Medical millennials: a mismatch between training preferences and employment opportunities

Abstract

Abstract Background Millennials, defined as those born between 1981 and 1996, have begun to enter the physician workforce, and now represent 15% of all working physicians. A better understanding of their aspirations and consideration of the unique education and skillset of millennials may lead to more effective recruitment and retention. In this study, we aimed to measure the availability of cross-training opportunities—that is, completion of more than one degree or complete combined medical residency training—for millennial physicians at the undergraduate and graduate levels in the USA. Further, we compared the availability of medical jobs that advertised for cross-trained physicians. Methods Data were obtained from published statistics fom the Association of American Medical Colleges and National Resident Matching Program. Additional data were obtained from a literature search and April 2018 internet searches of medical school websites. Findings US undergraduates had a 70% increase in college double majors between 2001 and 2011 and double majors are increasing among matriculated medical students. The number of medical schools offering an MBA in 2018 (n=63), has nearly doubled since 2006 (n=37). Before 2001, no residency programmes, apart from those in preventive medicine, provided trainees with formal opportunities to obtain an MBA or MPH. However, in 2018, 45 residency programmes have a pathway for residents to pursue an MBA, MPH, or PhD during residency. In the past 20 years, the rate of increase in total number of combined residency programmes (49% [from 128 in 1996 to 191 in 2017]) is triple that of corresponding categorical programmes (16% [from 1350 to 1562 in the same time period]). Between 1996 and 2016, 17 new specialty combinations became available for residency training. Data from USAJobs, the federal employment website, and the New England Journal of Medicine online CareerCenter show few advertised jobs that specifically require skills demonstrated by combined degrees or combined residency training. Interpretation Millennial physicians are choosing to cross-train throughout undergraduate, medical, and graduate medical education; however, the current physician marketplace does not match the skills of this population. A mismatch between provider skills and available jobs is costly for both employers and workers, and such a mismatch can adversely affect health systems. Health-care organisations should capitalise on the availability of multiskilled graduates in order to effectively recruit and retain the next generation of physicians. Funding None.