Issue 21 / 8 June 2015

FEAR of missing out, or FOMO, is one of the great undercurrents tugging at the feet of the Millennial Generation — that well connected group of people born between 1980 and 2000.

FOMO bobs up regularly on social media, where opportunities lost or gained are variously mourned or celebrated.

It appears that FOMO is also a key driver for medical students and junior doctors as they strive to get an edge over their peers in a highly competitive career environment.

These Millennial Medicos are competing with nearly twice as many of their peers as a decade ago for hospital placements, preferred rotations and specialist training places.

For some, going rural is deemed a bit of a backward step in this career race. We’re told that the FOMO perception at play here is that by going rural you may miss out on more prestigious city placements, with better facilities and exposure to the latest technology. Yet the students who think like that may actually be missing out on the more compelling advantages of rural training, and on more opportunities for their future career.

Rural Health Workforce Australia recently commissioned research on this subject, with the University of Queensland. The study was based on in-depth interviews with 41 junior doctors and 25 medical students from Adelaide, Brisbane and Melbourne.

If that sample is anything to go by, the Millennial Medicos are looking for quality training experiences that will develop their skills and boost their professional prospects. The research showed they prize:

  • Working in smaller teams, with more attention from supervisors
  • More responsibility, with opportunities for hands-on learning
  • Broader scope of practice
  • Greater continuity of care

These are the very benefits offered by going rural. As one student told us recently: “Rural placements are not career limiting. They are an opportunity to excel in practical and theoretical components of clinical medicine, make connections, smash your exams and advance your future career.”

When asked what else contributed to successful rural placements, the Millennial Medicos wanted strong professional and social support.

Not surprisingly, good internet access was deemed very important to stay in touch with friends and peers for study, research and remote clinical support. A preference for flexibility in relation to part-time training was also expressed by some of junior doctors.

We decided to explore a little further and asked 1000 university health students about their attitudes to clinical placements. These students belong to Rural Health Clubs, which we support through the National Rural Health Students’ Network.

Although this study is not published, this broader sample of medical, nursing and allied health students reiterated the benefits of rural training found in our research.

In fact, the number one answer from nursing and allied health students to the question of what factors they considered important when deciding to undertake a clinical placement was “opportunities for hands-on learning”.

Financial costs associated with placements, such as accommodation, were important for nursing and allied health students who clearly need more assistance in this area.

So what does all this mean for rural and remote health?

Our investigations have uncovered some defining characteristics about the new millennial generation of health professionals. They:

  • Are tech savvy (rural infrastructure and technology are critical)
  • Value work–life balance (rostering needs to be more flexible)
  • Thrive on social connection (team-based care fits into their world construct)
  • Question the status quo (are likely to adapt more readily to new workforce models)
  • Are competitive and are prepared to shop around (the rural health sector needs to “sell” itself more effectively).

These characteristics mean that the future workforce will be different to the past, as will future health service models and the workers they need.

Meanwhile, Australia continues to invest heavily in health care undergraduate and vocational training in the hope of developing a home-grown rural health workforce.

Matching culture to that workforce is going to be critical as these Millennial Medicos, nurses and allied health workers explore the various roads to rural.

The greatest FOMO is in Australian rural communities who will miss out if policymakers and health services fail to connect with the current up and coming generation of health professionals.


Mr Greg Mundy is the CEO of Rural Health Workforce Australia.


6 thoughts on “Greg Mundy: Millennial medicos

  1. V218680@amamember says:

    Dr Mackey,

    Whilst I understand the point you make regarding the difficulty in filling training places, I am afraid the two medical landscapes are in no way analogous.

    The flaw in your logic is that you are comparing training places that produce graduates (a very fixed risk/reward ratio) with jobs without guaranteed pathways for junior doctors.

    The article’s assertion that convincing more doctors to work in the country will help junior doctors and solve the training crisis is fanciful and irresponsible. It detracts from the true nature of the crisis and enables those with little empathy or understanding of the true issues to incorrectly label and disregard the concerns of the emerging generation of doctors.

    Until rural Australian hospitals, like their Canadian counterparts, offer integrated training programs with the guarantee of a fellowship to those they are trying to recruit, they will fail to attract, or help, junior doctors in any significant way.

    Until then, I suggest you advertise to Australian graduates. I am sure some of the 1604 odd doctors who missed out on GP or surgical training alone last year would be happy to move to BC. May I suggest targeting skiers or hockey fans. 

  2. Paul Mackey says:

    Overcoming the rural cringe amongst future docs is a challenge the world over. North Wales and Scotland have multiple unfilled spots. In Fort St John in Northern BC, Canada we have filled 16/32 positions in our Rural Family Practice Residency over 8 years. Our graduates finish with higher confidence in procedures, emergency and obstetrics. Unfortunatley that is still not enough to overcome the rural inferiority index that is inculcated very early in DITs careers.

    Dr Paul Mackey IncUBC Clinical Assistant ProfessorFort St John, BCCanada 



  3. V218680@amamember says:

    John Stokks I am afraid that I cannot agree with your view. In fact, I find it condescending and ill informed.
    Your assertions demonstrate a clear lack of understanding of the the training crisis and a worrying dearth of empathy.

    I, along with the many other unemployed DITs, do not need someone else to tell me about your ‘real world.’ In fact, I rather suspect that most junior docs battling through protracted training times, following longer and more costly periods at university than ever before, need little advice in this respect. 

    The world in which we work is a very unnatural one. There is a massive oversupply of DITs, yet we have no powers to negotiate as individuals. Australian medical schools offer little in the way of non-clinical training, yet we face the real prospect of being unwillingly forced into alternate careers. With rising unemployment, huge debts and little prospect of things improving, is it any wonder that the mental health of DITs is in such a perilous state?

    Many of us would love to go bush. Unfortunately, until the Colleges recognise training there, or do something to get the 800 GP or 82% of surgical applicants who missed out on training spots last year into training, sending us out on mass to the country remains an unrealistic solution.

    Perhaps I am part of the FOMO generation, but my fears consist of not being able to find a job, pay my debts or start a family before 45 for lack of any job security. These are things most people would be afraid of missing out on. I will not miss patronising attitudes like yours. The fact that it has been highlighted today in the Insight email is a shame and reflects poorly on the editors.

  4. John Stokes says:

    It is interesting to read this. Medicine is now entering the real world. No other profession (engineers,teachers, vets, dentists, lawyers, scientists, nurses, physiotherapists etc.,) get a guaranteed employment at year one and then expect the best of training everywhere they get employed at a very good salary for their working life. They  genuinely believe they deserve this.  Life and employment leads to rewards for those who take a risk, give all and make the best of every opportunity no matter where it comes. The cost of living is the same for all the other professions but we wish ours to be subsidised and for us to get special treatment. If our medical students looked around and truly visualised what nurses and other professionals have to compete for and what they get when they graduate they would realise they are very privileged. Rewards often don’t come immediately in life and sometimes aren’t delivered until you have worked hard practised and contributed for many years. The FOMO  generation of medical students need to understand this and accept they are now in the real world. Often the best teaching and learning may not be in the ivory towers of our capital cities and the opportunities may not be there also. That is why we have to move teaching to the regions and the areas of underserved medical need.

  5. Department of Health Victoria Clinicians Health Channel says:

    Thanks Greg for your article. This is my first ever comment to MJA insight.

    I’m of the FOMO generation. 11 years ago I was a third year medical student and spent a year doing a rural clinical placement. I loved that experience – the hands-on experience, the natural friendships that occur with other students and doctors for being (what I thought at the time), ‘stuck in the country together’. When I compared my experiences with my friends who had done city rotations, I realised that I had had a really good deal. I had seen more of medicine and surgery than my city counterparts.

    I enjoyed that one year rural rotation so much, I ended up returning in 4th year for GP/psych. And not to boast, but more as a testament that one can do well being in the country, I ended up graduating from med school with honours.

    Today, I have returned to that same rural town, and now work full-time as a medical specialist. And my career has far exceeded my dreams. I am now doing what I thought would take me at least 10 years to achieve. I am thankful for all the experiences I had as a medical student and junior doctor, which really set me on this path to working in the country.


  6. Judy O'Connor says:

    Going Rural or Regional is career enhancing.  Interns in regional areas are getting opportunities to practice with small teams where they are an important member of the team, everyone knows them and they have excellent supervision in the small teams. They are also getting opportunities to practice in the private sector in some areas and this can enhance their opportunities even further, with the ‘team’ being the Consultant and the Intern.  Then in second year many are getting opportunites to move very quickly into the  PHO/Registrar role because of the workforce shortage. This is the beauty of Australian grads , both domestic and international students, in the rural and regional areas.!!

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