A new study found that one-quarter of medical students are so disenchanted with their program they are considering quitting. A much larger proportion of medical students and nursing students (58%) would prefer a career in health care where they don’t treat patients. Students were especially worried about the cost of their education, but also burdened by the sheer volume of information they must learn. The Hill had this to say:
“I think there’s a common sort of chronic feeling of being overwhelmed by the amount of information that they need to obtain,” he added.
Erlinger noted that the high percentage of students considering their studies as stepping stones to administrative and support roles was “surprising,” as those sorts of decisions are typically seen later in their careers.
In a separate survey of practicing physicians nearly half would like to either leave health care or change their role in the next several years. In the survey 22% would like to leave health care while another 26% would like to leave their current role. One of the factors given is the stress of staff shortages, both doctors and nurses, and the long hours. This from the survey, Clinician of the Future:
For those who are considering leaving healthcare, the growing frustration with systems under pressure could be having an impact.
According to the National Governors Association, almost 20% of the US healthcare workforce left their jobs at the start of the pandemic, and another 20% were considering doing the same in the subsequent months.
We also know that many clinicians are planning to retire. In the USA, more than a quarter of doctors are older than 60, and the average age of a nurse is 50. In the Commonwealth Fund survey, doctors aged over 55 were more likely (67%) to plan to stop seeing patients regularly compared to those aged under 35 (15%).
The job of physician holds the top spot of the most lucrative professional occupation. However, working conditions have changed in the past few decades. Whereas physicians were historically self-employed males, now the ratio of male to female medical students is about equal. Both male and female physicians want more work-life balance. As a result, about three-fourths of physicians are now employed rather than self-employed. Physicians have traded the stress of running their own office or small group practice for reporting to a boss. Hospitals, health care systems and private equity investors are increasingly who physicians work for. These groups are often tough taskmasters, enforcing revenue targets, penalizing referrals outside the organization and requiring noncompete agreements that prevent physicians who want to leave an employer the ability to get jobs in the area. Employed physicians report pressure to work longer hours to see more patients. With an average of $251,000 in student debt, it is easy to see how it could be stressful when physicians face a mountain of debt while having less control over your career.
The news that about one-quarter of medical students and practicing physicians want to quite comes at a time when the United States is experiencing a physician shortage that is expected to get worse in the coming years. The American Medical Association (AMA) is even concerned about the growing shortage of physicians. Let us not forget that the AMA was instrumental in causing the physician shortage nearly 30 years ago. The physician advocacy organization told Congress back in the mid-1990s that there was going to be a huge surplus of physicians in the coming decades. This self-serving advice made little sense considering nearly 80 million Baby Boomers would increasing need care as they age.
Congress was receptive to predictions of a physician surplus because taxpayers subsidize graduate medical education. Medicare pays teaching hospitals an average of about $139,000 per resident each year to train physicians. As a result, Congress capped funding for the number of residency slots to the number that existed in 1996. The number of residencies can grow slightly but lack of funding for new residencies is a bottleneck that prevents some medical school graduates from practicing medicine.
It varies by year but up to 10,000 medical school graduates a year fail to match to a residency. Those who do not match to a residency either must give up or try again the following year. Each year that goes by without matching to a residency further reduces the likelihood a medical student will ever be allowed to practice medicine. Perhaps the fear they won’t match to a residency or match to a residency not of their choosing is partly why 25% of medical students are considering leaving their medical training.