Early Learning Experiences in Med School Shown to Impact Burnout, Empathy, and Career Regret

Early learning experiences in medical school impact students’ burnout, exhaustion, empathy, and career regret levels at graduation. A longitudinal study, published in JAMA, finds that medical students who report experiencing mistreatment prior to their second year have higher levels of burnout and career regret two years later. And the opposite also holds true. Students with positive experiences report lower burnout levels, higher empathy, and less career regret at graduation. 

The study, led by Liselotte Dyrbye, MD, MHPE, Daniel Satele, BA, and Colin West, MD, PhD, includes over 14,000 students from 140 allopathic medical schools who responded to the AAMC Medical School Year Two Questionnaire and the 2016-2018 AAMC Graduation Questionnaire.

The study findings show that just over three-quarters of students reported no mistreatment (77.1 percent) on the Year Two Questionnaire. Among the remaining 22.9 percent of students, 11.3 percent reported mistreatment in one instance, and 11.6 percent reported mistreatment in more than one instance. Within the group who experienced mistreatment more than once, the Graduation Questionnaires were more likely to indicate:

• Career choice regret (6.4 percent for those who never experienced mistreatment, 7 percent for once, and 11.4 percent for more than once)

• Greater exhaustion (mean scores: 12 for never, 13 for once, and 13.8 for more than once)

• Higher levels of disengagement (mean scores: 5.3 for never, 5.5 for once, and 6.0 for more than once)

Among those students who reported a more positive emotional climate on the Year Two Questionnaire, the relationships were the opposite. Their Graduation Questionnaires were more likely to show:

• Lower exhaustion levels (for each 1-point increase in emotional climate, there was a reduction by .05 in exhaustion) 

• Lower disengagement scores (for each 1-point increase in emotional climate, there was a reduction of .04 in disengagement)

Students who reported positive faculty interactions on the Year Two Questionnaire were more likely to receive higher empathy scores on the Graduation Questionnaire. And, positive interactions with other students resulted in lower instances of career regret at the conclusion of medical school. 

The study authors note that medical school administrators may use these findings to craft learning environments that “mitigate burnout, decline in empathy, and career choice regret among their students.” The authors write, "Although the most effective approaches to addressing mistreatment of learners remain elusive, the frequency of mistreatment varies between educational programs, suggesting there are likely to be levers within the control of the organization that adequate commitment, leadership, infrastructure, resources, and accountability can lead to a meaningful reduction in mistreatment." The authors also suggest that schools consider strategies to reduce stress among students and promote positive learning environments, such as installing learning communities, pass/fail grading, and faculty development. 

MedPage Today quoted Charles Griffith III, MD, of the University of Kentucky College of Medicine, who noted in a commentary on the study that, while the authors’ use of student-level, rather than institution-level data, limited the utility of the analysis, it may still inform interventions. "Some students in this study perceived mistreatment and did not believe the learning environment was supportive, but students from the same school believed the learning environment was indeed supportive," he wrote. "For a school considering change, based on these findings, does the school focus on making global changes to aspects of the overall learning environment, or do they identify students not supported by the current learning environment to tailor support on an individual level rather than a macro level?"

Profile of Recent MBA Alumni Shows a Shifting Student Base

The Financial Times has published its updated MBA alumni profile. Once again, it shows the ever-dynamic nature of the MBA degree and its student make-up. This year’s profile, in comparison with earlier alumni groups, showcases shifting demographics with greater percentages of alumni who are women, from the Asia-Pacific region, and fewer who went into banking. 

The profile uses data from the FT’s 2022 Global MBA rankings, which includes alumni from the top-100 ranked programs three years after graduation. We’ve listed the key insights below. 

• Reasons for Pursuing the MBA: Similar to the last two years, MBA alumni were most likely to name Personal Development and Management Development as their reasons for obtaining the degree. These two were followed by Improve Career Opportunities and Increase Salary as the third and fourth most highly-rated options. Falling to last place was Start Own Company, which most respondents rated at seven or below (out of ten) in importance. 

• Importance and Value of Courses. Alumni were asked to rate MBA courses in terms of importance and how well their alma mater teaches the subjects. Most alumni believe that General Management, Corporate Strategy, Entrepreneurship, and Finance are important and taught well. Alumni rated Organizational Behavior and Statistics/Quantitative Methods of average importance. However, they rated the performance of their schools higher for teaching Organizational Behavior than Statistics. Finally, Ethics and Environmental Issues and Fintech—two emerging topic areas for MBAs—were rated below average on both importance and performance. 

• Alumni demographics. Over time the makeup of the alumni profile has shifted significantly in terms of region of origin, gender, and post-MBA employment. 

  • In 2006, students from the US and Canada made up 50 percent of MBA alumni, however this proportion has declined steadily. Students from the Asia-Pacific region now make up the highest proportion at just under 40 percent. Students from the US and Canada fall next in line at just over 30 percent. 

  • While the percentage of women alumni held relatively steady at 33 percent between 2006 and 2014, it jumped significantly in 2022 with women now making up 40 percent of alumni three years post-graduation. 

  • The top sectors for post-MBA employment have also shifted over time. Declining steadily, finance/banking decreased from 31 percent of alumni in 2006 to 25 percent in 2014, and is down still further to 18 percent in 2022. The percentage of alumni in consulting has held relatively steady at 15 percent from 2006 to 2014, and has risen slightly to 17 percent in 2022. Not surprisingly, MBA alumni going into IT/Telecoms has increased over time, jumping from ten percent in 2006 to 14 percent in 2022. And, in 2022, e-commerce ranked among the top five employment sectors for the first time.

  • A demographic that has held relatively constant over time is age. The average alumni age, three years post-graduation, was 28 in 2006 and 2014, and increased slightly to 29 in 2022. 

• Since 2006, alumni salaries, both at graduation and three-years post-graduation, have increased by 28 percent. The FT notes that this is lower than the cumulative inflation rate of 37 percent over the same time period. In 2022, reported salaries for alumni three-years post-graduation are down compared to last year, which is the first time salaries have decreased year-over-year since 2014. 

Access the full alumni profile here. 

February Bar Exam Average Score Drops to Match All-Time Low

In a disappointing turn of events for many hopeful lawyers, the February 2022 bar exam results have dropped. The national average score decreased 1.4 points from last year’s February exam to 132.6, which matches the all-time low score garnered in February 2020. Of the twenty states who have reported their February bar exam results, twelve states’ pass rates have decreased. Just six states have seen increases and two states’ rates have held steady. 

New York—the largest bar exam jurisdiction—saw a decrease from 49 percent last year to 45 percent this year, and Florida experienced a similar decline, dropping from a 47 percent pass rate to 43 percent. Pennsylvania and North Carolina experienced more significant declines dropping 14 and ten percentage points, respectively. Among the six states with increasing pass rates were Illinois (up one percentage point from last year, to 43 percent), North Dakota (up 13 percentage points to an impressive 68 percent), and West Virginia (up eight percentage points to 56 percent). 

This year’s exam was notable in that it brought almost all test-takers back to in-person testing sites (with the exception of Nevada, which was experiencing the Omicron COVID-19 surge at the time). Last year, just 16 sites provided in-person testing while all others opted to provide the exam virtually due to the pandemic. 

The National Conference of Bar Examiners’ director of assessment and research, Rosemary Reshetar, reacted to the lower average by pointing out that various factors combine to influence the results. She noted that the February test cohort is smaller than it is for the July exam, which means that the scores tend to fluctuate more from year-to-year. She also said that this year’s February test-takers included more repeat examinees (68 percent) compared to the previous year, and that repeaters tend to have a higher fail rate than first time test-takers. 

Medical Researchers Gain Patient Experience Insights via Social Media Posts

Scrolling through Twitter may feel like a casual downtime activity, but a recent Wall Street Journal article describes social media’s growing utility as a medical research tool. Increasingly, researchers are using AI and other data-culling techniques, to sift through social media comments and gather real-time, unfiltered feedback on patient experiences—from the patients themselves. 

In an interview with the WSJ, Dr. Graciela Gonzalez-Hernandez, an Associate Professor at the University of Pennsylvania’s Perelman School of Medicine said, “Collecting abundant social-media data is cost-effective, does not involve burdening participants, and is available in real time.” She also points out that it may be more inclusive of populations often underrepresented in biomedical trials or cohort studies. And, most importantly, social media provides researchers direct access to unfiltered patient commentary on their experiences. “Healthcare providers report what they deem important, such that serious events are overrepresented, while bothersome side effects that may be of great importance to patients and lead to nonadherence and non-persistence are underrepresented,” Gonzalez-Hernandez said.

The article describes how researchers studying an opioid withdrawal drug have benefited from social media scans. Dr. Abeed Sarker, an Assistant Professor of Biomedical Informatics at Emory University, and his team used natural language processing algorithms to search Reddit for comments on opioid withdrawal experiences. Dr. Sarker’s team found that Reddit contributors frequently described concerns about withdrawal drugs causing “precipitated withdrawal,” or extreme withdrawal symptoms, among those who have used fentanyl. Importantly, many of these users’ comments expressed concern that their medical providers did not understand this condition. The study also found that the quantity of posts about fentanyl and withdrawal have increased over a seven-year period. These findings have played a key role in bringing to light the urgency of this issue for physicians researching withdrawal assistance drugs. 

In France, a similar study took place to better understand breast cancer patients’ quality of life. The researchers used an algorithm to scan comments left on Facebook and a French online forum for breast-cancer patients. Researchers compared these insights with the European Organization for Research and Treatment of Cancer’s quality of life questionnaire to ensure it was inclusive of the most pertinent topics. The online comments brought to light two additional topics that were top of mind for patients—nonconventional treatments and patients’ relationships with their families—which will be added to future iterations of the questionnaire for formal study. 

Many researchers seem intrigued by the possibility of using social media data in combination with traditional research. Su Golder, an Associate Professor at the University of York in England, is working on a medical literature review on HPV vaccines, which will incorporate Twitter and WebMD comments. “It’s important to research what the public is worried about,” Dr. Golder said. She notes that the benefits of social media data—patient perspectives and real-time information—can be meaningful, and that its shortcomings—comments that may confuse association with causation—can be overcome by combining the findings with traditional research efforts. 

Social media data might also work in combination with electronic medical records to improve patient care. A recent study by Dr. Munmun De Choudhury, an Associate Professor at Georgia Tech, created an algorithm to predict psychosis relapses and re-hospitalizations using the social media posts of 50 adult and adolescent psychosis patients who suffered relapses and hospitalization, along with their medical records. The study found that in the month preceding the relapse, there were distinct changes to social media usage in the form of language patterns—words related to “anger, death, or emotional withdrawal”—and the number of posts between midnight and 5am. The algorithm was able to accurately predict about 71 percent of relapses. Dr. De Choudhury is currently working with the state medical system to determine how to incorporate the algorithm into physicians’ clinical care processes. 

Growth Slowing for GRE in Business School Admissions

Applicants’ use of the GRE over the GMAT in MBA admissions continues to grow, but at a slower rate, according to a recent Poets & Quants analysis. For the past six admissions cycles (since 2016), GRE submissions have been increasing, while GMAT score submissions have been sinking significantly. The last two years, though, have shown a slowing in the GRE growth rate. The flexible test submission policies enacted in response to the pandemic have likely impacted the trend. 

GMAT testing volumes have declined annually since 2012, with the exception of 2016 when the numbers increased slightly compared to the year before. Last year’s GMAT testing volume decreased by 47.7 percent compared to 2018, the last pre-pandemic testing year. And the 2021 testing numbers totaled less than one-third of GMAT’s record-high numbers in 2012. 

Amidst this decline, the GRE testing volumes steadily increased. However, in the past couple of years, this growth has slowed significantly. Poets & Quants points out that, “For every Virginia Darden School of Business, which saw a 10-percentage-point increase in its GRE submissions from MBA applicants in 2021, there is an Indiana Kelley School of Business, which reported an 11-point year-to-year decline.” The analysis notes that in 2019, an average of 13.5 percent of applicants submitted GRE scores at the Poets & Quants-ranked top 25 business schools, but that number jumped to 27.8 percent in 2020. Within schools ranked in the top ten, the GRE submission averages all increased in 2020. Dartmouth’s Tuck led in GRE submissions at 39 percent, followed by Yale and UC-Berkeley at 35 percent. 

This year, within the top 25 schools (24 reported data), the average proportion of GRE submissions increased only slightly, from 27.8 percent to 28.5 percent. And, within the top ten, the average submissions decreased slightly from 28.1 percent in 2020 to 27.9 percent. Stanford, Columbia Business School, Dartmouth Tuck, Duke Fuqua, Michigan Ross, and NYU Stern all reported lower percentages of GRE submissions this year compared to last.

The longer-term trend from 2016 to 2021, though, actually paints a clearer picture of the GRE’s growing place in MBA admissions. Of the top 52 Poets & Quants-ranked MBA programs, 34 schools have increased in the percentage of GRE submissions over time, while just eight have decreased. None of the programs with decreases are ranked in the top 25. 

Female Law School Students Speak Up More in Small Classes and when Professors Use Systematic Methods for Student Participation

Women made up 57.4 percent of the 2021 incoming law school class according to LSAC data. But a new study confirms that they take up much less than half of the speaking time in required first-year lectures. Building on the “Speak Up” studies performed at elite law schools in the early  2000s on women’s participation in law courses, three professors at the University of Virgina— Molly Bishop Shadel, Sophie Trawalter, and J.H. Verkerke—designed three studies to better understand the dynamics at play. They found that while women do participate less than men, given certain conditions, there are structural changes that law professors can implement to promote more balanced classroom discourse. 

The first study was designed to understand the participation disparities between men and women. Using recordings of required first-year courses, Shadel found that the classroom discourse was disproportionately driven by men—62 percent of classroom utterances were attributed to men, while just 38 percent were from women. Men also spoke longer on average (302 seconds) than did women (194 seconds). Notably, the quality of the responses between genders was not significantly different, nor was the confidence displayed when providing the response (measured via use of verbal fillers and “qualified utterances” in the response). Shadel, describing the findings, said, “We saw that when answering cold calls, women spoke just as much as men, and they also spoke just as well and their answers were equally on point. The gender gap appeared when students were allowed to volunteer whether or not to participate.” Additionally, the gender gap occurred in lecture classes and disappeared entirely in classes with 30 or fewer students.

The second study asked students to self-report class participation at four points in time: at orientation, after the first semester, before the second year, and just prior to graduation. Women generally self-reported speaking less in class, however, the responses varied over time. Women reported speaking less in class after their first semester and before their second year. However, at orientation, women expected that they would speak as much as men, and nearer to graduation, they reported speaking as much as men. A disparity between the men and women occurred in the reasons they reported for not speaking. While men were more likely to say they didn’t speak due to a lack of interest in the subject-matter, women reported concerns about the size of the class, classmates’ judgment, or the professor’s personality and perceived supportiveness. Finally, women were also found to be significantly less positive about the Socratic Method than were men across all time periods. And, those students who expressed a greater dislike of the Socratic Method were also less likely to speak in class. 

The third and final study explored the perceived social backlash against class participation. The study authors surveyed the Class of 2021, who were in their third year and were taking courses in-person and online. Survey responses found that men and women reported speaking in similar amounts, and that both gender groups reported a fear of “backlash” after participating. Women reported feeling more backlash from women, and men from men; however, the highest-rated levels of backlash were by women and from women. 

Based upon the study findings, the authors provided recommendations for how law schools and professors might update the classroom environment to promote women’s participation:

• Reduce the number of large lecture courses and increase the number of smaller class (30 or fewer students) offerings 

• Rather than relying solely on volunteers, implement a systematic plan for calling on students to speak in class to drive a more diverse range of participation 

• Reduce reliance on the Socratic method or update the method from cold-calling to letting students know when they will be expected to participate

• Ensure that there is a clear expectation for all students to participate in classroom discourse to reduce the backlash against students who do

Shadel noted her firm belief that every student can learn to articulate their thoughts confidently and well in a classroom setting if given the opportunity. “You need to be able to take a deep breath and just do it,” she said. “If we are making it hard for students to take that deep breath because we’re putting them in a group of 90 people and putting them on the spot only one time, then I don’t think we’re serving them well.”

Medical Students Push for Climate-Related Health Courses

Emory Medical School, at the behest of its student population, has formally incorporated the health impacts of climate change into the medical school curriculum. The addition, which follows many public health programs throughout the country, makes Emory the latest elite medical school to incorporate climate-related health courses. 

Emory’s decision—and the student pressure behind it—falls in line with an article published last fall in The Journal of Climate Change and Health. In the article, survey results (including responses from 600 students from 12 medical schools) showed that most medical students want to include climate change in their studies. 83.9 percent of respondents believed that climate change and its health effects should be included within the core medical school curriculum. 13 percent believed that their school currently provided adequate education on the topic. And just 6.3 percent of students said that they felt “very prepared” to discuss how climate change can affect health with a patient. 

Momentum around educating students on climate change is growing within the medical community. Emory joins Johns Hopkins University, Harvard, Yale, and the University of Washington among others. Johns Hopkins created its Environmental Health Institute in 2007, and in 2017 Columbia University unveiled its Global Consortium on Climate and Health Education. Columbia’s Consortium, which develops best practices for teaching climate health, has now grown to include 47 U.S. medical schools as members, as well as more than 240 schools of medicine, nursing, public health, dentistry, and veterinary medicine globally. 

Additionally, the American Medical Association has endorsed teaching medical students about the impacts of the climate on health. “All physicians, whether in training or in practice for many years, have to be able to assess for, manage, and effectively treat the health effects of climate change,” Lisa Howley, PhD and AAMC Senior Director of Strategic Initiatives and Partnerships said. 

The AAMC understands that there will be some resistance to climate health’s inclusion in already packed curriculums, and have highlighted a few ways climate change has been meaningfully integrated into current medical curriculums:

• At the University of Illinois College of Medicine (Urbana-Champaign), climate-related health risks have been incorporated into case scenarios to promote a physician’s consideration of the environment along with other contextual factors. The physician also learns to incorporate and consider not just medical treatment, but also environmental mitigation factors (masks, HVAC filters, etc.).

• At the Icahn School of Medicine at Mount Sinai (New York City), climate information has been integrated into existing medical content for first- and second-year students. For example, slides that cover Lyme disease also include information on how climate change impacts tick habitats. The information is designed to complement existing content.

• At the University of Colorado School of Medicine, an elective course for fourth-year students titled “Climate Medicine,” incorporates op-ed writing in addition to climate and health content.

• At the University of California San Francisco Medical School, medical students partner with nursing and dentistry students to create the Human Health and Climate Change group to facilitate educational forums and on-campus sustainability initiatives.

INSEAD Announces Immersive Virtual Reality Masterclass for Global Executive MBAs

INSEAD Business School just announced that it would be further incorporating virtual reality (VR) into the learning experience of Global Executive MBA students by offering an immersive, masterclass titled “Mission to Mars.” The simulation will refine students’ management skills and provide an opportunity to exercise decision making in situations filled with ambiguity. After the experience, students will debrief their experiences together. 

INSEAD’s announcement follows a study by PWC on the efficacy of virtual reality (VR) based training for soft skills development. The study compared results for three similar cohorts who received training via different delivery mechanisms: classroom, e-learn and v-learn (VR). The results showed that the VR learners were four times faster to learn than classroom learners, 275 percent more confident in applying the material, 3.75 times more connected to the material than classroom learners, and four times more focused than e-learners. 

Ithai Stern, the Academic Director for INSEAD’s VR Immersive Learning Initiative, has previously provided insights into the lessons INSEAD has learned from experiences with VR, in the classroom and remotely, as a learning tool for its MBA and Executive Education students. Similar to the findings of the PWC study, Stern has found VR to be highly effective, and also noted that the best ways incorporate VR are through individual study and case studies. 

“In INSEAD courses, a VR headset, which is responsive to real-time head movements, allows a unique experience for each participant within the framework of fixed content (e.g., a boardroom scenario, a factory tour, or a market). As a result, participants can think through a specific situation in a low-risk, controlled environment, testing decisions and assumptions without being judged by fellow participants—and without being unduly influenced by any higher-ups that may also be in attendance. To benefit the group as a whole, these individual virtual experiences are typically preceded and followed by in-depth shared discussion,” he wrote.

Stern also acknowledges the unique ability of VR to promote empathy within students by placing them into new contexts previously not possible. “For example, it's the first time in history where, when I teach directors, I can literally position the 50 plus white male in the classroom in the body of the only black woman on the board of directors,” he said.

Stern, however, does point out that while VR is an excellent supplement to the business school curriculum, it is not a replacement for the “knowledge, feedback, and guidance” that professors, and classroom discourse provides students after their VR simulations. Other business school leaders, interviewed by the Financial Times on the use of technology in business school, take a more cautious approach to the use of VR suggesting that while it could be useful to simulate a real-life situation, it may be less practical due to its individualized nature and the equipment demands. 

Law School Admissions Council to Pilot Program that Replaces Standardized Testing Requirement with Defined Undergraduate Curriculum

The Law School Admissions Council (LSAC) recently announced that it is developing a pilot program, which will offer an alternative pathway to law school—one that does not require standardized testing. Rather, it will gauge student readiness using a defined undergraduate curriculum meant to prepare students for the rigors of law school. 

During the pilot, LSAC will partner with undergraduate institutions to define and implement a curriculum that students will complete before graduation to earn eligibility to apply to law school without LSAT or GRE scores. The underlying idea is that the curriculum will prepare students for the same skills that the LSAT covers. Currently, Cornell College in Mt. Vernon, Iowa, Northeastern University, and the University of Maryland Eastern Shore have committed to participate and are helping to develop the program. There is also an 11-member advisory committee including law school deans from University of Michigan, Northwestern, Howard, Suffolk University, and UC Berkeley.

LSAC representatives do not see the program as one that will eventually overtake standardized testing as the primary path to law school, but they are hopeful that it will create a viable alternative that could increase access to legal education. Kaitlynn Griffith, LSAC Vice President of Product Development and Business Intelligence, describes the pilot as a way to broaden the pipeline for law school. “One of our founding principles on this was to look at diversity, equity and inclusion and ask, ‘How can we be opening more doors into the legal profession?’” 

Once the pilot is in place, which will likely include having the initial group of participating students take the LSAT to validate their performance and readiness, the LSAC will have a continued role to play in convincing both the American Bar Association and law schools to accept the new applicant pathway. Griffith notes she is hopeful that, after a successful pilot period, the program will expand to include more undergraduate universities.

Medical Student Calls for Greater Transparency in Residency Match Data

National Match Day took place on Friday, March 18, 2022. According to the National Resident Matching Program, NRMP, it was a successful day, which “realized many significant milestones” including: 

• Consistent or increased match rates across applicant types: 

--US MD Seniors PGY-1 matched at 92.9 percent (+0.1 percentage points from 2021)

--US DO Seniors matched at 91.3 percent (+2.2)

--US citizen international medical graduates matched at 61.4 percent (+1.9)

--Non-US citizen international medical graduates matched at 58.1 percent (+3.3)

--And it was the highest match rate on record for previous year graduates, with US MD graduates matching at a rate of 50.5 percent (+2.3), and DO graduates matching at a rate of 53.6 percent (+9.3).

However, a recent article written by Nicole Mott, a student at the University of Michigan Medical School, and published in the New England Journal of Medicine, with a follow-up interview on MedPage Today contends that most current match reporting only tells part of the story. Mott is calling for the NRMP to reconsider how the match rate is calculated and to provide additional transparency into the match data. 

She starts by pointing out aspects of the current reporting that can be misleading or confusing. 

• The published NRMP “match rate” doesn’t include all specialties and programs; it excludes ophthalmology, urology, and military training programs. 

• The variation in match rates by applicant type should always be called out explicitly (as seen above) in recognition of the significant variation in match rates between applicant types: MD Senior, DO Senior, IMG (citizen or non-citizen), and graduates (MD, DO). The media often just reports one overall (or applicant type) match rate, which can be misleading and create inaccurate expectations among applicants regarding the likelihood of receiving a match. 

Next, she calls for a reconsideration of how the current match rate is calculated. Currently, the match rate is the proportion of “active applicants” who match into a participating residency program. However, an “active applicant” is someone who registers for the NRMP match and submits a rank order list. Mott points out that approximately eight percent of NRMP registrants withdraw or do not submit a rank order list and are thus excluded from the calculation. This includes participants who apply to programs but are not invited to interview and therefore do not submit a rank order list. This definition of active applicant likely inflates the match rate and underestimates the number of physicians who are unable to find a residency placement. 

She also provides suggestions for data that, if made publicly available, would help inform medical students as they make plans for the future.

• The number of applicants who register for NRMP match and don’t submit a rank order list, as well as the characteristics of this group. This would provide insight into potential inequities in the process, as well as applicant competitiveness for specialties. 

• The number and characteristics of unmatched physicians including those who only match into a preliminary first-year position. It would also be helpful to include information on the careers these physicians pursue and where they ended up, which could inform physician workforce planning. 

• Detailed match outcomes relevant to students going through the process, which could inform students pursuing a match, and also drive systemic improvements. This may include the specialty-specific matching positions on rank order lists, which could also inform decisions such as application or interview caps. 

Mott notes that the proportion of MD and DO seniors matched to their top-ranked programs has “subtly declined” over the past 15 years and, during the same period, the number matched to their fourth-ranked choice or lower has increased. Additionally, she calls out the “over-congestion” in the residency application process. Applicants are now applying to more programs than ever, just as programs are receiving more applicants. She recommends a review of the data to determine if caps should be placed on the number of applications and interviews. Similarly, she calls for more transparency from residency programs in their selection criteria. Programs should be explicit in the criteria they seek in an applicant, and applicants should be more specific about their goals and geographic preferences. 

Ultimately, better data, and more visibility into the match process will benefit students and residency programs, and allow each to make the best possible decisions.

More MBAs Seek Investors to Fund their Search, Acquisition, and Management of an Existing Small Business

Last week, the Wall Street Journal highlighted a small but growing career trend among MBA graduates: seeking investors who will fund their search, acquisition and management of an existing small business. 

A Wharton Magazine article described this niche career path, “The model, at its core, involves working with a group of investors to locate, acquire, manage, and grow a privately held business. The “searcher” starts by raising funds from a group of investors and then spends two to three years looking for one special business to acquire and grow. After finding the right business, the searcher is expected to take on a management role at the company and relocate to the business’s headquarters. One of the key differences between the search fund model and traditional venture capital and private equity fund models is that the search fund model is focused on the business owner and is designed to provide a unique transition plan to take the business to the next level.”

Although search funds are not new to MBA graduates, according to the WSJ, they have grown during the pandemic as investors with access to capital are seeking more investment opportunities. In 2019, Stanford’s Graduate School of Business counted 51 new search funds. In 2020, preliminary numbers showed 70 funds. And estimates suggest that more were launched in 2021.  

Initially most searchers came from Harvard or Stanford, though today, a growing number of MBA programs are developing search related offerings and bringing in experienced professors from the industry. “Search is really taking off. It doesn’t get better than the search fund model. The average person who does this is 32 years old, a very young CEO,” said Jan Simon, an MBA professor teaching a search fund course at UC Berkeley  Haas,  In addition to Haas, courses on search funds are now available at IESE, Duke, Dartmouth, and Columbia to prepare students to raise money from investors, as well as to understand the many complexities of the location and acquisitions process. Additionally, MIT, Northwestern, and other universities regularly host clubs and networking events for search, which have garnered the interest and participation of hundreds of students. 

While searchers can accelerate their careers and avoid some of the startup pitfalls by acquiring an established business, this career path necessitates a high-risk tolerance. They forego the support of an MBA program’s career center, as well as the stability of a position within a larger company. And the WSJ notes that about a third of searches end without an acquisition. Prospective MBA students wishing to pursue search should ensure that they select a program that has a support infrastructure with professors, coursework, and a network to best set them up for success. 

Access the Stanford Graduate School of Business Search Fund Primer to learn more. 

Nearly 100 Percent of 2L Summer Associates Receive Full-Time Employment Offers

Earlier this month the National Association for Law Placement (NALP) released its Perspectives on 2021 Law Student Recruiting report describing a surge in legal recruiting. The coupling of last year’s conservative hiring stance with strong industry-wide financial performance and a rebound in demand for legal services, has brought a resurgence in law firms’ hiring. James Leipold, NALP’s Executive Director, writes in the report that, “Law firms have been scrambling for talent at both the lateral and entry levels. As a result, recruiting activity in 2021 was robust, with offer rates for summer spots reaching their highest mark since 2007.” 

Among second-year students with summer associate positions at law firms, 97 percent received offers for full-time associate positions post-graduation, and 89 percent—an all-time high— accepted the offers. Similarly, among first-year summer associates, 93 percent received an offer to return for a second summer and 72 percent accepted the offer. Additionally, in the fall, 53 percent of law schools reported an increase of more than ten percent in the number of firms participating in on-campus recruiting (in-person or virtual) for summer 2022 positions for second year students, compared to last year. And 73 percent of law firms reported that they made more offers for summer associate positions for this summer compared to last.   

When it comes to entry into big law firms, prospective law students should review Law.com’s annual ranking of “go-to law schools,” which ranks schools according to the percentage of 2021 graduates that accepted associate positions at the 100 largest law firms (based on number of attorneys). 

The top ten schools include: Columbia (64 percent), University of Pennsylvania (60 percent), Cornell (56 percent), Northwestern (52 percent), Duke (51 percent), NYU (51 percent), UVA (48 percent), UC Berkeley (45 percent), University of Chicago (45 percent), and Harvard (41 percent). While the top schools have seen some movement, notably Duke narrowly overtaking NYU for a spot within the top five, Columbia has been the top feeder into big law firms for the past nine years. Law.com’s article does note that the ranking excludes clerkships, which likely explains the absence of Stanford and Yale in the top ten. In addition to the go-to law school rankings for big firms, Law.com also publishes a list of “Firm Favorites” that can provide valuable insight into those law schools firms recruit most heavily from.  

Yale Continues Reign as Top-Ranked Law School in Latest US News Ranking

The US News and World Report published its 2023 Best Law School Rankings today with Yale and Stanford (again) taking the top two positions. Notably, University of Chicago overtook Harvard for the third rank, while Harvard dropped to fourth, a spot it shares with Columbia University. Generally, the top ten looked similar to past years, with some slight movement, including Duke University dropping out of the top ten, to the eleventh rank, from tenth last year. 
Find the complete 2023 Best Law Schools ranking.

Harvard Medical School and University of Washington School of Medicine Maintain Top Ranking in US News’ Ranking of Research and Primary Care Medical Schools

Among research-oriented medical schools, Harvard and NYU Grossman maintained their positions in the top two spots of the US News ranking. However, the top ten did see movement with Johns Hopkins University School of Medicine moving up into the third spot, from a tie at seventh place last year. Johns Hopkins shares the third rank, in a three-way tie, with Columbia University and University of California San Francisco. University of Pennsylvania’s Perelman School of Medicine also moved upwards, from ninth place last year to a tie at number six this year. Perelman shares the sixth rank with Duke University.

Find the complete 2023 Best Medical Schools: Research ranking.

For the primary care ranking, the top two schools maintained their places with University of Washington first, followed by the University of California San Francisco. Two new schools entered the top ten—University of California Davis moved up three spots to the eighth rank, from eleventh last year, and University of Pittsburgh had a meteoric rise into the top ten from the thirty-fourth rank last year. The school shares the tenth rank, in a three-way tie, with University of Kansas Medical Center and University of Massachusetts Chan Medical School.

Find the complete 2023 Best Medical Schools: Primary Care ranking.

US News Ranks Chicago Booth and UPenn Wharton as Best Business Schools

The US News and World Report published its 2023 Business School Rankings today with University of Chicago’s Booth and University of Pennsylvania’s Wharton taking the top spot, previously held by Stanford’s Graduate School of Business. Stanford fell to the third rank, which it shares with Northwestern University’s Kellogg. Generally, the top ten looks similar to last year, although there was some movement. Notably, University of Michigan’s Ross moved to the 10th spot from 13th last year, and Dartmouth’s Tuck and NYU’s Stern, who were tied at 10th last year, dropped to 11th and 12th respectively. NYU Stern shares the 12th ranking with Duke’s Fuqua. 

Find the complete 2023 Best Business Schools ranking.

Chicago’s Booth also took the top spot in the part-time MBA program rankings. As per usual, there was no movement within the top five ranked part-time programs, with each program retaining its rank from last year. In fact, the top five ranked part-time MBA programs have been consistent for the past four years of rankings. 

Find the complete 2023 Best Part-time MBA ranking.

Narrative Medicine Helps Physicians Gain Empathy, Make Connections, and Accept Difficult Experiences

Creative writing may not be the first course that comes to mind when you think about a pre-med or medical school curriculum. But, writing—along with other arts and humanities courses—can play a vital role in preparing medical students for life as a physician. 

Rita Charon, along with a multidisciplinary group of scholars, founded the discipline of narrative medicine in 2003, in response to the increasingly bureaucratic direction of medical care. Narrative medicine’s goal is to recenter physicians on the humanity of their patients by providing tools to allow physicians to contextualize patients outside of the hospital setting and uncover ways to connect by considering a patient’s pain, stories, life, and loved ones. Charon describes narrative medicine as a “...commitment to understanding patients’ lives, caring for the caregivers, and giving voice to the suffering.” 

The benefits of incorporating narrative medicine, or the study of arts and humanities into the medical curriculum are clear. In 2010, Columbia Medical Students were required to take a half-semester arts and humanities course in narrative medicine, and these students were then interviewed in focus groups about the experience. The findings, published in the Journal of Academic Medicine in 2014, were summarized: “Students’ comments articulated the known features of narrative medicine—attention, representation, and affiliation—and endorsed all three as being valuable to professional identity development. They spoke of the salience of their work in narrative medicine to medicine and medical education and its dividends of critical thinking, reflection, and pleasure.” 

In addition to promoting empathy and connection, Pulitzer Prize-winning journalist Michael Vitez, Director of Narrative Medicine at Temple University’s School of Medicine, spoke to the value that writing can provide in helping students work through complex and painful experiences. He described a medical student who wrote a poem after a difficult day in her psychiatric rotation. “It helped her process her emotions and turn a really bad day into something valuable,” he said. 

Narrative medicine can also bolster physicians who are struggling with symptoms of burnout. “No one was talking about clinician burnout at that time. But, as narrative medicine programs began to spread across the country, some physicians trained in its principles began to see how it can protect clinicians from feeling a sense of depersonalization and other symptoms of burnout,” Dr. Charon told Neurology Today. In the same article, Sneha Mantri, MD, MS, and Assistant Professor of Neurology at Duke University School of Medicine, described how her struggle caring for critically ill patients during residency led her to seek an MS in Narrative Medicine. In her view, the degree gave her the tools to return to medical practice and deal with the “burnout-inducing frustration of treating chronically ill patients with difficult-to-manage symptoms” and replace it with empathy for the patient’s perspective and the reminder “that knowing medical facts is just one part of caring for a patient.”

If you are a premedical or medical student with an interest in the arts and humanities, pursue it! It will likely play an invaluable role in preparing you to analyze, contextualize, and show up for patients with empathy and understanding. And as you prepare your applications for medical school, residency, or fellowship, be sure to highlight the skills that you have gained through previous humanities coursework and experiences, and the perspectives you have gained. 

Examples of narrative medical texts here: 

“How to Tell a Mother Her Child Is Dead,” Naomi Rosenberg, MD, New York Times

“What We Talk About When We Talk About the Code,” Lilli Schussler, JAMA Cardiology

Related blogs:

Covid Crisis Brings Attention to the Need for Humanities in Medical School Curriculum

New Attorneys Lack Leadership and Client Interaction Skills

Law students name communication as the top soft skill required for lawyers. Practicing lawyers are more likely to say that it’s judgment. Bloomberg Law’s Law School Preparedness Survey provides insight into how law school prepares new attorneys for legal careers from the perspective of practicing attorneys, law students, faculty, and law librarians. And, on this particular point, attorney and student views were not quite aligned. After communications, students named research and self-management as the top soft skills, while attorneys placed communication and self-management after judgment.

Veteran attorneys were also asked to rate new attorneys’ soft skills on a scale from very weak to very strong. Not surprisingly, attorneys ranked new arrivals highest on email skills with 77 percent of attorneys reporting the skill slightly strong, strong or very strong. Attorneys ranked critical thinking (68 percent), organization skills (62 percent), and verbal communication (62 percent) next highest among the soft skills. On the other end of the spectrum, leadership skills and client interactions garnered the highest percentages of very weak, weak, or slightly weak ratings, at 65 and 64 percent respectively. Networking, decision-making, and judgment fared only slightly better with over 50 percent of attorneys rating new attorneys weak in these skills. Notably, the practicing attorneys’ ratings did not overlap significantly with the views of faculty, who generally rated new attorneys’ soft skills more positively, with the exception of client interactions and email.    

The survey also asked respondents where they thought the skills should be taught: in undergraduate courses, in law school, or on the job. There was consensus across all groups— attorneys, law students, faculty, and law librarians—that writing and research skills should be obtained prior to starting work and that management skills should be taught on the job. Across the groups, a majority felt that research and writing skills should be taught in law school. As for soft skills, there was a lack of agreement across groups. Law students and law librarians believe soft skills belong in the undergraduate curriculum at 46 and 47 percent, respectively. Attorneys were most likely to say that soft skills should be acquired on the job (43 percent), and 47 percent of faculty thought soft skills should be taught in law school. 

Finally, veteran attorneys were asked what skills they wish new attorneys had prior to practicing, and what skills they wish they had been taught prior to starting work. For new arrivals, the vast majority named client communications and interactions (80 percent), and professional writing (79 percent). Similarly, attorneys said that they wished they had learned client interactions (55 percent), conflict management (42 percent), leadership skills (33 percent), and professional communications (31 percent) prior to starting their careers.

Find the full survey results here.

Employers’ Need for Junior Employees Spurs Highly Competitive Summer Intern Market

The Wall Street Journal describes the current recruiting environment as one with unprecedented student leverage. Firms are scrambling to onboard junior employees. According to corporate recruiters, the offers are so plentiful, and many so generous, that they are seeing an increase in students reneging on previously accepted internship offers. Some employers say that they are boosting intern salaries to remain competitive. Others are increasing communications with students who have accepted offers to maintain the relationships. 

Private equity firms are expected to increase intern salaries again this summer. In 2021 the median monthly salary for private equity interns from Columbia, Harvard, and Stanford topped $11,000. This was a particularly notable spike for Columbia students who reported a 2019 median monthly salary of $9,000, and a solid uptick for Harvard and Stanford students who averaged just above $10,000 in 2019. The increases were likely due to pressure from investment banking and consulting firms, where interns made monthly median salaries in 2021 of $12,500 and $13,500, respectively. 

In addition to increasing compensation, private equity recruiters are updating their tactics in response to the competitive market. Ann Anastastia, Vice President of HR for the Americas and Greater China at Advent International, tells the Wall Street Journal, “I have been in private equity for over 15 years and in HR for over 25, and I have never seen anything like this recruiting climate.” She will start the MBA recruiting process much earlier this year, kicking off in the fall as opposed to January. Additionally, the WSJ article notes that private equity firms are promoting themselves more on campus, and engaging directly with students on topics including compensation, work-life balance, diversity, and career development. “In the past, private-equity firms haven’t needed to do that,” said Deirdre O’Donnell, Director of M.B.A. Career Services and Advising at Dartmouth’s Tuck School of Business. 

Law School Admissions Officers Express Preference for LSAT Over GRE Scores

Last November the council of the ABA’s Section of Legal Education and Admissions to the Bar voted in favor of allowing law schools to accept GRE scores in place of the LSAT for admissions decisions. However, a recent Kaplan survey suggests that law school admissions officers still give admissions preference to students who submit LSAT scores. 

Kaplan’s survey respondents included representatives from 25 schools that accept both LSAT and GRE scores from applicants. Of these, 13 reported an admissions advantage for students who submit LSAT scores and the remaining 12 reported that they view the tests equally. None of the schools expressed a preference for the GRE. 

Jeff Thomas, Kaplan’s Executive Director of Legal Programs, summarized the survey results: “What Kaplan’s survey shows is that while there is some definite movement to accept the GRE among law schools, there’s still not full acceptance. Of the schools we spoke with that accept scores from both exams, half say that applicants who submit LSAT scores have the edge over GRE applicants. In fact, no law school we spoke with gives the edge to GRE applicants. Some admissions officers noted the LSAT is created specifically for law school admissions so they have more faith in it, while the GRE, as its name suggests, is much more of a general exam. Schools also treat LSAT students more favorably, giving quicker admissions decisions to LSAT applicants, and scholarship awards exclusively to LSAT applicants. Our research suggests it will be at least several more years before law schools fully warm up to the GRE.”

The survey also provided an opportunity for law school admissions officers to write narrative responses. These direct quotes, while anonymous, offer additional insight into how admissions officers view the two tests. 

Some express a greater faith in the validity of the LSAT’s predictive value for an applicant’s performance in law school. 

“The GRE does not breed confidence in me to put my professional reputation on the line. (I still have bills to pay….) The primary reason why we are including the GRE as an option is because the faculty of this institution didn’t want to ‘fall behind’ the law schools. Well, how do we know where those other law schools are going? How do we know that that direction is the direction that we need or want to take?”

“The advantage to the LSAT is that it is established, accepted universally, and unique to law school. The vast amount of data and history gives it predictive value. Individually, there can be a benefit to someone who can perform better on the GRE, but in terms of competing in a pool, it is still relatively unknown in law schools.” 

“Individuals with an LSAT score will probably need to wait less time to receive an admissions decision. This is because the individuals who evaluate the application for admission have more faith in the validity, reliability and minimization of standardized testing bias that accompany the LSAT.”  

“From my own experience, the GRE is a glorified SAT that doesn’t actually tell us anything about a prospective student’s ability to be an effective law student. The LSAT’s not perfect, but it’s a much better diagnostic tool.” 

Others suggest that taking the LSAT is more indicative of a commitment to law school and the legal profession, as opposed to the GRE which may imply that an applicant is considering law school among other graduate options. 

“For now, we believe that applicants most interested in attending law school will take or have taken the LSAT. Considering the high focus on the cost of law school, graduate debt load, and volatile employment outcomes, we think it is prudent to admit students who have been preparing for law school over time. In addition, there is data that asserts the GRE has the same bias as other standardized tests, so it remains to be seen whether it will result in a significant increase in diverse applicants overall.” 

Finally, another admissions officer pointed out that the LSAT is the preferred test when it comes to determining who will receive scholarship funds.

“We do not offer robust scholarships to GRE only applicants.” 

Physicians Less Likely to Feel Happy Outside of Work

The covid-19 pandemic has caused significant stress to medical caregivers. And it extends beyond their professional lives. Medscape’s 2022 Physician Lifestyle and Happiness report provides insight into physicians’ habits, downtime, work-life balance, and relationships, and includes responses from more than 10,000 U.S. physicians representing almost 30 specialties. 

When asked about their life prior to the pandemic, eight in ten physicians reported that they were very (40 percent) or somewhat (41 percent) happy outside of work. Now, fewer than six in ten say that they are happy outside of work. Just 24 percent say they are very happy and 35 percent are somewhat happy. And, notably, just one-third of respondents feel that they have enough time (always or usually) to spend on their own health and wellness, with men more likely to have time (38 percent) than women (27 percent). Just under half of physicians, 44 percent, “sometimes” have the time to focus on their own wellbeing.

To maintain their happiness and mental health, most physicians say that they spend time with family/friends (68 percent), engage in activities/enjoyable hobbies (66 percent), and exercise (63 percent). Just under half say they focus on getting enough sleep (49 percent) and eating healthy (44 percent). The majority of physicians do say that they exercise regularly—34 percent exercise two to three times a week and 33 percent exercise four or more times a week.  When asked about weight, about one-third say that they are working to maintain their current weight (30 percent), while just over half are looking to lose weight (51 percent). 

Over half of physicians, 55 percent, say that they would take a salary reduction to have a better work-life balance, an increase of eight percentage points from 47 percent a year ago. Female physicians are more likely to express a willingness to take a pay cut for improved work-life balance, with 60 percent saying they would give up salary for balance compared to 53 percent of men. In terms of time away from work, most physicians take between one and four weeks of vacation; 30 percent take one to two weeks and 40 percent take three to four weeks. These numbers are similar to last year’s report. 

Most physicians are married or in a committed relationship (89 percent of men, 75 percent of women). And the majority, 82 percent, describe their marriage as very good or good, which is similar to last year. While the percentages are high across specialties, 91 percent of otolaryngologists and immunologists describe their unions as good or very good, while critical care (76 percent) and plastic surgery (75 percent) fall on the lower side. Forty-three percent of physicians are married to another physician or healthcare worker, though the majority (56 percent) are married to a partner outside of medicine. Among physicians who are parents, 35 percent feel conflicted between work and family demands. Almost half of female physicians, 48 percent, are conflicted or very conflicted, whereas 29 percent of their male counterparts report feeling the same. About 30 percent of both men and women physicians report feeling somewhat conflicted.

Physician wellbeing is critical for preventing burnout, particularly in the aftermath of the pandemic, as burnout levels remain high and directly impact the quality of care provided to patients. The AMA has taken on the topic of physician burnout to spur advocacy, research, and provide tactical resources to improve wellbeing, which prospective and current medical students may wish to review. Medical students should strive to integrate wellbeing practices into their lifestyles as early as possible—healthy dietary and movement habits, outlets for stress, and strong relationships that may help them to withstand the stress of medical school and patient care.