Doctors are having trouble deciding what they want to do when they grow up

Just one-third of respondents ages 12 to 17 said things were going well for children and teenagers today, in a survey published Monday by Common Sense Media, a children’s advocacy group. Less than half said they thought they would be better off than their parents when they grew up — a downbeat view shared among teenagers in many rich countries, other data shows .

It’s not just about teenage angst. A different survey, by Gallup and the Walton Family Foundation, the latest installment of which was also released Monday, has asked questions of young people over time and looked at how their answers have changed. Members of Gen Z, ages 12 to 27, are significantly less likely to rate their current and future lives highly than millennials were when they were the same age, it found.

Among those 18 to 26, just 15 percent said their mental health was excellent. That is a large decline from both 2013 and 2003, when just over half said so.

The average medical student is 24 years old, and they are concerned about their career choice and transitions. They are not the only ones in the sick care pipeline who are anxious and worried.

Here is the problem facing premedical students, medical students, residents, fellows, and early-stage career medical professionals:

" I am an MD-MBA graduating in June and going on to residency in July. I was hoping to find time on your calendar for some career advice. I want to be a practicing physician but also meaningfully contribute to furthering health equity, but I have had no instruction or guidance during medical school. I am usually LinkedOut but the algorithm suggested I contact you and thought I'd give it a shot."

Premedical students are clueless about the realities of medical school. Medical students are unprepared to take care of patients in their first year of residency. Graduating residents are ill prepared to practice the business of medicine because they get no education or training in the subject. They make residency choices with incomplete information. Clinicians practicing in every stage of their career are experiencing professional dissatisfaction, anxiety, burnout, and behavioral health disorders. Medical societies have lost touch with their doctors and memberships are dropping.

While many physicians retire due to age, others have chosen early retirement due to the current state of the U.S. health system. And too many young or midcareer physicians intend to leave their organizations within two years. With the ongoing physician shortage in medicine, finding ways to identify and address doctors’ intent to leave a health care organization is vital—and it may require smarter uses of technology. Between 2021 and 2022, when asked about the likelihood of leaving their current organization within two years, 40% of physicians said they had moderate interest in leaving, that they were likely to do so, or that they would definitely do so.

Most medical schools don't offer career counseling. I wasn't. I guess the powers that be didn't think I needed any help figuring out what I wanted to be when I grew up. They were wrong then, and they are wrong now. I'm still figuring it out after multiple career pivots.

Times have changed and those in the doctor pipeline want help with career decisions and how to navigate the four career crossroad crises.

But career counseling is not usually offered in medical schools or in graduate medical education programs. It wasn't when I was a residency program director and vice-chairman.

One of my colleagues (thanks Larissa May, MD, MSPH, MBA ) shared that business schools do have this resource although the quality might be questionable. Undergraduate programs have this. High schools have it. Again, it’s an old, fixed mindset that if you are in medical school, then Shirley, the only thing you need counseling on is the specialty you’re going to be spending the rest of your life in. And that also is done very poorly. About 6-8% of residents drop out or change specialties or live lives of quiet desperation until they run out the clock.

The other irony is that large university systems offer counseling on the undergraduate campus but don't see the need to offer those same services on the academic medical center campus across the street.

The problem is growing in all physician career stages, including the young and the restless, the desperados and the old and the grumpy.

Fixing the problem will mean rethinking the value proposition of medical education and the business we are in. Is it our business to create just competent practitioners, or is it to provide students with the knowledge, skills, attitudes, and competencies they need to navigate jungle gym career paths, learn to fail, experiment, develop a different mindset, drop the warrior mentality, and contribute to the health and welfare of their communities in the many alternate ways they see fit?

We owe it to future generations of doctors to guide and mentor them, help them rediscover the Lost Tribe of Medicine and rediscover the joy of medicine.

If you want to be part of this community, connect to me on LinkedIn, tell me you are interested, and I'll include you in the club.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs on Substack