Original Research

Millennials in Medicine: Cross-Trained Physicians Not Valued in Medical Marketplace

Health organizations must improve recruitment of millennial physicians who bring new skills in order to have more engaged employees and healthier patients.

Fed Pract. 2019 December;36(12):574-578

Author(s):

References

1. Dimock M. Defining generations: where millennials end and generation Z begins. http://www.pewresearch.org/fact-tank/2018/03/01/defining-generations-where-millennials-end-and-post-millennials-begin/. Published January 17, 2019. Accessed November 7, 2019.

2. IHS Inc. The complexities of physician supply and demand: projections from 2014 to 2025. Final report. https://www.modernhealthcare.com/assets/pdf/CH10888123.pdf. Published April 5, 2016. Accessed November 7, 2019.

3. Miller RN. Millennial physicians sound off on state of medicine today. https://wire.ama-assn.org/life-career/millennial-physicians-sound-state-medicine-today. Published March 27, 2017. Accessed November 7, 2019.

4. World Economic Forum. Matching skills and labour market needs: building social partnerships for better skills and better jobs. http://www3.weforum.org/docs/GAC/2014/WEF_GAC_Employment_MatchingSkillsLabourMarket_Report_2014.pdf. Published January 2014. Accessed November 7, 2019.

5. Brint SG, Turk-Bicakci L, Proctor K, Murphy SP. Expanding the social frame of knowledge: interdisciplinary, degree-granting fields in American Colleges and Universities, 1975–2000. Rev High Ed. 2009;32(2):155-183.

6. National Science Foundation. National survey of college graduates. https://www.nsf.gov/statistics/srvygrads. Updated February 2019. Accessed November 7, 2019.

7. Simon CC. Major decisions. New York Times. November 2, 2012. http://www.nytimes.com/2012/11/04/education/edlife/choosing-one-college-major-out-of-hundreds.html. Accessed November 7, 2019.

8. Berry SL, Erin GL, Therese J. Health humanities baccalaureate programs in the United States. http://www.hiram.edu/wp-content/uploads/2017/09/HHBP2017.pdf. Published September 2017. Accessed November 7, 2019.

9. Sorensen NE, Jackson JR. Science majors and nonscience majors entering medical school: acceptance rates and academic performance. NACADA J. 1997;17(1):32-41.

10. Association of American Medical Colleges. Table A-17: MCAT and GPAs for applicants and matriculants to U.S. medical schools by primary undergraduate major, 2019-2020. https://www.aamc.org/download/321496/data/factstablea17.pdf. Published October 16, 2019. Accessed November 7, 2019.

11. University of Michigan Medical School. Many paths, one destination: medical school welcomes its 170th class of medical students. https://medicine.umich.edu/medschool/news/many-paths-one-destination-medical-school-welcomes-its-170th-class-medical-students. Updated July 29, 2016. Accessed November 7, 2019.

12. Harding CV, Akabas MH, Andersen OS. History and outcomes of 50 years of physician-scientist training in medical scientist training programs. Acad Med. 2017; 92(10):1390-1398.

13. Association of American Medical Colleges. MD-PhD in “social sciences or humanities” and “other non-traditional fields of graduate study” - by school. https://students-residents.aamc.org/choosing-medical-career/careers-medical-research/md-phd-dual-degree-training/non-basic-science-phd-training-school/. Accessed November 8, 2019.

14. Holmes SM, Karlin J, Stonington SD, Gottheil DL. The first nationwide survey of MD-PhDs in the social sciences and humanities: training patterns and career choices. BMC Med Educ. 2017;17(1):60.

15. Association of American Medical Colleges Combined degrees and early acceptance programs. https://www.aamc.org/data-reports/curriculum-reports/interactive-data/combined-degrees-and-early-acceptance-programs. Accessed November 8, 2019.

16. Tufts University School of Medicine. 2023 class profile. http://medicine.tufts.edu/Education/MD-Programs/Doctor-of-Medicine/Class-Profile. Published 2015. Accessed November 8, 2019.

17. Zweifler J, Evan R. Development of a residency/MPH program. Family Med. 2001;33(6):453-458.

18. American Medical Association. The AMA residency and fellowship database. http://freida.ama-assn.org/Freida. Accessed November 7, 2019.

19. National Resident Matching Program. NRMP data. http://www.nrmp.org/wp-content/uploads/2013/08/resultsanddata1996.pdf. Published March 1996. Accessed November 7, 2019.

20. Brotherton SE, Etzel SI. Graduate medical education, 2016-2017. JAMA. 2017;318(23):2368-2387.

21. American Board of Psychiatry and Neurology. Update for psychiatry GME programs on combined training program accreditation/approval February 2012. https://www.umassmed.edu/globalassets/neuropsychiatry/files/combined-program-letter.pdf. Accessed November 7, 2019.

22. Massachusetts General Hospital. Surgical residency program. https://www.massgeneral.org/surgery/education/residency.aspx?id=77. Accessed November 7, 2019.

23. Lusco VC, Martinez SA, Polk HC Jr. Program directors in surgery agree that residents should be formally trained in business and practice management. Am J Surg. 2005;189(1):11-13.

24. New England Journal of Medicine. NEJM CareerCenter. http://www.nejmcareercenter.org. Accessed November 7, 2019.

25. US Office of Personnel Management. USAJOBS. https://www.usajobs.gov. Accessed November 7, 2019.

26. Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2001/Crossing-the-Quality-Chasm/Quality%20Chasm%202001%20%20report%20brief.pdf. Published March 2001. Accessed November 7, 2019.

27. Kohn LT, ed; Committee on the Roles of Academic Health Centers in the 21st Century; Institute of Medicine of the National Academies. Academic Health Centers: Leading Change in the 21st Century. National Academy Press: Washington, DC; 2004.

28. Goodall AH. Physician-leaders and hospital performance: is there an association? http://ftp.iza.org/dp5830.pdf. Published July 2011. Accessed November 7, 2019.

29. US Department of Health and Human Services, Office of the Assistant Secretary for Health. Public health 3.0: a call to action to create a 21st century public health infrastructure. https://www.healthypeople.gov/sites/default/files/Public-Health-3.0-White-Paper.pdf. Accessed November 7, 2019.

30. Centers for Medicare and Medicaid Services. Health care innovation awards round one project profiles. http://innovation.cms.gov/files/x/hcia-project-profiles.pdf. Updated December 2013. Accessed November 7, 2019.

31. US Department of Health and Human Services. Strategic Objective 1.3: Improve Americans’ access to healthcare and expand choices of care and service options. https://www.hhs.gov/about/strategic-plan/strategic-goal-1/index.html#obj_1_3. Updated March 18, 2019. Accessed November 7, 2019.

32. Kessler CS, Stallings LA, Gonzalez AA, Templeman TA. Combined residency training in emergency medicine and internal medicine: an update on career outcomes and job satisfaction. Acad Emerg Med. 2009;16(9):894-899.

33. Summergrad P, Silberman E, Price LL. Practice and career outcomes of double-boarded psychiatrists. Psychosomatics. 2011;52(6):537-543.

34. Rigoni B, Adkins A. What millennials want from a new job. Harvard Business Rev. May 11, 2016. https://hbr.org/2016/05/what-millennials-want-from-a-new-job. Accessed November 7, 2019.

35. Jung P, Smith C. Medical millennials: a mismatch between training preferences and employment opportunities. Lancet Glob Health. 2019;7(suppl 1):S38.

Millennials, defined as those born between 1981 and 1996, currently comprise 15% of all active physicians in the US.^1,2 A recent survey found that nearly 4 of 5 US millennial physicians have a desire for cross-sectional work in areas beyond patient care, such as academic research, health care consulting, entrepreneurship, and health care administration.³

For employers and educators, a better understanding of these preferences, through consideration of the unique education and skill set of the millennial physician workforce, may lead to more effective recruitment of young physicians and improved health systems, avoiding a mismatch between health care provider skills and available jobs that can be costly for both employers and employees.⁴

This article describes how US millennial physicians are choosing to cross-train (obtaining multiple degrees and/or completing combined medical residency training) throughout undergraduate, medical, and graduate medical education. We also outline ways in which the current physician marketplace may not match the skills of this population and suggest some ways that health care organizations could capitalize on this trend toward more cross-trained personnel in order to effectively recruit and retain the next generation of physicians.

Millennial Education

Undergraduates

The number of interdisciplinary undergraduate majors increased by almost 250% from 1975 to 2000.⁵ In 2010, nearly 20% of US college students graduated with 2 majors, representing a 70% increase in double majors between 2001 and 2011.^6,7 One emerging category of interdisciplinary majors in US colleges is health humanities programs, which have quadrupled since 2000.⁸

Medical school applicants and matriculants reflect this trend. Whereas in 1994, only 19% of applicants to medical school held nonscience degrees, about one-third of applicants now hold such degrees.^9,10 We have found no aggregated data on double majors entering US medical schools, but public class profiles suggest that medical school matriculants mirror their undergraduate counterparts in their tendency to hold double majors. In 2016, for example, 15% of the incoming class at the University of Michigan Medical School was composed of double majors, increasing to over 25% in 2017.¹¹

Medical Students

Early dual-degree programs in undergraduate medical training were reserved for MD/PhD programs.¹² Most US MD/PhD programs (90 out of 151) now offer doctorates in social sciences, humanities, or other nontraditional fields of graduate medical study, reflecting a shift in interests of those seeking dual-degree training in undergraduate medical education.¹³ While only 3 MD/PhD programs in the 1970s included trainees in the social sciences, 17 such programs exist today.¹⁴

Interest in dual-degree programs offering master’s level study has also increased over the past decade. In 2017, 87 medical schools offered programs for students to pursue a master of public health (MPH) and 41 offered master of science degrees in various fields, up from 52 and 37 institutions, respectively in 2006.¹⁵ The number of schools offering combined training in nonscience fields has also grown, with 63 institutions now offering a master of business administration (MBA), nearly double the number offered in 2006.¹⁵ At some institutions more than 20% of students are earning a master’s degree or doctorate in addition to their MD degree.¹⁶