“For instance, work hour limits mean that residents can only put in 80 hours a week and have to have specific rest times,” said Dr. Medina. “That is really a significant change from even 10 or 15 years ago.”
Explore This IssueJanuary 2015
While there are valid reasons for these changes, there are also concerns that residents are not getting in the hours they need to reach competency in some areas. The irony, noted Dr. Medina, is that these requirements are not totally in sync with the reality of practice, where there are no such restrictions. He noted that most practitioners of head and neck surgery probably work more than 80 hours in a week.
“Despite the work restrictions, we still have to impart an increasingly large and complex body of knowledge to our residents,” noted Giancarlo Zuliani, MD, the residents program director at the Wayne State University School of Medicine in Detroit. “We still have to make sure our residents know and fully grasp the information that is important to our specialty.” He does say that this concern is somewhat offset by the Millennial’s ability to multitask.
There is a dichotomy in the methods residents use to learn. Unlike earlier generations, Millennials do better when they are given specific goals to achieve; however, they also want the ability to meet those requirements in their own way.
“It is an odd dynamic,” said Dr. Zuliani. “Millennials need constant stimulation and constant direction. Just the amount of information is too much to tackle all at once, so they have had to become very active in their own education. We almost have to customize each residency, unlike the 50s and 60s, where they were told what they needed to know to get out and into practice.”
There is also a need for a more active feedback component. In earlier generations, it wasn’t unusual to get an evaluation every three to six months. “Millennials want constant feedback, both negative and positive,” said Dr. Zuliani. “They want to know immediately what they need to do to improve instead of waiting until their memories of the event have faded.”
The current residents are also more interested in balancing personal and professional lives. Not sacrificing family to the profession is important. “With two-earner families, the dynamics have had to change,” said David S. Cohen, MD, a PGY-4 resident at Wayne State. “If you want to take your kids to soccer, then you can’t be on call every day. We see the strain that medicine can often put on a family and want to maintain a good balance.”