The design and operation of the RealMD program is notable in three main ways:
- Integrates career, professional identity, and leadership development
- Emphasizes practice over competence
- Provides choice and agency in one’s development
Integrating Career, Professional Identity, and Leadership Development
RealMD is a professional development program which takes a holistic approach towards the development of the student during medical school. Often, career development is something separate from leadership development. We don’t think they should be separate. Often, career development and leadership development take place in the context of tasks (e.g. writing your personal statement) or skills (e.g. negotiation), but with little or no connection to the development of the student’s professional identity. We believe the student’s professional identity must be cultivated and integrated into the context of career and leadership development.
REAL MD (Professional Dev) = Professional Identity Dev + Career Dev + Leadership Dev
A main strategy of the program is to link professional identity development with career development with leadership development. The integrated approach strengthens each component and makes the whole program more effective.
Students and faculty will be encouraged to reflect and develop answers to key questions in the domain of Meaning (e.g. What matters most to me?), Community (e.g. How do I develop meaningful connection with others?), and Purpose (e.g. What am I committed to that is greater than myself?). The answers to the questions will be refined during medical school and will serve to help students define their professional Identity.
Medical school is a professional school. We will be working with students on Day 1 to help define their professional direction. The career development component will define a robust process that demystifies the career development process. Students will be able to meet with career advisors to plan and navigate the process effectively, leading to positive outcomes (e.g. finding mentors, making good decisions on specialty, interviewing well, matching)
We believe that all doctors are leaders. Leadership is a state of being rather than a title or position. Leadership is developed in medical school through the reinforcement of professional values. This process is a relationship and a dialogue with those in the community (faculty, students, staff) about becoming the best doctor one can be to provide great service to patients and to one’s community.
Emphasizing Practice Over Competence
The development of purpose and character is a life-long practice. One does not master it in a few years and then move on to the next task. We believe that medical school is time to develop habits and practices which will be continued and refined in professional practice. Therefore, although this program does have objectives, it does not define competencies relative to those objectives. Rather, the program seeks to promote practice along three principles:
- Leadership – relating to the objective of Purpose. We don’t mean stuff to put on the CV. We mean the activities that people take on through one’s initiative to benefit others within the professional community or the patient community. How has a person, as a result of being in a community, left that community in a better place?
- Participation – relating to the objective of Community. Relationships are an indispensable part of a meaningful education. People value relationships through their participation. RealMD facilitates community and belonging through activities which invite people to show up and participate.
- Reflection – relating to the objective of Meaning. What is a person’s (unique) purpose? A professional is not a blind follower of rules and incentives. Professionals take the responsibility to define their relationship to their profession. One’s purpose is one aspect of the relationship and taking time to reflect is an essential part of the process.
Providing Choice and Agency in Development
Part of the process of professional identity and leadership development is agency and choice. Only those who are free to choose can make the commitment needed to grow in meaning, community, and purpose. Therefore, the RealMD program is an “opt-in” program. Learners can participate based on the depth of their commitment. For some, certain elements may not feel appropriate. The RealMD community will encourage learners to engage in developmental activities but will not compel people to do so.
The process of professional identity development and leadership development is developmental rather than based on set standards. It is difficult to enforce a minimum standard for “sense of purpose” at the end of a program. Rather, the aim is for a greater sense of purpose relative to the starting state of the learner. It is also worth noting the distinction between purpose and sense of purpose. It is difficult to define a standard for purpose that is static; our purposes in life shift and change. Rather than assessing whether one’s stated purpose is the “right” purpose, the goal is to increase one’s sense of purpose, which is the factor which guides one’s action.
The RealMD program is not a curriculum in the traditional sense. There are no summative assessments; learners do not “pass” or “fail” professional identity development. Assessments are not a major aspect of the program, and if they are used, they are formative only. We want learners to reflect, participate, and initiate leadership activities. We use the word “want” intentionally, because we do not require that learners participate. For example, although students do have to interview as a part of the residency process, they do not have to have an authentic message. This may sound counter-intuitive, but it is difficult to mandate authenticity, empathy, or ethics. People may comply outwardly to mandates, but the RealMD program is not looking for superficial compliance.