Recent medical school graduates are gravitating toward higher-paying specialties with more controllable hours compared with their more senior counterparts, according to the Medscape Physician Lifestyle & Happiness Report 2020: The Generational Divide.

Travis Singleton, executive vice president for the physician recruiting/search firm Merritt Hawkins, told Medscape that the trend toward higher-paying fields is "often due to high debt loads rather than any particular calling for the specialty."

He added that millennials seem to be drawn toward controllable hours for better work-life balance.

The report examined how physicians balance their work and their lives outside work and how that varies by generation. It compared answers from millennials (ages 25–39); Generation X (40–54); and baby boomers (55–73).

More than 15,000 physicians in 29 specialties responded to the survey.

Similarities and Differences

For some categories, common threads ran through all three groups, but in others there were sharp divisions.

Millennials were heavily represented in dermatology (31% of all dermatologists are now millennials), neurology, and internal medicine (millennials made up 29% of both specialties), as well as oncology and general surgery (millennials made up 27% in each specialty).

Critical care had high numbers of Gen-X'ers (43%). Nephrology and emergency medicine had the next highest percentage in that age group (both 42%), with diabetes & endocrinology and infectious diseases close behind, at 41% and 39%.

Boomer-heavy specialties were gastroenterology, represented by 53% of physicians from that age group, then pulmonary medicine, public health and preventive medicine, urology, and plastic surgery, in each of which baby boomers represented 49% to 51%.

Most Physicians of All Ages Happy in Home Life

Happiness outside work overall was fairly universal for physicians: Fewer than 20% in each category said they were unhappy.

Millennials edged out the others in happiness; 81% said they were happy outside of work, compared with 77% for Gen-X'ers and 76% for boomers.

The vast majority of all physicians were either married (80%) or were living with a partner (4%). About twice as many female physicians (13%) reported that they were single in comparison with their male colleagues (6%).

Asked to describe the quality of their marriages, most rated them high: 87% of millennials, 83% of Gen-X'ers, and 86% of baby boomers said their marriages were good or very good. Across age groups, 11% to 12% checked "fair."

By specialty, those happiest in their marriages were nephrologists and physicians in physical medicine and rehabilitation, at 61%. The lowest marriage happiness percentages were for physicians in psychiatry and critical care, at 48% and 45%.

Rheumatologists and general surgeons were happiest outside work overall (60% reported the highest levels of happiness), followed by physicians in public health and preventive medicine and allergy and immunology (both had 59% at the highest levels). Neurologists and critical care physicians were least likely to report that they were happy outside work (both averaged 44%.)

Most physicians overall reported religious or spiritual beliefs (68%). The highest percentages with those beliefs were baby boomers (74%), followed by Gen-X'ers (67%) and millennials (61%).

Physicians were fairly split regarding anxiety about the current political climate in the United States.

While 44% of physicians overall reported they were somewhat or very anxious about the political climate, 45% said they were only slightly anxious or not anxious at all.

Both percentages are considerably below the average for American adults ― the American Psychological Association reports that 62% of American adults said the current political climate is a significant stressor, behind healthcare concerns (69%) and mass shootings (72%).

Time for Well-Being Is Challenging

Fewer than half of physicians across the three age groups said they spend enough time on personal health and wellness outside of work always or most of the time.

Boomers were best at that, with 46% answering that they devoted enough time to their well-being always or most of the time, compared with 34% for Generation X and 35% of millennials.

Conversely, 3% of those in Generation X said they never have enough time to devote to well-being, compared with only 1% who answered that way in the other two age groups.

Male physicians overall were more likely to find time for wellness: 42% of men and 33% of women said they mostly or always had enough time for self-care.

There was little differentiation by age in categories of hours worked each week. The same percentages (23%) of the three age groups worked 40 hours or fewer. The percentages were similar in the 70-plus hours group (below 10%).

Nearly One Quarter Take 5 or More Weeks of Vacation

However, physicians also report taking a fair amount of vacation time. Nearly half (44%) reported taking 3 to 4 weeks of vacation, and 23% reported taking 5 or more weeks. One third reported taking 2 weeks or less each year.

The survey also asked respondents to gauge their Internet use.

As might be expected, millennials were the most likely group to spend more than 10 hours a week on personal Internet use. Nearly three quarters of boomers (71%), conversely, spent 10 hours or fewer a week on personal Internet use, compared with 56% of millennials.

Regarding professional use of the Internet, percentages were similar across the age groups for all time categories.

Most Don't Use Marijuana; Few Drink Much

The survey asked about other lifestyle factors, such as use of cannabidiol and marijuana, and found that 7% to 10% partake across all age groups and that only 2% to 3% use it recreationally.

Among millennials and Gen-X'ers, 67% said they had two drinks or fewer per week at most; 64% of baby boomers said the same; 20% to 24% in each age group said they do not drink at all.

Boomers were much more likely to exercise every day than were their younger counterparts. About twice as many boomers (12%) as Gen-X'ers (7%) and millennials (5%) said they exercise every day. Millennials were the most likely group (26%) to say they worked out once a week or less.

Certain car manufacturers appeal to physicians across the age spectrum. Toyota topped the preference list at 20%, followed by Honda (15%). Those top choices were the same across all three age groups.

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