Monday, March 26, 2012

Life - Do med students have one? Work-life balance across generations

I gave a journal club last week discussing some general ideas about generational differences between the three main groups trying to work together in medical education: Boomers, Gen X, and Gen Y (or whatever it is your preferred term for this generation is).  As I was looking into the topic to prepare for this talk, one of the themes that kept popping up was the work-life balance theme.  In general, the common wisdom is that the Boomers value hard work, and are willing to sacrifice family life for career advancement.  Gen X and Gen Y tend to have less of a focus on work as a source of primary identity, and see much more value in maintaining balance between career and home.  The purpose of this blog post is not to decide whether this is indeed true or not.

What I'd like to spend a moment discussing is how this generational difference is creating conflict in the halls of medical schools.  Medical students are primarily Gen Y (although there are some Gen X in the mix).  Faculty who now populate Dean's office level positions are primarily Boomers, and course/clerkship directors are now Boomers with some Gen X filling the junior ranks.  So, what happens is that the Boomers remember their medical school life which was ruled by the Greatest Generation (even more value on work due to their experiences in the Great Depression).  The biggest place I've seen this conflict play out is in requests for time off or for changing a date to take a test.  The Boomers were given very little room to change their schedule.  I've talked to many of them, and the stories were essentially that if you wanted to take a day off during the clinical years for anything other than being near-death, there would be severe consequences (like repeating the entire clerkship).  Things were a little better for me, but not a lot.  I remember having friends in medical school who had a lot of trouble getting time off to attend weddings or family reunions.  There was minor grumbling, but we all decided it was a transient time, and this was preparing us somehow for the trials of residency.  And we kept telling ourselves that things would eventually get better.  We also had the usual weeks of vacation around the Holidays and Spring Break for some time off.  Everyone also had some lighter rotations, and the fourth-year comes with a much more flexible schedule.

Then along comes Gen Y.  They are much more vocal about their need for time off, and much more vocal about providing feedback on things that they are not in agreement with.  And they are now complaining primarily to the Boomers, who primarily don't want to hear about it.  I'm not so sure.  Maybe it's my Gen X roots showing or maybe I'm still close enough to being a student that I remember the bind it puts you in if your schedule is completely inflexible.  So, I'm wondering if maybe school policies for personal days off should be revisited.  I'm thinking most of the policies were set in place for a very different world, and haven't been changed much for 20-30 years.  With the advent of technology, it is possible to make up some assignments which may not have been possible to make up in the past.  There's also a different cultural norm emerging (or maybe I just think this should happen), and missing a wedding because you are assigned to spend a day in clinic is not an acceptable trade-off.

As a disclaimer - I've been told by several fourth-year students that as a clerkship director, I run a 'tight ship'.  To my mind I'm just doing what the school time off policy is telling me to do.  Our school policy is that student have 2 days off per year which can be used for attending a professional meeting or if they are ill/ have a family emergency.  All other time off is at the discretion of the clerkship director, and must be made up.  I'm not sure I have a perfect answer as to how to change the current policy, but maybe working with appropriate representatives from Gen Y, Gen X, and Boomers we can work together to figure something out.

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