How and why we set up the High Impact Medicine Career Fellowship

And what we learned from piloting it with two groups in early 2023

Summary

We developed and piloted the Hi-Med Career Fellowship, a five-week programme for medical students and doctors who aim to increase the positive impact they have through their careers.
The ease with which we recruited participants suggests to us that a significant number of medical students and doctors have a strong interest in impact-focused career planning support.
By choosing to participate in our pilot programme, all 11 fellows committed to spending at least ~15-20 hours on career planning. We provided them with information, resources, and structure, as well as social support and accountability.
By the end of the fellowship, all participants had completed a “Career Masterplan,” and all but one of them completed a feedback survey. The overall evaluations of the programme were broadly positive.
We also learned a lot from running the programme.
Following the successful completion of the pilot groups, three more groups have completed the programme, and six additional groups have begun it.
Markus concludes the post by reflecting on his personal experience with leading the planning, execution and evaluation of Hi-Med’s Career Fellowship.

Introduction

The Hi-Med Career Fellowship is a five-week online programme designed to help medical students and doctors to explore, plan, and begin to act on impact-focused short- and medium-term career goals. In this post, we explain the programme’s rationale, goals, and structure. We also explain how we set up and ran our pilot programme and what we learned from it.

We expect that this post will be most useful for you if you are:

considering applying (as a participant or facilitator) for a future cohort of the fellowship,
considering running a similar programme yourself, and/or
interested in the outcomes of our pilot programme and the lessons we learned from it.

If you are interested in becoming involved in future cohorts of the fellowship, or if you are considering running a similar programme yourself, we warmly invite you to reach out to us at highimpactmedicine [at] gmail.com. We would love to hear more about you and your interests. And if you have feedback or thoughts about this post or our fellowship, we would be very happy to hear them. If you’d prefer to submit feedback anonymously, you can do so through this form.

Background

High Impact Medicine (Hi-Med) is a non-profit organisation dedicated to inspiring and empowering medical students and doctors to make impact-driven decisions in their careers and giving. Since our inception in November 2021, we’ve conducted various programmes, interacting with >500 medical doctors and students from around the world. Our activities include fellowships (>320 participants), coaching calls (>210 calls), setting up mentoring relationships (>33 pairs), producing a podcast (15 episodes), writing academic publications (1 published and 1 under development), and setting up a university collaboration. We’ve grown our community to >760 newsletter subscribers and >460 Slack members. Please have a look at our Theory of Change and our 2023 Impact Survey Executive Summary to get a better understanding of our work.

Rationale

There are millions of doctors and medical students in the world, and many of them are (unsurprisingly) already motivated to help others (Győrffy, Birkás, & Sándor, 2016; Xu, 2014; Yang et al., 2021). There is a very wide range of positively impactful careers for which medical students or doctors could be a good fit if they choose to pursue them, and they do not all require specialty training or clinical work. Through such careers, it is possible to work on some of the major problems in the world, from pandemic prevention to reducing antibiotic resistance. Many of these career options can span multiple disciplines, including academic research, policy formulation and implementation, operations, advising, and advocacy. With sufficient forward planning, some of these paths may allow individuals to do far more good than an average clinical career; furthermore, many of these paths can be pursued alongside, before, after, or even instead of specialty training.

Despite this, medical career planning is often assumed to mainly involve selecting a specialty and progressing through speciality training. It is also common for career advice to implicitly assume that doctors will either be working in a hospital or a clinic/practice (e.g., this is implicitly assumed here, here, and here).

We have collaborated with Probably Good to produce a career guide that aims to make medical students and doctors aware of the wide range of ways in which they can have a high-impact career (including, but without necessarily limiting themselves to, the “traditional” options available to them). But when it comes to actually putting these principles into practice, we have noticed that many of the people we talk to who aspire to help the world are hesitant to spend time on career planning. Career planning can be a complex and challenging topic, leaving many people unsure where to start. Finding time for career planning can be difficult, and it’s often a challenge to locate helpful resources.

Additionally, figuring out one’s career path alone can be confusing, and you might not know who to talk to, learn from, or check in with. (In her 2022 post, “80k would be happy to see more projects in the careers space,” Michelle Hutchinson acknowledged the value that can come from planning one’s career alongside others, such as in a workshop setting.)

In summary, medical students and doctors face multiple barriers to planning positively impactful careers. Our five-week-long Career Fellowship aims to remove each of the barriers we identified. Participants are medical students or physicians who apply from around the world. They typically find the application form via newsletter updates, social media posts, or personal referrals.

Characteristics and goals of the Career Fellowship

In one of the appendices, we provide specific examples of how each of the problems described above translated into the specific career planning needs and desires of our pilot participants, along with the ways in which our fellowship seeks to address each of these areas. We also provide a very brief summary of the fellowship characteristics and goals in the table below.

Fellowship characteristics & goals
The Career Fellowship…	The purpose of this was to…
Provided a structured curriculum that: Introduced career planning tools such as cause area prioritisation and Weighted Factor Models Included a selection of external courses (from Non-Trivial and Clearer Thinking) and readings (including from 80,000 Hours)	Provide structured guidance (which many students and doctors have previously reported to us that they’ve been lacking when they face the prospect of trying to plan their careers)
Required fellows to commit to a dedicated time each week (for five weeks) for group discussions and for doing self-directed exercises before each of these	Create a mechanism by which people could spend more time on career planning than they otherwise would have
Paired fellows up with another fellow who then acted as their “impact buddy” throughout (or, depending on the cohort, beyond) the fellowship	Provide accountability and social support
Formulation of a specific near-term plan (by each fellow) that represented the culmination of the previous weeks of reflections and planning	Provide a sense of confidence and direction for fellows as they plan their next steps

Fellows’ satisfaction with the pilot programme

Since the pilot programme only involved a limited number of participants, we cannot draw any strong conclusions regarding the outcomes for participants. However, the feedback we received was very helpful in qualitatively identifying the ways in which we were creating or failing to create the outcomes we hoped for.

It seems that the programme was well-received by the pilot cohorts: they appeared to enjoy it (Figure 3) and were likely to recommend it to others with similar interests to them (Figure 4). This provides some tentative evidence that the programme was engaging and that it aligned relatively well with participants’ interests.

Figure 3: Fellows’ responses to the question, “How did you like the fellowship overall?” Available response options ranged from “Very poor,” 1, to “Excellent,” 10.

Figure 4: Fellows’ responses to the question, “Would you recommend the programme to a friend with similar interests to you?” Available response options ranged from “Definitely not,” 0, to “Definitely,” 5.

Summary of general lessons we learned from developing and evaluating our Career Fellowship pilot programme

We provide the context for the first six lessons in the Appendices. The last lesson is expanded upon in the next section.

There are many high-quality resources available for planning high-impact careers. This helped us to design the fellowship curriculum efficiently.
It takes at least 20 hours of work to prepare to run a five-week-long Career Fellowship.
There appears to be demand for this fellowship. Despite spending very little time (and no money) on recruitment, we found it relatively easy to find highly motivated people to participate in our Career Fellowship.
It’s worth knowing your audience. For example:
- All of our fellows were medical students or doctors who placed a strong emphasis on having a positive impact when planning their careers.
- Our content tended to focus on short- and medium-term goals, which made it useful to the majority of our fellows, who were facing imminent career decisions. The programme was less useful for the minority of participants who weren’t facing imminent career decisions.
- We believe that much of the value of the fellowship arises from the fact that it provides a mechanism by which fellows are guaranteed to spend at least ~15-20 hours on career planning. For people who’ve already spent significant time on career planning, the fellowship may have been less useful.
At the same time as setting up the programme, it’s worth investing significant time in planning how to evaluate programmes over time.
Both positive and negative feedback is critical for iteratively improving your programme over time.
Running a programme like this is a process of continual learning. It helps to invest a lot of time in planning, seeking feedback from others, and iteratively improving.

Personal reflections

In this section, I (Markus) reflect on my personal experience with leading the planning, execution and evaluation of Hi-Med’s Career Fellowship.

Personally, I’ve struggled with vague ideas about my future career and the cause area I would like to work in. I never expected it to turn out so helpful to have a clear and structured way to sort through all my areas of interest and potential next steps. That was one of the main things I learned through initiating the Career Fellowship.

Helping to set up and run the Career Fellowship also helped me to test my personal fit for entrepreneurial roles. On this subject, I would like to share some insights regarding how I initiated and ran this programme, and what I’ve learned from it. I think that many of the points listed below could be helpful to others setting up similar programmes.

Figure 6: The timeline from the conception of the idea to the execution of the pilot programme. The idea was initially developed in February 2022. I decided to begin acting on it in October 2022, and developed the curriculum with the help of others in the team between November 2022 and February 2023. The pilot programme itself ran from March to April 2023.

What I found valuable and can recommend…

… before starting the project:

Figuring out your theory of change and discussing it with the team.
Recognising what each of your team members brings to the team (including their viewpoints, ideas, and strategies).
Having a mentor who pushes you to think about timelines, roles, and resources required, taking your situation into account.
Finding your own blindspots (like underestimating the time needed to complete things).
Making it a priority to work on your blindspots. For me, this has meant investing in personal organisation and self-management, e.g., task and knowledge management, calendars and reminders, communication platforms, and a lot more, and setting up systems that work for you. If possible, test them in advance.
I was surprised that just planning a project can take more than 20 hours, not including research beforehand.
For the project itself, I was very happy to have a main directory document ready ahead of time (to organise everything about the project).
for you. If possible, test them in advance.
I was surprised that just planning a project can take more than 20 hours, not including research beforehand.
For the project itself, I was very happy to have a main directory document ready ahead of time (to organise everything about the project).

… during the project:

I found it particularly valuable to have a shared project lead, and would recommend this to anybody.
Furthermore, communication is key. Communicate regularly and effectively and create a strategy that fits you. Personally, I appreciated group calls once a week to coordinate todos, share experiences from the sessions, and check whether everyone received the information needed.
Lastly, I also discussed our methodological ideas and my findings with friends and colleagues and found their feedback very valuable.

… evaluating the project:

If you want to use an evaluation platform that is new to you, get good guidance for the whole evaluation process.
I personally struggled a lot to not lose myself in details. Try to avoid perfectionism and look for the “big results,” such as unexpected outcomes, great changes, or valid feedback.
Set yourself a realistic timeline.
Plan a good handover to facilitate the continuity of the project.

From all this, I learned a lesson: Running a programme like this is a process of continual learning. It helps to invest a lot of time in planning, seeking feedback from others, and iteratively improving.

Finally, I would like to say that I am very grateful for what I have learned. I was surrounded by extremely warm people who helped me, supported me whenever questions arose or when I was struggling, and pushed me to make the fellowship what it was. In running this fellowship, I tackled a problem I had faced for more than a year. Running the Career Fellowship created a feeling of agency that I never imagined before.

Therefore, I would like to thank the organisations and the people without whom this programme would not have been possible. I was particularly inspired by EA Germany’s Career Fellowship to run the programme. We were also able to set up the programme quickly due to being able to build on resources from the Global Challenges Project (for our Week 1 working document), Clearer Thinking (for our workshops in Weeks 3 and 4), the Effective Altruism Forum and 80,000 Hours (for our readings), and Charity Entrepreneurship (for our Weighted Factor Model Template).

Personally, I would like to thank Louisa Rasp (LinkedIn), who worked with me to create the fellowship, including setting its strategy, putting together the content and its M&E, was a crucial co-facilitator and manager for me, and further improved the programme as a manager for our summer cohort. She covered the weekly monitoring and evaluation of the programme and gave helpful feedback on this post.

I would also like to thank Marie Firgau, Erik Jentzen, and Akhil Bansal for their ongoing invaluable mentorship, contributions and feedback on every aspect of the fellowship as well as Marie’s personal involvement as a facilitator and speaker. We were furthermore grateful to have highly motivated fellows. I give a special thanks to Sarah Gebauer and her insights from a senior professional’s point of view.

I also thank Clare Diane Harris for her significant contributions to writing this post. Finally, we both thank everyone who reviewed and/or edited earlier drafts of this piece, including Marie Firgau, Louisa Rasp, Sarah Gebauer, Akhil Bansal, Calvin Smith (who also created the charts), Abinaya Arulalagan, and Rafael José Vieira.

References

Győrffy, Z., Birkás, E., & Sándor, I. (2016). Career motivation and burnout among medical students in Hungary-could altruism be a protection factor?. BMC medical education, 16, 1-8.

Xu, M. (2014). Medical students’ motivations for studying medicine: changes and relationship with altruistic attitudes, expectations, and experiences of learning at university (Doctoral dissertation), accessed from: <https://digital.library.adelaide.edu.au/dspace/handle/2440/91873>.

Yang, C., Jin, X., Yan, J., Zhang, J., Chen, C., Cheng, Y., You, J. & Deng, G. (2021). An investigation of the intention and reasons of senior high school students in China to choose medical school. BMC Medical Education, 21, 1-10.

Appendices

Especially interested readers can find detailed information here.

Thank you for your interest in our work! If you would like more information about any aspect of our curriculum, please reach out to us at highimpactmedicine [at] gmail.com.