LCME Element 11.2 – Career Advising

A medical school has an effective career advising system in place that integrates the efforts of faculty members, clerkship directors, and student affairs staff to assist medical students in choosing elective courses, evaluating career options, and applying to residency programs.

Hidden Curriculum

We know the LCME always looks for well-documented systems and the same applies to career advising.  A school must provide career advising to all students throughout all four years in a well-resourced and coordinated manner.  To be clear, advising is not limited to specialties with an eye toward residency matches.  Rather, it encompasses general career advising to determine the most appropriate career paths based on students’ preferences, strengths, and interests.  It also includes counseling to select electives to advance career goals.

An effective career advising program is organized centrally, giving direction to clinical departments to avoid overlapping and conflicting efforts.  This approach also holds true for schools with branch campuses.  Keep comparability in mind – the same quality of programming must be delivered to branch campus students.  

Finally, this element is particularly sensitive to the results of the Independent Student Analyst (ISA), Graduation Questionnaire (GQ), and internal surveys.  The results of these instruments can determine a school’s success during re-accreditation. 

Best Practices

Label and promote career counseling in obvious and clear terms, using multiple modes of communication.  Maintain consistency in language that is reflected in surveys.  Using the same terminology ensures that students actually recognize the provision of career counseling and can evaluate it accurately on surveys.  The LCME has become more reliant on the ISA and internal surveys because their data are timelier than the GQ.  In fact, the 2023-24 DCI template removed the GQ data table on student satisfaction with career planning. 

The 11.2 table in the DCI requires you to describe optional and required career activities across all four years.  Career advising includes full group sessions and individual sessions, and schools should aim for a minimum of one required activity each year.  Be very clear with students when their attendance to full-group sessions is required and if they are obligated to meet for a specified number of individual sessions.  It may be in a program’s interest to document student attendance.   

A new question in the 2023-24 DCI requires a program to describe how the different groups of individuals (e.g., faculty specialty advisors) involved in career advising are trained for their specific roles.  As such, train faculty on up-to-date trends and requirements in the residency application and match process, as well as ensure they have carved out time in their busy clinical schedules to meet with students (setting well-publicized office hours may be a good strategy).  Additionally, impart the need to maintain consistency in messaging as established by the lead faculty member who centrally manages career advising.  This can be one of the toughest aspects of the element because many schools have an unregulated marketplace of career advice reflecting the personal opinions/experiences of multiple sources.  Keep in mind that mixed messages can elevate medical students’ naturally high anxiety levels. 

Continuous Quality Improvement

A program’s best resource to determine whether they are meeting students’ career needs is to hear from them via internal surveys.  While the GQ and ISA are great resources, they represent limitations due to their timing and exposure.  A program should plan to incorporate questions about career advising into its internal surveys to monitor program quality.  Apart from formal annual surveys, short, post-session questionnaires can provide real-time feedback on the utility of presentations and quality of individual advisors.