the right place at the right time, was a theme common to many of our participants. These chance encounters greatly influenced their decisions about how they were going to practice medicine and in ultimately choosing academic medicine. This seemed to be the case whether their passion for academic medicine was focused on teaching or research.

What about those who don’t have these chance encounters with a mentor or role model? Academic medicine may be missing the opportunity to cultivate future talent. Indeed, our participants said that, as students, they were unaware of or naïve about the daily life of their attendings. It was only later, as residents or fellows, that they started envisioning their practice lives and considering academic medicine as an option.

With the increasingly competitive nature of The Match and the emotional and financial costs involved in changing specialties or practice type, it is more important than ever for medical students to make wise career decisions. While we can’t discount the role of serendipity in career decisions, it seems critical in today’s environment to take intentional steps in developing future talent for our medical schools.

Realistically, most of our medical school applicants just want to “get in.” They don’t know how they want to practice medicine for the next 30 years. Once our applicants become students, however, they are a captive audience. Offering structured opportunities for students and residents to explore academic medicine as a practice option is critical in developing and cultivating future physicians for academic medical centers. While serendipity often plays a role in careers, medical educators can and should help students with this important life decision in a way that leaves less to chance.

—Anita Navarro is a research analyst with the Association of American Medical Colleges (AAMC) Careers in Medicine (CiM) program. She can be reached at