The Baby Boomers make up about 55 percent of the current physician workforce and hold most positions of authority. They associate hard work with self-worth, typically arriving early and leaving late. They are known for being competitive, and their personal lives often are casualties of professional success.⁷

Enter the Generation X-ers. Raised by Baby Boomers, they were characterized as “latch-key kids” and, possibly as a result, are more equally focused on their personal and professional lives. Their loyalty lies with themselves and with their families rather than with the institution. They are associated with the technological advances that developed at the same time. They are more likely to question authority and feel that evaluations should reflect accomplishments rather than time put in. They currently represent about 30 percent of the physician workforce.⁷

The majority of current residents and students (and about 5 percent of the practicing physician population) are Millennials. There has been a lot of attention given to Millennials entering the workforce and the differences they bring to the table. They are characterized as the first native online population, widely connected, with a penchant for advocacy for the underserved. Growing up, they were included by their parents on many family decisions, so they are not afraid to express their opinions but may be less independent, requiring more structured learning styles. They expect schedule flexibility to maintain work-life balance but feel a connection with their work colleagues as well.⁷ And, at least in my limited experience at one medical school, more of these students are choosing emergency medicine than ever before. This year, emergency medicine was the third-most sought out residency spot at the University of Alabama School of Medicine, behind only internal medicine and pediatrics.

Millennials bring a lot to the workforce. They have high expectations of themselves and of their coworkers and employers. They like to multitask and rely more heavily on technology. In terms of motivations, they tend to weigh achievement and affiliation more than power.⁸ From an emergency medicine standpoint, that sounds like a win-win! But potential conflicts can arise as well. A Millennial employee questioning a Baby Boomer boss (because that’s what they were taught to do) can lead to a tense workplace. The “everyone wins” mentality comes up against the “second place is first loser” attitude, with a few “live to work” people thrown in.

When I look at my own division, I see a little of each generation, and although this will continue to evolve, there are still issues that face all of us as we try to maneuver being a successful physician in 2014. It also gives us a glimpse into what the future holds.

The majority of current residents and students (and about 5% of the practicing physician population) are Millennials.

By 2025, Millennials will comprise almost 75 percent of the workforce. As that transition occurs, I would like to offer some insight into what makes them tick and what will drive their performance:

1. Give feedback and plenty of it. However, remember that many of these people grew up surrounded by people telling them they could be whatever they wanted, and everyone got a trophy for participating. You might have to ease them into some of the constructive portions, but when they are given that, they respond very well.
2. Be ready to negotiate. That’s what Millennials have been taught to do.
3. Allow work in teams with many small deadlines. Long-term time management may be an issue.
4. Don’t assume they are technologically savvy, but even if they aren’t, they are quick to master new things (unlike me and our ultrasound machine).
5. Be able to enforce the “work to live” attitude. Life outside the department is crucial to longevity in this profession, although this is something I think we all need to learn to take advantage of.⁹