I'll probably regret getting in the middle of a boomer vs millennial slap fight, but I'll just throw out the data point that mid-1990s residency grads had a sub-50% board pass rate.
There actually is a cohort of statistically inferior anesthesiologists who are approaching 30 years in practice ...
🙂
I followed those stats fairly closely. I believe that the oral board pass rate for one year was something like 56%. I don’t think it went lower than that and it recovered quickly back to normal (high 80s and low 90s). The ABA did not change the expectations or lower the bar to adjust for the seemingly lower quality candidates who were entering the specialty at the time, and the pass rates reflected that dip in quality of the pool of candidates.
The standardized test passing game is also very different now. It’s big business and Q-banks and hand held devices make it possible to study in much more efficient ways than were available back in the day. So it is a very different world compared to that time. That being said, I believe the candidates that I work with who are of a significantly younger generation than myself are significantly smarter than I am. However, I think there are also many things that are different for them, some good and some bad. With the duty hours rules, they get significantly more time off now and a far better work life balance than the older generations. When you arrive in the work force and suddenly are forced to work 100 hour weeks when you’re used to 60, it can be eye opening. But today’s residents must deal with so much useless stuff as well such as logging everything and so much data entry of rubbish. They have protocols that they are not allowed to vary from. For good or bad, they don’t get to be as adventurous and learn as many outside the box techniques. They’ve got duty hours, milestones, and all kinds of other stuff that turns into busy work data entry. Often, they don’t get autonomy until after they graduate (that can be both a good and bad thing). There also new stressors such as the idea that you can graduate med school and not get a residency program…at all. That happens to many who are bottom quartile or don’t choose wisely based upon how competitive they are. Students frequently no longer have ways to distinguish themselves as quality students as med schools have gone to great lengths to try and hide their worst students by going to pass fail and now with step scores doing the same. Many Dean‘s letters do a very good job making a 4th quartile student look like middle of the road.
So, if believe that, even with certain things to try to make a trainee’s life better, the younger generation actually has it worse, with more stressors and wash out points that can occur. With Q banks and grade inflation on standardized exams, it raises the bar significantly so that the old “average” is no longer good enough. People have to fight to over achieve in order to make the cut. The ramifications of NOT doing that can be graduating and not having a job. I’ve seen it happen way too many times. I think it was extremely rare 2-3 decades ago.
So, I think the younger people are extremely bright and have to deal with a lot of things that the olders never did.
Then there is the fact that the older generation sold out to private equity and killed opportunities for the younger generation.
So, each generation has their own goods and bads and it isn’t as simple as saying whippersnappers vs boomers and being a clear cut difference with one being better than the other. It’s just a totally different pathway.
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www.ncbi.nlm.nih.gov
