The Millennials are Coming

Steven H. Dayan, MD, FACS is a facial plastic surgeon practicing in Chicago, IL. He is Co-Chief Medical Editor for Modern Aesthetics^® magazine.

For the last six years I have taught an undergraduate course at DePaul University and on my first day of class as I stood at the lectern welcoming the class, I quickly recognized that the learners of today are much different from what I remembered from back in my Washington University days. Brookings Hall was a voluminous vaulted gothic structure that pews 150 coeds. We sat as if in a house of worship listening to an esteemed professor soliloquy for 60 minutes. We knelt before the professor, opened our mouths, and accepted every drop of information as if it was the Eucharist. We wrote furiously so as not to miss an important dictum.

My experience at DePaul, though, is rather different. The classroom is carpeted and small, a whiteboard has replaced the chalkboard, the students amble in with ear buds in, splash down into their seats, recline back in their comfortable chairs, open their laptops, look up at me with a not so subtle look, and demand to be taught. At first miffed by their open laptops, I was told by my TA this is how they take notes, but I soon realized it means they also reserve their constitutional right to surf the net if they are not being adequately entertained. I quickly learned my lesson.

Teaching as well as social interacting has changed, and it was I who was now going to have to adapt if I wanted to share my knowledge with the current generation. I scrubbed my lecture and rewrote my lesson plans. No longer was I paternalistically shoveling information into their fertile minds. I had to demonstrate, paint, and entertain them. I developed teaching methods that became interactive, including role-playing, and social experiments. We even once sat in circle discussing the evolutionary make up of bananas—whatever it took to keep their skeptical, certainly abbreviated attention spans and compartmentalized minds interested. I now had to deliver information by merging presenting and entertaining into what I called “presentainment.” Utilizing this strategy, teaching became an incredibly rewarding experience. But I also learned that the new generation learns, interacts and is inspired differently than a generation ago, and to stay relevant it is necessary to adapt.

Who are Millennials?

Millennials are defined as those individuals who turned 18 in year 2000. David Roberts from Harvard Medical School described them as “…technologically savvy, interested in fairness, attracted to teamwork and community building, and accepting of diversity. However, they are driven by self-interest, often prefer structured environments for learning, and are used to immediate satisfaction of needs.”¹ While this makes sense, in order to gain a deeper understanding, I decided to sit down with my millennial staff members and three daughters questioning them further. And what I learned fascinated me.

Millennials see the social world as flat

This unfurling generation sees a broader, flatter social landscape absent of the structural architecture and hierarchy common to yesteryear. There is no better example than that which is found in the sleepy affluent Chicago suburb where I reside. The local neighborhood kids call parents by their first name! To the 12-year-old cookie chomping, Lululemon-draped, hair flipping seventh grade drama queen, I am “Steve” not Dr. Dayan. And this lack of hierarchal etiquette is not limited to personal arenas. In my operating room, medical students tell me when they feel they have learned enough and are ready to scrub out for lunch! Such blasphemous behavior a generation ago would have resulted in a measure of reprimand, however, caution is advised today. Such retributions are better known by one of the named abuses: child, student, verbal, psychological, or environmental.

As my millennial medical assistant Meaghan told me yesterday, the demise of the societal pecking order is due to the democracy of social media, which has done away with hierarchies. Through Instagram, Twitter, Facebook, and the like, Millennials comfortably can and will reach out to anyone regardless of their age, profession, or status. They feel less venerable to authority, and while this may seem insulting to the “hard knocks”-raised Gen X or Baby Boomers there can be an advantage to those who are willing to accept the new interactions openly. An opportunity for an honest exchange of information and frank feedback is there for the taking, an ability to learn for the mentor as much as the mentee is an eye-opening proposition that can and should be welcomed. And while at first the lack of deferential demure may be interpreted as an insult perhaps in an evolving world, challenging the cannons of the past sooner than later should be an appreciated offering. Nourishing an intellectual garden that will allow such flowers of promise to sprout can shade out the weeds of doubt that too often sideline the pathways of progress commonly found between the white towers of academia. In practicality, as medical professionals, perhaps we should aim to get our younger generation of physicians up on the panels, advisory boards and in leadership positions more quickly.

Millennials are impatient

Just as Millennials are unlikely to wade through pages of books housed in the bowels of a library or wait until the end of the season to get a trophy, they are less inclined to methodically work their way up a chain of command. They aren't clear on the reasoning behind “paying their dues” as was the previous generations' expected protocol. They also don't see this as an efficient means to their end goal. Millennials want to feel and know they are contributing now and not have to wait their turn. And with a tech world that is doubling every three years, they just may have a lot to offer. The information age is advancing incredibly quickly and understanding, mastering and using it to an advantage is necessary for messaging, marketing and education.

Most of our senior leaders have little interest or knowledge of Instagram, Pinterest or Up To Date App. Can a progressive academic society consider this demand? Can we provide fast-track opportunities for Millennials to publish, teach and organize? Should there be more than a token Millennial representative helping to organize our meetings? Should there be a Millennial chairman, maybe a Millennial board member or a viable mechanism for the next generation to truly contribute to our policies?

Millennials tend to be less
trusting of authority, relationships

A generation ago a leader with a hole in their sock rarely worried about its revelation, but today breaking scandals surrounding our biggest political leaders are the expected daily fare. Additionally with social media, electronic friends and relationships are more fleeting, less vested and defined more by fallacious highlight reels then pivoting singular life experiences. Romantic twists can be swiped and swapped with just the touch of a finger. Millennials therefore seem to trust less in relationships and empty words of future promises. A generation ago going through the rigors of medical schools meant following rather formulaic rules of delayed gratification. Study hard, get good grades, get a good residency, get a good job, and then finally get a house in the ‘burbs and a Cadillac. That payoff or promise is no longer, but Millennials don't seem dismayed.

Millennials want a more fulfilling life enriched with meaningful experiences. They don't see the futility in devoting themselves to another's cause unless there is an immediate return. Can we offer more experiential learning options, visiting internships, more travel medicine opportunities, establishing outreaches to charitable organization both at home and abroad, celebrate awards and praise recognition at earlier milestone achievements?

Today, when I hire a Millennial I no longer encourage them to mislead by telling me by how they want to work in my office for next 25 years and get a watch. I have come to accept that I am just a stop on their yellow brick road to something else bigger and better. So now during our interviewing process we have a frank discussion about their dreams and desires and we brainstorm how a stint at my office can help them to achieve their goals. Whether it be a CEO of a marketing company, a medical science liaison (MSL) at a pharma company or a stay at home mom, if they are straightforward with me, I'll do my best to craft their job so that they can get the necessary skill and meet the appropriate contacts propelling them closer to their dream. I only ask them to be honest and to work hard while they are with me, and when it is time for them to move on we both are the better for it. This has resulted in enormous fulfillment for me as I now see many of my former employees going on to reach new levels of acclaim professionally and it allows new people to come in and be inspired by those ahead of them who have reached great heights. I get better staff. But it took me adapting to them, not the other way around.

Millennials are Team Players

Millennials are recognized to be better team players; they are not as interested in individual power gains common to a previous generation.² Millennials understand the group dynamics and benefits of team achievements. They likely won't see or care about the inter-specialty conflicts or battles of a previous generation. Moving forward, the educational programs that are more multi-specialty in nature which have already begun can expect to triumph to greater success. Attempting to draw lines in the sand between specialties, reliving turf battles, and shunning other groups can probably be packed away for good. Our Millennials will be forging stronger bonds and relationships with other specialties, as it is clear we have mutually aligned interests. Additionally thanks to Internet, email, and social media, the medical universe is shrinking rapidly. Cross-continent training and sharing of information is no longer a rarity but now the norm. And our Millennials with mastery of technology and the electronic world will be as likely to learn from a colleague in Singapore as from one in Seattle.

Millennials want to be entertained

Millennials are tech savvy and desire their information from multiple sources packed into quick hitting quantas of information. They won't sit in a cold large lecture hall and listen to a litany of professors crow about their successes. Our presentations will have to become more visually attractive, integrating multiple touches from social media modalities. Other tentacles of education will likely include streaming social media pings that hit them where they look most to virtual learning centers, interactive role playing and simulation technologies allowing for near life like experience. If we are to stay relevant, new educational methods will be requisite to our future meetings. And for those Millennials who can't make the meeting because they are scaling base camp at Mount Everest, surfing the break on Bondi Beach, or coaching the 6th grade soccer team how do we provide the meeting highlights to them? Perhaps the future will bring ghost lecture halls and social networking events where we can virtually attend and interact with our colleagues' electronic likenesses on screen but yet not be there physically.

Adapting for the Future

The future of medical societies and medical education is exciting to contemplate, and if there is one thing we can say for sure it is going to change from what it is today. The days of bulleted Power points, complicated charts and over extended tables splashed upon slides are coming to a screeching halt. As Charles Darwin so prophetically stated over 140 years ago, “It is not the strongest of the species that survives, nor the most intelligent that survives. It is the one that is most adaptable to change.” Are we ready?

1. Roberts, David H., Lori R. Newman, and Richard M. Schwartzstein. “Twelve tips for facilitating Millennials' learning.” Medical teacher 34.4 (2012): 274-278.

2. Borges NJ, Manuel RS, Elam CL, Jones BJ. 2010. Differences in motives between Millennial and Generation X students. Med Educ 44(6):570–6