Internal Medicine Enrichment & Development (IMED): Early exposure to medicine subspecialties and its influence on students’ perceptions of a career in internal medicine

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Shaima Kaka
Kaitlin Endres
Katina Zheng
Sarah Elias
Mimi Deng
Alexandra Kobza
Aimee Li



Introduction: There are limited opportunities for pre-clerkship medical students to experience the breadth of internal medicine (IM) subspecialties. Previous studies suggest specialty choices are made as early as prior to clerkship. Due to limited exposure, factors influencing students’ career decisions may be rooted in bias. Internal Medicine Enrichment & Development (IMED) is a two-week program of clinical observerships, career talks and workshops in nine IM subspecialties. This study aimed to investigate whether IMED would influence students’ interest, understanding and perceptions toward IM.

Methods: Sixteen pre-clerkship students at the University of Ottawa participating in IMED were surveyed at baseline and at program completion on their interest and understanding of IM, as well as on negative biases towards a career in IM. Likert scale survey responses were compared using Wilcoxon signed-rank testing.

Results: Comparison of pre-program and post-program surveys revealed an overall significant improvement in student interest in IM and understanding of IM physician lifestyle, differences between subspecialties and between academic and community-based practice. 81% of participants stated they were more likely to pursue a career in IM following the completion of IMED. Participants reported changes in perceptions of the work hours, paperwork, and level of procedural skill required in IM. Career talks were the component of IMED most attributed for being responsible for changes in perception. Despite the self-reported changes in perception, there were no significant differences in the number of negative biases towards IM held by participants at baseline and program completion.

Conclusion: This study demonstrates how a structured, early-exposure program can influence pre-clerkship students’ perceptions of a career in IM. Participation in IMED increased students’ understanding of the career along with interest in IM. Implementing programs such as IMED across Canada can provide increased clinical exposure to IM subspecialties for pre-clerkship students and help inform early career decision making.