In defense of selectives

"What selective are you on?"

I dreaded answering this question because for a good week after starting this selective, I still struggled to describe what I was doing to others. Not only did I find it difficult to describe what I was doing, but also WHY I was doing it. I knew that I was interested in internal medicine and in medical education, but I suppose that I was less clear on what my learning objectives were for this selective.

So then I took a moment to think about the purpose of selectives. According to our course description for Transition to Residency, selectives "will allow students to work more independently than they did during their 3rd year core rotations, but with supervision commensurate with their pre-MD status. Students will be engaged in the workplace environment of the selective and are expected to gain tangible knowledge, skills and attitudes from it; they will also have responsibilities to study, independently, the population and systems they encounter in the selectives."

For me, selectives are a time for career exploration. I believe it should be a time for students to expand their ideas of what it means to be a physician and test out some areas in which they can be a "clinician +". I've heard terms like "clinician-scientist" or "clinician-educator" thrown around quite a lot and I always figured that selectives were a good opportunity to explore what these terms actually meant. It was a time to meet scientists and educators and talk to them about how they integrated their side-passions into the practice of medicine. It should also be a time to start carving out our own paths in our fields of interest. With residency literally around the corner, there is no better time than now to lay the foundation for a rich and fulfilling career path.

In the end, I see selectives as a chance for soul-searching and exploration, 2 activities that (unfortunately) do not get much attention in our busy medical school curriculum. Our portfolio sessions do cover some of it but mostly through stories and words. Selectives are an opportunity for us to put these words into action.

While I feel that this CEEP selective will allow me to do just that, I wonder whether other selectives are equally as set up to help their students through this process. I know of many other selectives that honestly don't seem to different from an elective in that they are very focused on developing clinical acumen. From a curriculum design perspective, I strongly feel that selectives should be a time to develop interests outside of the typical clinical encounter. Perhaps the objectives of this period need to be more explicitly stated? Perhaps we should be presenting students with a more tailored set of experiences that will encourage development of side-passions? Either way, I am thankful for the opportunity to explore questions like these while spending time with top-notch clinicians and educators. Let the soul-searching begin.

~CW