The Era of the Millennial Doctor

Do a quick Google search on “Millennial Doctor”.

First one that pops up for me is the Forbes article Do we have a Millennial Physician Problem? in which the author outlines a common theme about millennials in general.  We’re “entitled, narcissistic and self-absorbed”.  Certainly problematic if we’re relying on such people to help maintain health.

My personal favourite is What to Expect When Millennial Doctors in Training Become Doctors in Practice in MDMag.  In it, the author outlines the difference between my generation of physicians vs the physicians that are already “well established”.  Some are pretty common sense, such as we’re just more comfortable with technology.  Others are so comical I can’t believe they even put it in a paragraph header:  “Reject Racism, Sexism, and Discrimination in General” and “Feel Special”.

So what’s the deal?  What is with the need to explain this generation of physicians to the rest of our colleagues and society?  What is so terrifying about millennials in medicine?

I think it helps to place it in the broader context of how medicine was practiced in the past.  Starting with training, residents used to work upwards of 100 hours a week.  It wasn’t until 2003 that the 80 hour work week restriction (averaged over 4 weeks) was put into place.  In addition, the longest shift a resident could do was 30 hours as long as they didn’t see any new patients in those last 6 hours.  Residents now had 10 hours between shifts for “rest”, then back to the daily grind.  They also were generously granted 4 days off a month.  In 2011, these restrictions were refined somewhat further – 1st year residents (aka interns) could only work 22 hour shifts whereas more senior residents could still do 30 hours.

I was an intern in 2011 when these restrictions came down, and it was enlightening to hear the older docs talk about these duty hour restrictions.  Some felt like it was the sign of the apocalypse for medicine – how were doctors in training possibly going to see and learn all the things they needed to if they cut back hours even further?  The 80 hour work week ALREADY was wreaking havoc and these new doctors were entirely inadequate.  Plus, the increase in patient handoffs between shifts were the most vulnerable times when mistakes happen.  Patients were going to suffer immensely for this!  Others were happy that these work hour restrictions were coming through – they reasoned no one was thinking properly after being on the job for 16 hours anyway, and we were asking people to work an addition 6 to 14 hours on top of that.  Truck drivers have 14 hour limits on their days and can’t drive longer than 11 hours in a row.  Pilots were limited to 9-14 hour shifts.  Are doctors so special that we can push through fatigue and still take care of patients well??   In July 2017, they increased the duty hour limits for interns back up to 24 hours because learning was being sacrificed.  This is still the culture of medicine for better or for worse.

I was told when I was in training this was going to prepare me for life in the real world.  I was going to work 50-60 hour weeks, would be on call at all hours of the night and I needed to be able to handle everything that came at me, even if I was sleep deprived.  It was so deflating, to think I had pushed myself through 4 years of med school and 4 years of residency just to end up at the other end and still have to be work more than the average person’s full time work schedule.  Flashbacks came back to me of my intern year – out of 52 weekends, I had only 13 where I had both a Saturday and a Sunday off.  That was not the life I wanted.

So I made a choice – I was only going to work 40 hours a week.  Yes, I’d make less money, but whatever.  I would find a practice that would let me split call with my colleagues, and so now I’m only on call 24/7 for an entire week every 6 weeks.  When I told some of my older colleagues this, they were very skeptical.  No one only works 40 hours a week.  I was asked, “Why would you go through all that just to work part time?  And, don’t you care about patients?”  They didn’t understand that the life I wanted did not put my job front and center.  I am more than a doctor – I am a wife, a friend, a traveler and other non-medicine things.

Now, I don’t speak for all millennial doctors.  There are certainly people who work way more than I do.  But as a whole, I believe the reason there is so much terror and confusion about millennial doctors is that we don’t want our identities totally wrapped up in our career.  This is unfathomable to previous generations.  It is an outright rejection of how they defined how doctors should be.  In another article about millennial doctors in NPR, a baby boomer doc says of his era, “Your job came first. It was your family life; your personal life was second. You were supposed to sacrifice that. The newer generation, they’re more willing to ask the question, ‘Well, how much vacation time do I have? How much time do I have with my family?’ Where, in my day, that could be a killer,” he says.”

Thanks, but no thanks.  Call me entitled, narcissistic or self-absorbed.  I’m pretty sure I’m happier for it.

***Main photo taken of a banyan tree at Pipiwai Trail, Hana, Maui, HI