2023 Match Data

[Beeftenderloin]

Curious how anesthesia faired in the match this year. I hear EM was a bloodbath with >550 unfilled spots. Anyone have the data on number of unfilled anesthesia spots and willing to share?

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[anbuitachi]

Won't most of those spots fill by unmatched and foreign? May be a good time for foreign grad to match into em. Good specialty

but also possible programs are purposely not filling those spots.

that # is many times last year unfilled spot for EM. seems like a huge jump in 1 year

i wonder where this info came from. i saw it on fb. but i t hought match data not released yet

 

[DocVapor]

3 open spots in anesthesia from my understanding but I haven't personally looked at the data. I'm sure they'll fill

 

[anbuitachi]

3 open spots in anesthesia from my understanding but I haven't personally looked at the data. I'm sure they'll fill

insane! how did it get so popular

 

[Dr. Rude]

insane! how did it get so popular

lots of discussions about how good the job market currently is, high hourly locum rates, etc.

The notorious bank robber Willy Sutton was once asked (so the story goes) why he continued to rob banks (he was caught more than once). "Because that is where the money is,".

 

[Test Boy]

insane! how did it get so popular

A big reason is the people who were previously attracted to EM are now applying to anesthesia instead.

 

[Endee]

 

[Anesthesia_Guy]

insane! how did it get so popular

$$$$$

 

[anbuitachi]

$$$$$

honestly looking at highest paid specialties, anesthesiology isnt' particularly high up.
in fact , accounting for our #s worked, we are paid pretty low compared to other specialists. the fields below us are mostly generalists. (Peds, IM, FM, etc).

 

[CubsDynasty]

ER went from about 150 programs in 2010 (when it was very competitive) to over 300 today. Supply significantly increased. That doesn’t even consider what has happened to the field itself with ED staffing with mid levels, reimbursement, defensive medicine, etc.

 

[anbuitachi]

ER went from about 150 programs in 2010 (when it was very competitive) to over 300 today. Supply significantly increased. That doesn’t even consider what has happened to the field itself with ED staffing with mid levels, reimbursement, defensive medicine, etc.

EM has a ton of space to go down in IMO, especially if they dont work everyday

 

[Drwine]

I started out in EM before seeing the light and going into anesthesiology. I reached out to a friend in EM and asked him and he blamed the proliferation of marginal HCA and contract medical group residency programs for the growth of unfilled EM slots when I opened the conversation with my question if this was the result of too many MD?MBAs who went to the dark side and threw their specialty under the bus?

 

[aneftp]

EM has a ton of space to go down in IMO, especially if they dont work everyday

average er doc works 16 shifts a month. Combo of 8/12 hours.

It’s equivalent to crna’s doing (8) 24 hours I know who cover ob at many hospitals.

People want days off. Fortunately for anesthesia the crna’s aren’t taking less money like the np in the er.

The low point for anesthesia in this modern era was around 2012-2015 range. Salaries as low as 180k for full time doc in the south I saw advertised. Most in the low 200s when the AMCs were in full swing. It was almost laughable mednax (American anesthesiology) brought over north Atlanta practice and tried to pay in the low 200s for overnight Friday/Saturday/Sunday weekend coverage at 240k full time. Same stuff down in central Florida. Weekend overnight coverage. And that’s full time. Like 45 weeks coverage

 

[anbuitachi]

average er doc works 16 shifts a month. Combo of 8/12 hours.

It’s equivalent to crna’s doing (8) 24 hours I know who cover ob at many hospitals.

People want days off. Fortunately for anesthesia the crna’s aren’t taking less money like the np in the er.

The low point for anesthesia in this modern era was around 2012-2015 range. Salaries as low as 180k for full time doc in the south I saw advertised. Most in the low 200s when the AMCs were in full swing. It was almost laughable mednax (American anesthesiology) brought over north Atlanta practice and tried to pay in the low 200s for overnight Friday/Saturday/Sunday weekend coverage at 240k full time. Same stuff down in central Florida. Weekend overnight coverage. And that’s full time. Like 45 weeks coverage

yes. so there is more room to push. one shift at a time . soon it'll be average of 20 shifts. etc

 

[medicine2wallstreet]

honestly looking at highest paid specialties, anesthesiology isnt' particularly high up.
in fact , accounting for our #s worked, we are paid pretty low compared to other specialists. the fields below us are mostly generalists. (Peds, IM, FM, etc).

Hours worked don't equate to work put in. We got it pretty nice pard.

 

[Dr. Rude]

Hours worked don't equate to work put in. We got it pretty nice pard.

call intensity is everything. Availability or productivity or combination? Varies hugely.

 

[nimbus]

Hours worked don't equate to work put in. We got it pretty nice pard.

Yep. One patient at a time. World burning down outside the OR? Not my problem

 

[Iso4ane]

Yep. One patient at a time. World burning down outside the OR? Not my problem

Not if you got windows and you can see the spot were your Porsche is parked is on fire.

 

[Anesthesia_Guy]

Not if you got windows and you can see the spot were your Porsche is parked is on fire.

Porsche!? What am I a family practitioner?! Maybach baby.

 

[vector2]

the proliferation of marginal HCA and contract medical group residency programs

How wonderful that we're following the same path in our specialty.

ACGME needs to do their damn job and make sure that not every BFE-glorified-surgery-center-HCA-"hospital" can start a residency program on a whim.

 

[Agast]

When I graduated anesthesiology 2014 there was a lot of doom and gloom about being replaced by CRNAs. That’s still an issue of course, but suddenly there’s a shortage and anesthesiology is more desirable? What happened?

 

[Dr. Rude]

When I graduated anesthesiology 2014 there was a lot of doom and gloom about being replaced by CRNAs. That’s still an issue of course, but suddenly there’s a shortage and anesthesiology is more desirable? What happened?

Baby boomer docs and CRNAs cutting back/retiring.
Baby boomer patients needing more care.

 

[Dr. Rude]

How wonderful that we're following the same path in our specialty.

ACGME needs to do their damn job and make sure that not every BFE-glorified-surgery-center-HCA-"hospital" can start a residency program on a whim.

From the acme website:

ACGME Mission:
The mission of the ACGME is to improve health care and population health by assessing and enhancing the quality of resident and fellow physicians' education through advancements in accreditation and education.




One interpretation of their mission: More docs is in the interest of population health. The fact that some those docs are less well trained than previous generations is a cost that we should accept in the name of increasing numbers of practitioners. I submit that on how one chooses to interpret their mission that they are doing their job.

 

[aneftp]

Can’t believe they pay residents 70-90k a year now. I looked up some gme salaries

Back in my days in expensive top 7 metro population area (hint not Texas which was cheap cost of living). I made in the low to mid 30s as resident working 80-120 hours a week.

Congrats to those who matched. And don’t complain about pay and work hours. And if you single. Get a roommate to cut housing costs down.

 

[nimbus]

How wonderful that we're following the same path in our specialty.

ACGME needs to do their damn job and make sure that not every BFE-glorified-surgery-center-HCA-"hospital" can start a residency program on a whim.

ACGME Mission:
The mission of the ACGME is to improve health care and population health by assessing and enhancing the quality of resident and fellow physicians' education through advancements in accreditation and education.




One interpretation of their mission: More docs is in the interest of population health. The fact that some those docs are less well trained than previous generations is a cost that we should accept in the name of increasing numbers of practitioners. I submit that on how one chooses to interpret their mission thatchy are doing their job.

Yes.

Some of the newer residencies are in BFE communities that have had trouble recruiting anesthesiologists for decades….eg the Central Valley of California. Even when the job market was terrible, it was difficult to recruit anesthesiologists there. There are newer programs in Stockton and Visalia. I’m sure the hope is that some of the residents will form ties to the area and remain. But if the job market stays as it has been, I’m sure the majority will relocate to more desirable locales.

 

[kb1900]

Can’t believe they pay residents 70-90k a year now. I looked up some gme salaries

Back in my days in expensive top 7 metro population area (hint not Texas which was cheap cost of living). I made in the low to mid 30s as resident working 80-120 hours a week.

Congrats to those who matched. And don’t complain about pay and work hours. And if you single. Get a roommate to cut housing costs down.

not sure what’s more awkward. Your overall message or saying “top 7” when everyone knows that means #6 or #7. congrats residency sucked more for you. everyone is impressed when you bring it up completely out of context


how bout we encourage residents to have a spine so our entire profession doesn’t continue to act spineless when it comes to politics and lobbying. learning your worth and demanding it from the powers that be seems pretty important these days in light of reimbursement cuts, negotiating with large hospital corps, dealing with encroachment etc.

 

[GravelRider]

Can’t believe they pay residents 70-90k a year now. I looked up some gme salaries

Back in my days in expensive top 7 metro population area (hint not Texas which was cheap cost of living). I made in the low to mid 30s as resident working 80-120 hours a week.

Congrats to those who matched. And don’t complain about pay and work hours. And if you single. Get a roommate to cut housing costs down.

What a strange and oddly out of context post.

Were you in the top 7 of your 7 person anesthesia class as well?

 

[DocVapor]

Can’t believe they pay residents 70-90k a year now. I looked up some gme salaries

Back in my days in expensive top 7 metro population area (hint not Texas which was cheap cost of living). I made in the low to mid 30s as resident working 80-120 hours a week.

Congrats to those who matched. And don’t complain about pay and work hours. And if you single. Get a roommate to cut housing costs down.

Please also let us know your total debt load and interest rates after graduating med school. We'll let some recently matched med students compare those numbers to yours.

Sorry you're so bitter about your residency experience.

 

[aneftp]

Please also let us know your total debt load and interest rates after graduating med school. We'll let some recently matched med students compare those numbers to yours.

Sorry you're so bitter about your residency experience.

My debt load was 110k give or take. Interest rate on student loans was around 4.5%. Average med school loan debt around that time was 80k for in state and 150k for out of state.

But starting salary for new grads was 220k (that’s with full calls and no call incentive). My first job was for for 185k!! With a 15k sign on bonus. I am not kidding. I finished in 2004 in time of rising home prices and mortgage interest rates around 7%. Sound familiar?

Starting salary for new grads in 2023 is rough 400k plus call incentives worth up to 100k in many places. So if new grad is making 450k and owes 250k-300k. It’s not that bad. Even owing 400k and making almost 500k isn’t bad.

My residency was pretty chill. I’m not bitter. Icu hours were hard. 120 hours. OR experience was fine. We average around 65-85 hours depending on weekends.

 

[DocVapor]

My debt load was 110k give or take. Interest rate on student loans was around 4.5%. Average med school loan debt around that time was 80k for in state and 150k for out of state.

But starting salary for new grads was 220k (that’s with full calls and no call incentive). My first job was for for 185k!! With a 15k sign on bonus. I am not kidding. I finished in 2004 in time of rising home prices and mortgage interest rates around 7%. Sound familiar?

Starting salary for new grads in 2023 is rough 400k plus call incentives worth up to 100k in many places. So if new grad is making 450k and owes 250k-300k. It’s not that bad. Even owing 400k and making almost 500k isn’t bad.

My residency was pretty chill. I’m not bitter. Icu hours were hard. 120 hours. OR experience was fine. We average around 65-85 hours depending on weekends.

Much respect for putting up the numbers.

Now the average med school debt is a hair over 200k at 6.5-7.5% interest with most owing 50k more from undergrad. They're coming into a market with average home prices that are double what it was before 08, with rates that are skyrocketing even faster. We can go round and round on who has or had it worse but it's all pointless in the end.

The hospitals have been making enormous sums of money off the backs of residents like you that used to be essentially indentured servants. You should be applauding the progress made in resident pay and hours while recognizing that it still probably isn't enough.

 

[Drwine]

Please also let us know your total debt load and interest rates after graduating med school. We'll let some recently matched med students compare those numbers to yours.

Sorry you're so bitter about your residency experience.

We were having this discussion and the break room the other day and a new attending asked me how much I paid in medical school tuition. I was able to open my wallet and count out what I paid for my most expensive tuition during my last year of medical school. Only people that went to medical school in Washington, DC paid much in tuition in the late 1970s or early 1980s.

 

[Anesthesia_Guy]

not sure what’s more awkward. Your overall message or saying “top 7” when everyone knows that means #6 or #7. congrats residency sucked more for you. everyone is impressed when you bring it up completely out of context


how bout we encourage residents to have a spine so our entire profession doesn’t continue to act spineless when it comes to politics and lobbying. learning your worth and demanding it from the powers that be seems pretty important these days in light of reimbursement cuts, negotiating with large hospital corps, dealing with encroachment etc.

Well, you've got the passive-aggresive part down pretty well....

 

[Anesthesia_Guy]

Sorry you're so bitter about your residency exexperience.

My man! Kudos on getting the you're/your correct in one succinct sentence. I wouldn't expect anything else but I appreciate when I see correct usage since sooooo many people mess it up. It drives me absolute bug sh1t.

 

[DocVapor]

My man! Kudos on getting the you're/your correct in one succinct sentence. I wouldn't expect anything else but I appreciate when I see correct usage since sooooo many people mess it up. It drives me absolute bug sh1t.

My mama didn't raise no fool.

 

[Beeftenderloin]

Can’t believe they pay residents 70-90k a year now. I looked up some gme salaries

Back in my days in expensive top 7 metro population area (hint not Texas which was cheap cost of living). I made in the low to mid 30s as resident working 80-120 hours a week.

Congrats to those who matched. And don’t complain about pay and work hours. And if you single. Get a roommate to cut housing costs down.

::cure for cancer comes out::

@aneftp : “I can’t believe how easy these cancer patients have it these days! Back in my day they all just got sick and died. I better not hear any complaints about the side effects!”

I’m most definitely not saying residency is like having cancer. Just pointing out how obtuse this take is.

 

[HemeOncHopeful19]

::cure for cancer comes out::

@aneftp : “I can’t believe how easy these cancer patients have it these days! Back in my day they all just got sick and died. I better not hear any complaints about the side effects!”

I get what you’re saying but right or wrong we do legit say this about CML every once in a while…

 

[BLADEMDA]

The goal for most med students after med school is to get a job. For many, they want a good job and the student gets to define "good." If the job prospects in that specialty are poor with low pay and low demand that will deter many students. If Matching into that residency is NOW based on DEI plus some metrics that will change the applicant pool as well.

Look at Orthopedics for example. DEI is now a huge factor in who the programs will accept. No longer will the top metrics and bro culture be the norm in the vast majority of programs. Neurosurgery has also fully embraced DEI in terms of applicants. This leaves fewer spots for the traditional White/Asian male applicant with very high metrics. In fact, in many of these former elite specialties, only 1/2 the spots are available for the traditional applicant.

So, where are these applicants supposed to Match? Urology and ENT are also paying attention to DEI. These applicants must turn to Radiology, IM, and General Surgery if they want a job after med school. Heck, even Anesthesiology is now an option for those who can't get survive the DEI initiatives of 2023.

The WOKE agenda has arrived to Residency programs across the USA and this has a huge impact on Med Students. The combination of DEI and the job market will play major roles in deciding a med Student's specialty. Of course, hard metrics still matter to some degree but a lot less today than it did in 2020.

Step 1 is now Pass/Fail and many schools don't issue grades. Eventually, programs will simply use the Woke agenda to decide those who get to Match and those who don't. All that is left is to make Step 2 Pass/Fail and the transformation from objective to subjective, DEI, will be complete.

 

[Beeftenderloin]

I get what you’re saying but right or wrong we do legit say this about CML every once in a while…

Yes, and we used to “anesthetize” patients with whisky and a piece of leather to bite down on. Patients complaining of sore throats and nausea seems awfully trivial, even annoying at times given that history. Doesn’t mean that I’m not genuinely happy with the progress we’ve made. Way too many folks out there, particularly in medical training, with the attitude that “I had to suffer so you should too”.

 

[medicine2wallstreet]

My debt load was 110k give or take. Interest rate on student loans was around 4.5%. Average med school loan debt around that time was 80k for in state and 150k for out of state.

But starting salary for new grads was 220k (that’s with full calls and no call incentive). My first job was for for 185k!! With a 15k sign on bonus. I am not kidding. I finished in 2004 in time of rising home prices and mortgage interest rates around 7%. Sound familiar?

Starting salary for new grads in 2023 is rough 400k plus call incentives worth up to 100k in many places. So if new grad is making 450k and owes 250k-300k. It’s not that bad. Even owing 400k and making almost 500k isn’t bad.

My residency was pretty chill. I’m not bitter. Icu hours were hard. 120 hours. OR experience was fine. We average around 65-85 hours depending on weekends.

I bet you also did residency before there were EMRs and when you could show up with a crayon in your hand write your name and pass step 1. Medical information is at light speed now for residents with EMRs and they had to make step1 pass fail because it was a nuclear arms race of competition that was unsustainable. I bet you'd get boat raced by these new kids on a standardized test.

 

[sanityonleave]

The goal for most med students after med school is to get a job. For many, they want a good job and the student gets to define "good." If the job prospects in that specialty are poor with low pay and low demand that will deter many students. If Matching into that residency is NOW based on DEI plus some metrics that will change the applicant pool as well.

Look at Orthopedics for example. DEI is now a huge factor in who the programs will accept. No longer will the top metrics and bro culture be the norm in the vast majority of programs. Neurosurgery has also fully embraced DEI in terms of applicants. This leaves fewer spots for the traditional White/Asian male applicant with very high metrics. In fact, in many of these former elite specialties, only 1/2 the spots are available for the traditional applicant.

So, where are these applicants supposed to Match? Urology and ENT are also paying attention to DEI. These applicants must turn to Radiology, IM, and General Surgery if they want a job after med school. Heck, even Anesthesiology is now an option for those who can't get survive the DEI initiatives of 2023.

The WOKE agenda has arrived to Residency programs across the USA and this has a huge impact on Med Students. The combination of DEI and the job market will play major roles in deciding a med Student's specialty. Of course, hard metrics still matter to some degree but a lot less today than it did in 2020.

Step 1 is now Pass/Fail and many schools don't issue grades. Eventually, programs will simply use the Woke agenda to decide those who get to Match and those who don't. All that is left is to make Step 2 Pass/Fail and the transformation from objective to subjective, DEI, will be complete.

Woah, Blade... Maybe time to turn off Tucker (OAN?) for a few minutes.

What evidence do you have that the change in resident match and applications has anything to do with "DEI"?

And just so we're clear on your implication, your point is that you think that straight white men are the smartest people with the best CVs applying in the match? You clearly aren't reviewing the same applications I am...

Go back to talking about Hunter's laptop, or whatever the conspiracy du jour is.

 

[Lecithin5]

Can’t believe they pay residents 70-90k a year now. I looked up some gme salaries

Back in my days in expensive top 7 metro population area (hint not Texas which was cheap cost of living). I made in the low to mid 30s as resident working 80-120 hours a week.

Congrats to those who matched. And don’t complain about pay and work hours. And if you single. Get a roommate to cut housing costs down.

And do a Roth IRA!

 

[aneftp]

Woah, Blade... Maybe time to turn off Tucker (OAN?) for a few minutes.

What evidence do you have that the change in resident match and applications has anything to do with "DEI"?

And just so we're clear on your implication, your point is that you think that straight white men are the smartest people with the best CVs applying in the match? You clearly aren't reviewing the same applications I am...

Go back to talking about Hunter's laptop, or whatever the conspiracy du jour is.

It’s true the dei initiative. An average med student or minority female or even white female will get into an ortho residency over a white/Asian AOA male.

I just talked to one of the big professors at major academic university. They weren’t surprised one of their AOA white male students didn’t match into one of those competitive male dominated specialities while an average white female got into that same speciality. So the AOA is just taking a prelim surgery position at their home university. And yes. He knows their scores as well.

Doesn’t make sense. But those white/Asian males are competing for 60-70% of those slots. The other 30-40% of the slots are reserved for DEI woke culture agenda.

 

[sevo00]

Can’t believe they pay residents 70-90k a year now. I looked up some gme salaries

Back in my days in expensive top 7 metro population area (hint not Texas which was cheap cost of living). I made in the low to mid 30s as resident working 80-120 hours a week.

Congrats to those who matched. And don’t complain about pay and work hours. And if you single. Get a roommate to cut housing costs down.

“My life sucked as a resident! As a result yours should too”!

Sick logic brah

 

[Fpg1245]

It’s true the dei initiative. An average med student or minority female or even white female will get into an ortho residency over a white/Asian AOA male.

I just talked to one of the big professors at major academic university. They weren’t surprised one of their AOA white male students didn’t match into one of those competitive male dominated specialities while an average white female got into that same speciality. So the AOA is just taking a prelim surgery position at their home university. And yes. He knows their scores as well.

Doesn’t make sense. But those white/Asian males are competing for 60-70% of those slots. The other 30-40% of the slots are reserved for DEI woke culture agenda.

Proof that meritocracy isn’t dead, it merely changed form. Haha. This is what I always suspected to be the case.

Med school was really the time I realized working hard simply wasn’t going to be enough.

I’ve seen orthos version of DEI. It’s basically the same culture but now with females. Same basic attitude though.

 

[Gern Blansten]

It is difficult to compare the old days of low pay and long hours with the newer days of higher pay, crippling inflation, and duty hours restrictions. Both groups had (have) it rough. The younger generations have a whole new set of issues that the older group never dealt with including increasing competition for spots and crushing debt load. In addition, many of the older generation got to experience life when pay was far above other lines of work and the respect for physicians was at a peak. Now, everyone else's pay is quickly catching up as physician pay has stagnated and payers are lowering reimbursements. In addition, most new grads will never know true private practice and will be cogs in a wheel. Respect for physicians is declining and will likely never return to what it once was. The pressure to perform for the younger generation has been ratcheted up significantly and the administrative burden on residents at present is something I could have never imagined. Death by a thousand clicks, as they say.
I say it all of the time. I think the younger generation of physicians that I have the honor to work with are far brighter than I was at their stage of training. Yeah, I may have worked a few more hours here and there and I have gained knowledge they may not have yet through my years of experience, but the burden of issues they deal with carries its own heavy weight and their book smarts are through the roof. So, any slight advantage that I may have through years of experience diminishes quickly as the younger generation passes me by. Medicine is tough and we should all respect what each of us have accomplished, no matter if we are young or old. I consider it a badge of honor when someone that I helped train flies past me in their skills and knowledge of medicine (and they usually do because we recruit some of the best and brightest). These are the ones who will be taking care of me when I need them in a few years. It is nice to know that we are in good hands and I hope it remains true for many years to come.

 

[Dr. Rude]

I bet you also did residency before there were EMRs and when you could show up with a crayon in your hand write your name and pass step 1. Medical information is at light speed now for residents with EMRs and they had to make step1 pass fail because it was a nuclear arms race of competition that was unsustainable. I bet you'd get boat raced by these new kids on a standardized test.

Kids these days. Jeez.

 

[nimbus]

As an intern, I got along just fine in Manhattan on $29k with a $600 hospital subsidized studio apartment furnished with a mattress and plastic lawn furniture.

For more perspective.


“But by 1874, the faculty recognized the need for a physician to examine patients as they arrived, and provide care during their stay. The Regents set forth the duties of a new type of employee called a “hospital physician” as follows:

“Examine patients as they arrive, assign them quarters after they have paid the admission fee, and notify the physician to whose department they belong.

See that they receive proper food and that accurate record is kept of the treatment of each case. Dispense all the medicine himself and charge regular drug store prices, and charge for all dressings.

See that the hospital is kept in a comfortable and cleanly condition, shall prevent persons not belonging in the hospital from lounging in the building, and promptly report any irregularities occurring therein.”

They authorized the hiring of Robert J. Peare, M.D., an Irish immigrant who had graduated from the Medical School in 1869, as the first Hospital Physician. He oversaw the care of the 185 patients who stayed in the hospital – often for weeks at a time – when the hospital was open from October to July of his first year.”

“In addition to the house staff, U-M’s first young physicians to be called “interns” were hired in 1899, and were paid $125 a year. They also received room and board in the hospital or nearby houses.”

Doctors in the house: History of medical interns and residents at U-M hospitals

Every July, a new crop of recent medical school graduates arrives at teaching hospitals nationwide – including hundreds at Michigan Medicine.

www.michiganmedicine.org

 

[BLADEMDA]

It is difficult to compare the old days of low pay and long hours with the newer days of higher pay, crippling inflation, and duty hours restrictions. Both groups had (have) it rough. The younger generations have a whole new set of issues that the older group never dealt with including increasing competition for spots and crushing debt load. In addition, many of the older generation got to experience life when pay was far above other lines of work and the respect for physicians was at a peak. Now, everyone else's pay is quickly catching up as physician pay has stagnated and payers are lowering reimbursements. In addition, most new grads will never know true private practice and will be cogs in a wheel. Respect for physicians is declining and will likely never return to what it once was. The pressure to perform for the younger generation has been ratcheted up significantly and the administrative burden on residents at present is something I could have never imagined. Death by a thousand clicks, as they say.
I say it all of the time. I think the younger generation of physicians that I have the honor to work with are far brighter than I was at their stage of training. Yeah, I may have worked a few more hours here and there and I have gained knowledge they may not have yet through my years of experience, but the burden of issues they deal with carries its own heavy weight and their book smarts are through the roof. So, any slight advantage that I may have through years of experience diminishes quickly as the younger generation passes me by. Medicine is tough and we should all respect what each of us have accomplished, no matter if we are young or old. I consider it a badge of honor when someone that I helped train flies past me in their skills and knowledge of medicine (and they usually do because we recruit some of the best and brightest). These are the ones who will be taking care of me when I need them in a few years. It is nice to know that we are in good hands and I hope it remains true for many years to come.

I don't begrudge the kids today getting more pay and better hours. There is sky high inflation and the shift to work-life balance has occurred even at the residency level. But, the training in some fields is simply inadequate like Surgery and even some Anesthesiology residencies. The trainees need exposure to cases and adequate hours at work. The new surgical graduates I have seen are in general extremely weak vs the ones from 20+ years ago. There are some things you simply can't learn from a You Tube Video.

I wouldn't trade my decades of experience for all the book knowledge in the entire field. Nothing makes you a better Anesthesiologist than actually being on the ground doing cases, preferably some solo cases, day after day and year after year. I would add the caveat that skills and/or mental acuity do start to decline for most at some point in their 70's. I do hope the next generation and the one after that continues to advance the field to an even higher level.

 

[deleted1156722]

It is difficult to compare the old days of low pay and long hours with the newer days of higher pay, crippling inflation, and duty hours restrictions. Both groups had (have) it rough. The younger generations have a whole new set of issues that the older group never dealt with including increasing competition for spots and crushing debt load. In addition, many of the older generation got to experience life when pay was far above other lines of work and the respect for physicians was at a peak. Now, everyone else's pay is quickly catching up as physician pay has stagnated and payers are lowering reimbursements. In addition, most new grads will never know true private practice and will be cogs in a wheel. Respect for physicians is declining and will likely never return to what it once was. The pressure to perform for the younger generation has been ratcheted up significantly and the administrative burden on residents at present is something I could have never imagined. Death by a thousand clicks, as they say.
I say it all of the time. I think the younger generation of physicians that I have the honor to work with are far brighter than I was at their stage of training. Yeah, I may have worked a few more hours here and there and I have gained knowledge they may not have yet through my years of experience, but the burden of issues they deal with carries its own heavy weight and their book smarts are through the roof. So, any slight advantage that I may have through years of experience diminishes quickly as the younger generation passes me by. Medicine is tough and we should all respect what each of us have accomplished, no matter if we are young or old. I consider it a badge of honor when someone that I helped train flies past me in their skills and knowledge of medicine (and they usually do because we recruit some of the best and brightest). These are the ones who will be taking care of me when I need them in a few years. It is nice to know that we are in good hands and I hope it remains true for many years to come.

Thank you for writing such a nuanced perspective!

The older and younger generations of physicians, often practicing side-by-side, need to learn to live and work together in harmony, even if they have different outlooks.

What I have observed is that physicians of the previous generation are often more selfless and insensitive to their own personal and family needs. They burn both ends of the candle and maybe in the process, accumulate a good retirement nest egg, but may not have had the time to enjoy their working years with their family and loved ones as much.

Clearly the Gen Z is asking for more and making the physician role to be “fulfilling” and not draining, and are really emphasizing the elusive “work-life” balance—even during residency and job interviews, which was never even brought up by the previous generation of physicians.

In the next few years, the newer generation of physicians will work less and less, will be more and more demanding about the way they are treated, and will tend to focus more on personal fulfillment and their quality of life, rather than selfless service or retirement life.

As a physician who is somewhere in between this generational change, I am really curious to see how this paradigm-shifting change in mindset will change this amazing profession in the future!

 

[nimbus]

I bet you also did residency before there were EMRs and when you could show up with a crayon in your hand write your name and pass step 1. Medical information is at light speed now for residents with EMRs and they had to make step1 pass fail because it was a nuclear arms race of competition that was unsustainable. I bet you'd get boat raced by these new kids on a standardized test.

At one of our hospitals (Bellevue) we used to put a drop of blood in a capillary tube and spin it in a centrifuge. Then we’d hold up the tube next to a “reader board”in order to get a stat hematocrit. We spent hours “prerounding” drawing and then collecting lab results and imaging results in order be ready to present at rounds.