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The Challenge of Staying Happier: Testing the Hedonic Adaptation Prevention Model

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The Challenge of Staying Happier: Testing the Hedonic Adaptation Prevention Model

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Sheldon and Lyubomirsky (2012) argued in this paper that hedonic adaptation does not just occur from bottom-up processes (i.e., declining positive emotions generated by the positive change) but also the top-down processes (i.e., increased aspirations for even more positivity).

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How would you balance your outside interests with studying a degree?

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What do you feel are the good and bad points about being a doctor?

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What qualities do you have that mean you will be a good doctor?

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do we have to be worried about job opportunity? bcs i heard there's too much of doctors nowadays

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what do you love the most about your speciality?

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How much will us earn when we are still in houseman?

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lets talk about salary.

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Is there race bias in hospital. Some mentor prefer some race like that

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Is there race bias in hospital. Some mentor prefer some race like that

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How to become an emergency medicine specialist?

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How to pass EOB?

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Can we do housemanship overseas?

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What if he/she prefers patient interactions but chooses to continue a surgical specialist in hope to do research?

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Share your experience during ho

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what does an emergency specialist do specifically?

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I heard people said doctors have no job nowadays. True ah?

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do i have to be worried about my soulmate for now

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do i have to be worried about my soulmate for now

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please share how you challenge yourself, finishing medical school

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is being an emergency specialist as busy as the dramas show us?

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How old are you?

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Can you share your journey of becoming a specialist? (From A to Z)

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Maslow hierarchy of needs

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Click on this link to access this padlet

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Click on this link to access this padlet

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https://tinyurl.com/y5o47mrs

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Here's How Money Really Can Buy You Happiness

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Here's How Money Really Can Buy You Happiness

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Money misery

The new science of happiness starts with a simple insight: we’re never satisfied. “We always think if we just had a little bit more money, we’d be happier,” says Catherine Sanderson, a psychology professor at Amherst College, “but when we get there, we’re not.” Indeed, the more you make, the more you want. The more you have, the less effective it is at bringing you joy, and that seeming paradox has long bedeviled economists. “Once you get basic human needs met, a lot more money doesn’t make a lot more happiness,” notes Dan Gilbert, a psychology professor at Harvard University and the author of Stumbling on Happiness. Some research shows that going from earning less than $20,000 a year to making more than $50,000 makes you twice as likely to be happy, yet the payoff for then surpassing $90,000 is slight. And while the rich are happier than the poor, the enormous rise in living standards over the past 50 years hasn’t made Americans happier. Why? You overestimate how much pleasure you’ll get from having more. Humans are adaptable creatures, which has been a plus during assorted ice ages, plagues and wars. But that’s also why you’re never all that satisfied for long when good fortune comes your way. While earning more makes you happy in the short term, you quickly adjust to your new wealth—and everything it buys you. Yes, you get a thrill at first from shiny new cars and TV screens the size of Picasso’s Guernica. But you soon get used to them, a state of running in place that economists call the “hedonic treadmill” or “hedonic adaptation.”

Doing things can bring us more joy than having things. Our preoccupation with stuff obscures an important truth: the things that don’t last create the most lasting happiness. That’s what Gilovich and Leaf Van Boven of the University of Colorado found when they asked students to compare the pleasure they got from the most recent things they bought with the experiences (a night out, a vacation) they spent money on.

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Here's How Money Really Can Buy You Happiness

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Research shows you can use your hard-earned cash to improve the quality of your life. You just have to know what to spend it on

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What the lecturer says (Dr. Dr. Ang Ai Ling, Psychiatrist): 

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What the lecturer says (Dr. Dr. Ang Ai Ling, Psychiatrist): 

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What do you are the top three characteristics that a student should have to pursue a career in your field:

1. Patience
2. Empathy
3. Good communication skills
(not in a particular order)

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What the lecturer says (Dr. Dr. Htwe Htwe Chit, Internal Medicine Physician): 

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What the lecturer says (Dr. Dr. Htwe Htwe Chit, Internal Medicine Physician): 

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What do you are the top three characteristics that a student should have to pursue a career in your field:

1) Having good physical and mental health. (It will cover important things like stamina, ethics, interpersonal skills etc).

2) Having the ability to acquire good theoretical knowledge and physical skills (physical skills for 1st year level)

3) Ability to apply and analyze the knowledge

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What the lecturer says (Dr. Myo Nyunt, Surgeon): 

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What the lecturer says (Dr. Myo Nyunt, Surgeon): 

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What do you are the top three characteristics that a student should have to pursue a career in your field:

Three characteristic should be:

ready to work under stress

well observant to clinical signs

respect to patient safety

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7 Reasons Why Spending Money on Experiences Makes Us Happier Than Buying Stuff 

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7 Reasons Why Spending Money on Experiences Makes Us Happier Than Buying Stuff 

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The assumption had been that spending money on material possessions would increase happiness because possessions last longer than an experience. A 20-year study by Dr. Thomas Gilovich, a psychology professor at Cornell University, found the opposite is true.

Dr. Gilovich is just one of several researchers who believe in the the Easterlin Paradox. This phenomenon simply states that after our basic needs have been met, money will only increase happiness to a certain point for several reasons including the fact that:

Happiness over material items quickly fades.

“One of the enemies of happiness is adaptation,” says Dr. Gilovich. “We buy things to make us happy, and we succeed. But only for a while. New things are exciting to us at first, but then we adapt to them.”

Psychologists call this "hedonic adaptation." In other words, the excitement of that new car, iPhone or furniture set will quickly fade into the background as they become a part of our daily lives. Experiences, like traveling, attending an art exhibit or trying a new restaurant become a part of our identity, which brings us greater satisfaction.

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Image credit: ramihalim | Getty Images

Opinions expressed by Entrepreneur contributors are their own.

Because they're now the largest age demographic, I spend a lot of time researching and discussing millennials. What I've found most interesting about this demographic is how they prefer to spend their money on experiences over stuff.

Millennials "aren't spending our money on cars, TVs and watches," Taylor Smith, CEO and co-founder of Blueboard, told CNBC. "We're renting scooters and touring Vietnam, rocking out at music festivals, or hiking Machu Picchu."

This statement was backed-up by a study conducted by the Harris Group that found out that 72 percent of millennials prefer to spend more money on experiences than on material things.

The thing is, this isn't exactly limited to millennials.

Researchers have been studying how people could allocate their money to make themselves happier. The assumption had been that spending money on material possessions would increase happiness because possessions last longer than an experience. A 20-year study by Dr. Thomas Gilovich, a psychology professor at Cornell University, found the opposite is true.

Dr. Gilovich is just one of several researchers who believe in the the Easterlin Paradox. This phenomenon simply states that after our basic needs have been met, money will only increase happiness to a certain point for the following reasons:

1. Happiness over material items quickly fades.

"One of the enemies of happiness is adaptation," says Dr. Gilovich. "We buy things to make us happy, and we succeed. But only for a while. New things are exciting to us at first, but then we adapt to them."

Psychologists call this " hedonic adaptation." In other words, the excitement of that new car, iPhone or furniture set will quickly fade into the background as they become a part of our daily lives. Experiences, like traveling, attending an art exhibit or trying a new restaurant become a part of our identity, which brings us greater satisfaction.

"Our experiences are a bigger part of ourselves than our material goods," says Gilovich. "You can really like your material stuff. You can even think that part of your identity is connected to those things, but nonetheless they remain separate from you. In contrast, your experiences really are part of you. We are the sum total of our experiences."
Related: You Should Spend Your Money on Experiences, Not Things
2. Experiences define your purpose and passions.

Your daily activities should be guided and influenced by your purpose and your passions, not material possessions.

Think of it this way. Let's say that your favorite musician of all-time is Bruce Springsteen. Even though you have all of his albums, and some other items like shirts or posters, do all of those possessions top seeing The Boss in concert? Probably not. In fact, if someone offered you a front-row ticket in exchange for all of your Bruce memorabilia, you would probably take them up on that offer in a heartbeat.
Related: Money -- Even Lots and Lots of Money -- Can't Buy You Happiness
3. Possessions don't contribute to social relationships.

"We consume experiences directly with other people," says Gilovich. "And after they're gone, they're part of the stories that we tell to one another."

Do you bond more with other people when discussing material possessions or experiences? Think of Bruce again. When you run into a fellow fan, you have a certain bond and connection. You can talk about his music, the concerts you've attended and how much his music has positively impacted your life. That seems like a more in-depth and interesting conversation that discussing your cars, gadgets, wardrobe or even your Boss souveniers, right?

Social relationship expert John Hall, author of the book recently told me "Relationships are like ketchup -- only you can figure out if you need to have it on your burger or not." We can all relate to wanting or not wanting this.
Related: 10 Reasons You're Still Not Happy
4. Moments are more memorable.

While experiences are designed to be fleeting, they provide high level of arousal and memorability thanks to anticipation. Again, let's revisit The Boss.

You hear he's coming to town, so you mark your calendar not only for the date of the show, but also when tickets go on sale. You're anticipating purchasing tickets and then attending a show after you've secured your tickets. Going to this show is an entire experience, not just a singular moment.
Related: How Very Successful People Think Differently
5. Experiences introduce you to a whole new world.

Unlike stuff, experiences introduce you to new perspectives, life lessons and the importance of gratitude. Take traveling, for example. If you live in New York City and travel to West Virginia, you may realize the pros and cons of living in the Big Apple. Even though there's culture, public transportation and plenty to do, that weekend trip south made you appreciate nature, the quiet and the beauty of clear, starry nights.

You may realize and come to understand cultural differences. Even if you don't agree with these points-of-view, at least you've walked away learning how to be more thoughtful, compassionate, humble, or grateful.
Related: How She Built a $50 Million Postcard Empire
6. Stuffocation.

Do you have a garage full of stuff? That build-up of junk that you'll never use can actually do harm to your mental health. This is because when our homes are filled with junk and clutter it increases our levels of stress.

7. It's no fun keeping up with Joneses.

"The tendency of keeping up with the Joneses tends to be more pronounced for material goods than for experiential purchases," says Gilovich. This is because, according to research from Ryan Howell and Graham Hill, it's easier to feature-compare material goods than experiences.

"It certainly bothers us if we're on a vacation and see people staying in a better hotel or flying first class. But it doesn't produce as much envy as when we're outgunned on material goods."

In other words, spending money on experiences can decrease this envious behavior, which means that we'll be healthier and happier in the end.
What makes you more happy? Money or experiences?

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7 Reasons Why Spending Money on Experiences Makes Us Happier Than Buying Stuff

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Opinions expressed by Entrepreneur contributors are their own. Because they're now the largest age demographic, I spend a lot of time researching and discussing millennials. What I've found most interesting about this demographic is how they prefer to spend their money on experiences over stuff.

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Science Says Money Does Buy Happiness If You Spend It the Right Way 

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Science Says Money Does Buy Happiness If You Spend It the Right Way 

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There is frequent talk about how much money it takes for someone to truly be happy. Many studies have shown that happiness levels increase with income up to roughly $75,000 in annual salary. After that, there tends to be little correlation between income and happiness.

The reason that money demonstratively increases happiness levels up until a point is that it takes a certain salary to feel financially secure. Having enough money means no anxiety when shopping at the grocery store, going out to eat or paying your rent. This type of security is overlooked when you are used to it.

Money can lend you the opportunity to have memorable experiences. Although you do not need a lot of money to have certain experiences, to travel the world and do so comfortably, significant amounts of money can go a long way. Therefore, spending money on experiences will give you many moments of happiness as well as positive memories to look back on.

One important point to note is that the experiences you pay for should be ones that you genuinely enjoy, not just things that society values. If you hate going to concerts, for example, then splurging to go to a show is not a good use of your money.

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Opinions expressed by Entrepreneur contributors are their own.

There is frequent talk about how much money it takes for someone to truly be happy. Many studies have shown that happiness levels increase with income up to roughly $75,000 in annual salary. After that, there tends to be little correlation between income and happiness.

For me, I think making 1000x more than that seems like the best option in the world. But what I've found is that with more money comes a lot more stress in my life. That being said, I still like it.

The studies

These studies are looking at averages, not the experience of any particular individual. There are some people happy making $30,000 a year and others who believe they need hundreds of thousands to support their lifestyles.

These studies are not looking at how people are spending their money. There have been many studies demonstrating that people are happiest when they spend money on certain things. Therefore, money really can buy happiness if you spend it correctly.
Related: Here's How Much Money You Have to Make to Be Satisfied and Happy
Eliminating financial anxiety

The reason that money demonstratively increases happiness levels up until a point is that it takes a certain salary to feel financially secure.

Having enough money means no anxiety when shopping at the grocery store, going out to eat or paying your rent. This type of security is overlooked when you are used to it.

Remembering and being appreciative of the fact that you are free to purchase things, though, will make you happier even after it has settled in as normal amount of your finances. Fundamentally, having enough money to buy these basic necessities will no doubt increase your happiness levels.
Related: My Constant Hustle and Grind Led to a Serious Anxiety Attack -- Don't Let It Happen to You
Buy experiences.

Money can lend you the opportunity to have memorable experiences. Although you do not need a lot of money to have certain experiences, to travel the world and do so comfortably, significant amounts of money can go a long way. Therefore, spending money on experiences will give you many moments of happiness as well as positive memories to look back on.

One important point to note is that the experiences you pay for should be ones that you genuinely enjoy, not just things that society values. If you hate going to concerts, for example, then splurging to go to a show is not a good use of your money.

This is despite how many others might tell you they are jealous. Instead, you should buy experiences you truly enjoy. The examples are endless but include vacations, sporting events, nice meals, tours and shows.

Money can also enable you to learn new things. You could buy musical instrument lessons or pay for a fitness instructor to get into better shape. Picking up new skills and finding hobbies that we love will make us happier. Consequently, it is worthwhile to spend money to get more out of your hobbies and interests.
Related: 7 Reasons Why Spending Money on Experiences Makes Us Happier Than Buying Stuff
Give to charity.

Giving back to others also makes us happier. Sharing your wealth with those who need it can go a far way in others' lives. Being able to see the impact you are making is a warm feeling. Subsequently, wealth gives you a larger opportunity to give to charity and leave an impact that will leave both others and yourself better off.

I personally have gotten involved with Open to Hope and Compassionate Friends. Both these organizations help people who are suffering with grief from the loss of someone in their life. We help millions each year, and I'm proud to help. Both organizations give me a peace inside that I'm truly helping give back more from this world than I'm taking. I recommend you get involved with a chartiy and put your heart into it.

Help loved ones.

Another great way to spend money is on people you care about. Helping a sibling, parent or friend through a tough time can be a great feeling. Even being able to throw extra money into a birthday party for your child or a good friend will make you happier.

Without higher levels of wealth, it can be difficult to rationalize putting money into things like this. When you have the opportunity, though, it will make you happier.

Buy things that give you more free time.

An underrated way to spend your money is on saving yourself time. There are many tasks we do throughout the day that we do not enjoy. These differ for everyone, but examples might include doing the laundry, cooking, driving and doing household chores.

When you have more money, you can spend it on eliminating these meaningless tasks. You can pay others to do them for you or find ways to automate them with technology. Doing so will free up time so you can do more of what you love.

Some items are also valuable.

One of the largest struggles faced with buying things is that, although they are novel and exciting at first, they become normalized and you forget to appreciate them. That is why, generally, experiences tend to create higher happiness levels than items.

Of course, this is not always the case. Buying things you will be able to frequently appreciate and use often will generally make you happier.

One good example is art. If you are someone who enjoys art, then buying paintings and pictures for your house will make you happier. You will frequently see them and can take the time whenever you would like to appreciate and admire them. While I personally don't enjoy art, many around me do, like my wife and several members of my family. Find what's important to you, then make time on your schedule for it.

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Science Says Money Does Buy Happiness If You Spend It the Right Way

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Opinions expressed by Entrepreneur contributors are their own. There is frequent talk about how much money it takes for someone to truly be happy. Many studies have shown that happiness levels increase with income up to roughly $75,000 in annual salary. After that, there tends to be little correlation between income and happiness.

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Another good guide on chossing a medical specialty. This resource is originally available at this URL.

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Roadmap to Choosing a Medical Specialty 

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Physician burnout: It’s not you, it’s your medical specialty

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Physician burnout: It’s not you, it’s your medical specialty

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Physician burnout: It's not you, it's your medical specialty

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When thinking about becoming a physician, medical students might be interested in knowing which specialties can be considered the most stressful medical jobs. More than 15,000 physicians from 29 specialties responded to a recent survey about burnout and depression. The survey asked about the prevalence of burnout factors and how they affect physicians' lives.

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High income improves evaluation of life but not emotional well-being

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High income improves evaluation of life but not emotional well-being

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Link to the full text of the paper by Kahneman and Deaton (2010)

High income improves evaluation of life but not emotional well-being

Daniel Kahneman, Angus Deaton

Proceedings of the National Academy of Sciences Sep 2010, 107 (38) 16489-16493; DOI: 10.1073/pnas.1011492107

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High income improves evaluation of life but not emotional well-being

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Recent research has begun to distinguish two aspects of subjective well-being. Emotional
well-being refers to the emotional quality of an individual’s everyday experience—the
frequency and intensity of experiences of joy, stress, sadness, anger, and ...

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Listed on this page are some of the practical decision making tools. For the purpose of this talk, click on "factor exercise".   The exercise enables you to compare careers you may be interested in so you need to have thoroughly researched the ones you are considering.  It allows you to list the factors you want to include in your decision and to assign a value to them in terms of their importance.

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This page provides some useful exercises that are designed to help you consider decisions in a thoughtful way.

Try out some of the exercises below to help you with these decisions:

When using the exercises, bear in mind:

different people make decisions in different ways - if you have a method that works then use it

you must take responsibility for your own decisions. Good decisions come from examining the reasons that underpin them and these tools will help you to do this

if one approach doesn't work, try adopting a different strategy

you can only make a decision based on the information known at the time. Do you need to do some more research?

perfect decisions are rare. Strive to make a decision which best fits your ideal criteria in light of your current circumstances

At first, this may seem labour-intensive but rest assured that these exercises can provide a structure and balance that just 'thinking things through' cannot.

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This page provides some useful exercises that are designed to help you consider decisions in a thoughtful way. Try out some of the exercises below to help you with these decisions: When using the exercises, bear in mind: different people make decisions in different ways - if you have a method that works then use it you must take responsibility for your own decisions.

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A popular, fun algorithm to choosing medical specialty. 

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A popular, fun algorithm to choosing medical specialty. 

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This is a popular algorithm, often used in light (and not so light) chats and discussions among doctors on choosing medical careers. Click here for the original source: https://www.bmj.com/content/331/7531/1529

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Dear students, this is the wall where you can write your own idea, question, videos, post link, curate contents, blah blah on career exploration for medical students. All ideas and questions are allowed as long as no profanity and sensitive remarks. Perhaps to start with,  tell us what do you wish to learn or what question do you have on this topic.

Class activities:

Based on the description of the different specialties given in this link, describe in your groups some of the characteristics that are needed to pursue a career in that specialty. Share your group findings in this padlet

Based on the 4 crucial questions given here and here, share in this padlet, what are some of the probable career choices you may want to pursue and give your reasons.

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This specialty Guide is designed to simplify medical students’ specialty selection process, highlight major specialties, detail training information, and provide access to related association information.

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FREIDA's Specialty Guide is designed to simplify medical students' specialty selection process, highlight major specialties, detail training information, and provide access to related association information.

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FREIDA's Specialty Guide is designed to simplify medical students' specialty selection process, highlight major specialties, detail training information, and provide access to related association information.

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National Specialty Register Malaysia Database

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National Specialty Register Malaysia Database

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This database lists all the current medial specialties recognized by Malaysian Medical Council (MMC) and the qualification criteria necessary to be a specialist in that field. Click here to access

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Which Medical Specialty Would Suit You? Quiz

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Which Medical Specialty Would Suit You? Quiz

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There are many different medical specialties. Would you be best suited to cardiology or A&E? Is working as a GP or a psychiatrist the right fit? Or are you best suited to medical research?

Remember that while this quiz is designed to give you a good idea of the specialty that would suit you, remember that this quiz is only a fun indication!

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Which Medical Specialty Would Suit You? Quiz - The Medic Portal

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Would you be best suited to cardiology or A&E? Is working as a GP or a psychiatrist the right fit? Or are you best suited to medical research?

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Choosing a medical specialty: 4 questions to help get you started

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Choosing a medical specialty: 4 questions to help get you started

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1. Procedures or patient interaction?

2. How do you want to interact with patients?

3. What kind of work-life balance do you want?

4. Who do you want to treat?

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As a medical student pondering your future as a physician, there are many key considerations in choosing a medical specialty to pursue. The most obvious move-particularly considering the $100,000-plus loan debts most medical students accumulate-may be to go straight to a list of the highest-paid medical specialties and proceed from there.

Yet a physician's day-to-day existence is shaped by factors that extend well beyond compensation.

The AMA offers tools to aid you with your medical specialty choice, including the Choosing a Medical Specialty resource guide (member login required). For specialty-specific insight, the AMA's "Shadow Me" Specialty Series offers perspective from physicians in fields such as infectious disease, adolescent medicine, physical medicine and rehabilitation, radiology and orthopedic surgery, among others.

These four questions can help you narrow down your medical specialty choice.

Procedures or patient interaction?

On the surface, this question comes down to surgery versus office-based care. Some specialties, such as obstetrics and gynecology, may offer a mix of both.

"In medical school, I knew that I wanted to engage deeply with my patients every day, help them lead happy and productive lives, and have fun too," said Caroline Barangan, MD, a pediatrician who focuses on adolescent medicine. "So, I chose a field that isn't all about medical procedures and crises. Because of this, I knew that my salary would support a comfortable lifestyle but not an extravagant one."

How do you want to interact with patients?

Primary care specialties such as internal medicine, family medicine or pediatrics offer the opportunity to form lasting relationships with patients while others, such as radiology, feature limited patient interaction and more time working on the technical aspects of medicine.

"I have had many of my patients in my practice for 15-20 years, so I get to form such long-lasting, meaningful relationships with them," said Susan Thompson Hingle, MD, an internist. "I truly get to know my patients as people, and I am forever grateful for that."

What kind of work-life balance do you want?

Some people are at their best when the pressure is on and the hours are long. Working in that kind of medical specialty is not for everyone. A recent survey found that the specialties with the highest levels of burnout were those in which the stakes were the highest.

"Work-life balance is important for all human beings," said Amit Pandya, MD, a dermatologist. "Because the amount of work for a doctor can be overwhelming, it's important to put limits on the amount of income one desires and work one has to perform on a daily basis. Although I work hard, I take time off every day for myself to pursue time with family and friends, exercise or hobbies that help bring balance into my life."

Who do you want to treat?

Circumstances and demographics are going to change depending on the type of medicine you practice. Use your clinical training to map out the types of patient populations you enjoy working with and the scenarios in which you might thrive.

"Internal medicine patients tend to be older and sicker, with multiple medical problems and often significant social and psychologic challenges as well," Dr. Hinkle said. "However, internists-me included-enjoy the complexity this provides. It is so rewarding to work through not only the acute issue at hand, but how that interdigitates with their chronic issues and how to best provide patient centered care."

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Choosing a medical specialty: 4 questions to help get you started

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As a medical student pondering your future as a physician, there are many key considerations in choosing a medical specialty to pursue. The most obvious move-particularly considering the $100,000-plus loan debts most medical students accumulate-may be to go straight to a list of the highest-paid medical specialties and proceed from there.

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Family Medicine, Rad Onc, or OB? How to Choose a Specialty

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Family Medicine, Rad Onc, or OB? How to Choose a Specialty

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For many medical students, choosing a specialty is one of the most challenging aspects of medical school. Although many medical schools are expanding third-year exposure to different specialties to include more time in clinical rotations and a wider variety of experiences, it remains a relatively short amount of time and exposure from which to base a career choice. A few students enter medical school with the goal of becoming a vascular surgeon or rural primary care doctor, but many are swayed to another specialty by the myriad of clinical experiences and career advice they receive. Often medical students believe they have chosen a specialty only to change their mind in the next rotation.

NEJM Resident 360 recently hosted a rich discussion on choosing a specialty ( Family Medicine, Rad Onc, or OB? How to Choose a Specialty). I wish there was an easy checklist or formula for making this choice, but the decision is driven by many individual factors and unique experiences. In this blog post, I review some tips offered in that discussion and add some other suggestions for choosing a specialty.

For many medical students, choosing a specialty is one of the most challenging aspects of medical school.

It's never too early to begin thinking about your specialty career choice

Even though a specialty decision is not required until you submit your list into the National Resident Matching Program ( NRMP) early in your fourth year, it's never too early to begin thinking about your specialty career choice. Until then, take advantage of every opportunity to learn about different specialties. I recommend that you also make the most of the numerous clinical opportunities offered through your medical school (e.g., volunteering in a free student-run clinic or shadowing in the emergency room). Spend an afternoon with a primary care provider even if you see yourself going into a surgical field.

Use every opportunity to talk to attendings from different specialties

Working with physicians in a variety of settings during medical school provides you with a unique opportunity to learn about the different specialties. Also, seek advice from mentors (e.g., medical school deans and clinical attendings) to help you through the process of choosing a specialty. As you start to whittle down your choices, hopefully late in your third year or early in the fourth year, try to identify a few mentors that you can trust to give you unbiased viewpoints. Schedule a meeting with a program director or associate program director in a specialty of interest. Although residents and fellows can give you some insight into why they chose a specific specialty, their advice might be biased by limited experience or a particularly stressful rotation.

Factors to Consider When Choosing a Specialty

Clinical Experience

Clinical experience is the most influential factor in choosing a specialty. Every specialty involves a wide variety of job descriptions, depending on the practice setting, provider interest, and local clinical needs.
For example:

A surgeon is not only involved in surgical cases, but also sees patients in a surgical clinic, provides consults to patients in the hospital, and inserts central lines for nonsurgical patients admitted to the hospital.

A pediatrician working as a clinician-researcher in an urban medical center will most likely have a much different weekly schedule than a pediatrician working in a rural setting where the closest hospital is 40 miles away.

To add to the variety in careers, subspecialties in internal medicine such as gastroenterology can be even sub-subspecialized into fields such as hepatology or inflammatory bowel disease. That being said, each specialty encounters definite "flavors" of clinical cases.

During the third year of medical school, you will find yourself gravitating towards certain cases or never wanting to leave the hospital on certain rotations. Take the time to evaluate when and why you gravitate toward certain cases or rotations. Were the cases interesting, did you like the pace, or was the setting perfect for you? Identifying these factors will take you a long way towards identifying a career specialty. It is important for medical students to ask attending physicians what their work week looks like, what cases they see in a typical day, and what their job would like if they were in a different setting. Almost every field involves less-desired cases or nonclinical tasks that providers struggle with; these should not be major factors in specialty choice because avoiding them is impossible.

Take the time to evaluate when and why you gravitate to certain cases or rotations.

After residency and/or fellowship, most of your clinical care, possibly research, and learning will occur in the clinical area of your specialty. Unlike medical school, where you focus on one specialty for 4 to 8 weeks, most or all of your post-medical school training and career will be in that one specialty. Most of your colleagues, clinical care, conferences, and journals will be related to that specialty. Although factors such as work-life balance and salary are important, I cannot emphasize enough how important it is to truly enjoy the clinical work you will spend your life doing. Therefore, you should choose a specialty where you truly enjoy the clinical care. Several colleagues have said that if they could go back in time, they would choose a different career in medicine as they do not enjoy their current work. Although the prospect of choosing a "wrong" career can be daunting, you can be assured that each specialty in medicine offers a wide variety of career options. It is never too late to change practice locations or career focuses.

Although factors such as work-life balance and salary are important, I cannot emphasize enough how important it is to truly enjoy the clinical work you will spend your life doing.

Procedures

The number of procedures involved in each specialty varies. A specialty that requires lots of procedures is obviously important if you are a hands-on person. Some residencies (e.g., internal medicine) include career options with varied levels of procedures.
For example:

Internal medicine trained gastroenterologists might spend most of their week doing endoscopies while primary care physicians might only do intermittent procedures (e.g., joint injections).

Within a specialty such as cardiology, an interventional cardiologist spend most days doing procedures while a clinic-based cardiologist never does procedures.

Students should also consider where they like to complete procedures. Do you like working in the operating room with a team of nurses and technicians or as an endocrinologist doing ultrasound-guided biopsies in the clinic setting?

Career Goals

Some medical students will have set career goals (e.g., oncology researcher, global health, or family medicine doctor in a rural setting). If you are someone with a preference or predefined career goal, make sure that your specialty choice will give you the best opportunity to reach that goal. Even if your career goals are just beginning to formulate, consider how your specialty choice will lead you towards those career goals.
For example:

A student who wants to work with children and adults might be undecided about choosing between a family medicine residency and a combined medicine-pediatrics residency. If the student is not interested in obstetrics, they should consider a combined medicine-pediatrics residency.

Choosing a career that is rewarding and fulfilling is also very important. Although relatively nebulous concepts, they factor into your career goals.
For example:

Working as a general surgeon in an under-resourced setting might not garner as much attention as being a trauma surgeon in a big academic setting, but physicians working in under-served areas often have high levels of job satisfaction and fulfilment that far exceed their colleagues in other settings.

Work-Life Balance

Work-life balance is an increasingly important factor in career choice. Certain specialties (e.g., emergency medicine or hospitalist medicine) have set shifts that limit direct clinical duties. In contrast, specialties such as general surgery can require long work hours and less work-life balance, depending on the setting. More and more, physicians are deciding to work part time or on alternative schedules (e.g., work for 5 days on and then have 5 days off). Although some specialties do not lend themselves to these type of schedules, considering the options within each specialty is important. Also consider your long-term life goals.
For example:

Do you hope to be parent with 3 children with a job that offers the flexibility to attend kids sporting events?

Do you want to be able to travel abroad for several months per year?

Certain specialties and practice settings lend themselves to more job flexibility than others. Note that while the Accreditation Council for Graduate Medical Education (ACGME) limits all resident and fellowship training duty hours to a maximum of 80 per week, duty-hour regulations after training do not exist. Attending physicians in certain specialties (e.g., general surgery) can routinely work more than 80 hours per week, depending on the setting. But, if your work is rewarding and brings you joy, you might not think twice about an 80-hour work week. Each individual should consider factors such as expected weekly work hours and coverage for emergencies.

Salary

Between medical school and undergraduate tuition and associated costs, a medical student can graduate with large loan repayment obligations. Future salary potential is another factor to consider in your career choice. The field of medicine offers a wide range of salaries, depending on factors such as number of procedures, practice setting, and patient volume. Current physician salaries and job availability are partially based on supply and demand that can change drastically in a short period of time. Technology advancements and increased numbers of advanced practitioners have already started to affect career opportunities in areas such as radiology and anesthesiology. What will happen to physician salaries is uncertain as more hospital systems move toward Accountable Care Organizations (ACO) with greater emphasis on cost control, including minimizing the use of unnecessary tests, procedures, and consultations. One thing that is certain - as a physician you will be relatively well compensated and have stronger job security than most adults in the United States.

Personality

At some point in your training, you will realize the strong association between personality types and career choice, with some obvious exceptions (e.g., internal medicine). However, in general, certain personality types gravitate to certain specialties. As you rotate through your clinical rotations, take the time to see if you match well with the resident and attending personalities around you. The personalities you are exposed to in these settings will often correlate with the personalities in other settings.

As you rotate through your clinical rotations, take the time to see if you match well with the resident and attending personalities around you.

In closing, choosing a specific specialty in medicine can seem daunting. Your medical school training provides you an once-in-a-lifetime opportunity to work with providers and in specialties across the entire spectrum of medicine. Make the most of these opportunities to help you decide on a career. Choosing a specialty is usually not an easy stepwise decision. Each student should consider all the personal and specialty specific factors that go into making this choice. Taking the time to define your career and life goals will take you a long way towards helping you choose a specialty. Good Luck!

Dr. Noronha is currently an associate program director for the Internal Medicine Residency at Boston University School of Medicine. He has served on Association for Program Directors in Internal Medicine E-Learning and Communication Committees. Dr. Noronha is the Director for Quality Improvement Education at Boston Medical Center.

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Family Medicine, Rad Onc, or OB? How to Choose a Specialty

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For many medical students, choosing a specialty is one of the most challenging aspects of medical school. Although many medical schools are expanding third-year exposure to different specialties to include more time in clinical rotations and a wider variety of experiences, it remains a relatively short amount of time and exposure from which to base a career choice.

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The 10 Things Economics Can Tell Us About Happiness

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The 10 Things Economics Can Tell Us About Happiness

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Generally speaking, richer people are happier people. But young people and the elderly appear less influenced by having more money.

But money has diminishing returns -- like just about everything else. Satisfaction rises with income until about $75,000 (or perhaps as high as $120,000). After that, researchers have had trouble proving that more money makes that much of a difference. Other factors -- like marriage quality and health -- become more relatively important than money. It might be the case that richer people use their money to move to richer areas, where they no longer feel rich. Non-economists might chalk this up to the "keeping up with the Jones'" principle.

The diminishing-returns principle is true for entire countries, too... The "Easterlin Paradox" suggests that once a developed country passes a threshold average income, more growth doesn't increase average reported happiness.

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As a naturally analytical person, I am constantly in pursuit of ways to "hack" my life with the collection of data and manipulation of my habits. Recently, I stumbled upon the idea of the Law of Diminishing Returns.

For those unfamiliar with this economic principal, here is a working definition:

The Law of Diminishing Returns is a concept in economics that if one factor of production (number of workers, for example) is increased while other factors (machines and workspace, for example) are held constant, the output per unit of the variable factor will eventually diminish. Although the marginal productivity of the workforce decreases as output increases, diminishing returns do not mean negative returns until (in this example) the number of workers exceeds the available machines or workspace.

In everyday experience, this law is expressed as "the gain is not worth the pain."

But, there is a way to get around that pain and still experience the gain.

As I invest more time, energy, money, etc. into something, there eventually comes a point where I stop reaping the results I used to in proportion to my investment. How do I capitalize on this? Keep reading...

Low on the scale, the ROI is high. As you make your way up the scale, the ROI decreases and can eventually become negative.

At some point, what I am investing will either not be worth the return, or will return negatively.
How do I know when my ROI is no longer worth the investment?
Let's take this into a real-world situation: Jon Doe's Video Career

At the start of his videography career, Jon invests a chunk of money into quality gear [Here the comparison is between Money(x) and Quality(y)].

There comes a point when the proportion of his investment to his return will decrease. In other words, at a certain point, the amount of money he spends on new gear will only be able to bring his quality up a small amount compared to what his ROI was when he started.

When he reaches this point, he should begin to invest his money in other areas of his career, such as hiring actors instead of using his friends. Instead of investing in better camera gear - which will now only show a small difference in quality - he should invest in actors which will show a large boost in overall quality.
He will invest the same amount of money, but have a higher return on quality because he moved his money when he experienced diminished returns.

In the case above, the idea was not to stop the investment of money, but to invest that money into different areas where it was not previously invested. When you notice that returns begin to diminish, reallocate your investment.

Jon changed what he was investing his money into, and still reaped a high return on quality.

Another thing that could be done in the above example is to change the investment. The desired return is quality, so no matter what is invested, the goal is to see an increase in quality.

Instead of investing money into getting better camera gear - which at this point would cost thousands instead of hundreds of dollars - Jon could start to invest time into things like storytelling, learning how to edit, etc. Now his return is still quality, and he is saving the money he would have spent on expensive cameras to reap a low proportion of return on quality.

Here are some of my personal investments and desired returns:
Investments

Time

Money

Energy/Effort

Knowledge

Desired Return

Knowledge (Yes, an investment can also be a return. Think about investing money.)

Ability to travel

Healthy life

Deeper relationship with God

I encourage you to apply this principle to your own daily life and habits.

Take a few moments to write down the things that you want to acquire, learn, and become in this season of your life.

Think about the things that you have at your disposal to invest.

Thanks for taking the time to read this. Seriously. It means a ton. Feel free to let me know what you think!

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The Law of Diminishing Returns: How economics can be used to accelerate personal growth.

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As a naturally analytical person, I am constantly in pursuit of ways to "hack" my life with the collection of data and manipulation of my habits. Recently, I stumbled upon the idea of the Law of Diminishing Returns.

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Salary is definitely one of the considerations in career choices. In the initial stage, however, you will all go through the same process (housemanship) with similar salary. Hence, it is important to budget carefully. Take a look at these articles:

https://www.thestar.com.my/news/nation/2019/11/03/malaysian-salaries-are-insufficient

https://www.thestar.com.my/news/nation/2019/11/03/are-salaries-keeping-up-with-increased-prices#cxrecs_s

https://www.thestar.com.my/news/nation/2019/10/28/economist-rm1200-minimum-wage-still-below-living-wage-in-klang-valley#cxrecs_s