I used to think I was a young doctor until I started working at the College of Podiatric Medicine at Western University of Health Sciences. I’m not referring to the staff – I’m one of the junior doctors on the faculty – but rather our students. Am I getting old at 37 years-old or is there a generational gap? Are we seeing the birth of the “next” podiatric generation? Am I part of this new generation, a hold-over from the previous generation, or something in between?

I Am Generation-X

By age, I am considered part of the X Generation (anyone born after the baby boomers – 1961-1981). This term was originally coined by the photographer Robert Capa in the 1950’s and was referred to as the 13th Generation in the book Generations as the 13th generation since Benjamin Franklin to be familiar with the US flag. Gen X is considered a “nomad” or “reactive” generation because we were born during a time of spiritual and social “awakenings” a la the 1960’s Civil Rights Movement, the Sexual Revolution, and the Viet Nam War. Culturally, Generation X is considered postmodern in that the scientific objectivity of modernism is rejected for a more subjective view of life. Many Generation Xers have been involved in the Dot Com boom and bust and are now those “in power” (think George Bush and Barack Obama).

Today's Students are Generation-Y

In contrast, here comes Generation Y, also known as the Millennial Generation. There are no specific dates to characterize Generation Y, but some place it as starting with the mid to late 1970’s. The term “Net Generation” has been used to indicate this generation’s familiarity with communications, technology, and the Internet. This is where the difference between the established podiatrists and our young podiatrists-to-be really lies.

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Texting

The use of new technologies has permeated all of our lives. Whether it’s cell phones, smart phones, computers, lap tops, or electronic medical records, technology is all around us. However, the difference is shown in how we use this technology. For example, I own a smart phone which I purchased about 2 months ago. Until that time, I used a cell phone, but except for limited applications, I’m still using my smart phone as a cell phone. In contrast to me, my students live in a double world, the first being where they are physically at that moment, and the second, a world of text messages, both of which exist concurrently. It used to bother me that my prior medical assistant (a 26 year-old) was able to have a conversation with me while texting someone else.

Learning with Laptops

Other differences exist as well.  When I went to podiatry school at CSPM, information was delivered in pure lecture format, with the use of a syllabus, and the students taking handwritten notes.  Communication occurred through verbal and paper-based methods.  In fact, I can’t remember receiving an email from anyone at CSPM.  Now, as an assistant professor at Western University, I see most of our communication occurs either via email or a program called Blackboard in which lectures, assignments, etc. are posted for the class to see.  I was surprised when I sat in on one of our earlier lecture classes (we have very few at Western U, since we use a problem-based educational format).  I looked around and noticed a sea of laptop computers.  Every student had the Power Point lecture on his or her laptop and was taking notes directly on the computer!  No paper in sight.

How They Learn

These students don’t just use technology - they have an organic relationship with it. Looking for the answer to a question has become, for them, a matter of “Googling” the answer. Does anyone see the problem with this? At Western University, we’re trying to teach our students using an evidence-based format in which we don’t just lecture to them, but rather teach them how to access the medical literature to find their own answers. The problem with this is that the EBM process we want our new physicians to learn (creating an appropriate clinical question, searching the literature, evaluating an article, and applying it to a patient issue) is a much longer process than looking up an answer on Wikipedia. And these students have grown up with the rapid flow of 15 second information bites and having the answer at their fingertips. The problem, then, is accuracy of information, which as we all know, is impossible to guarantee on the Internet.

The technological inclination of this new generation has significant ramifications, not only for them individually, but for the podiatric profession in general.  Do these upcoming doctors have different training needs?  Is our current residency training the best method for these new types of learners?  Should we force them to adapt to our current ways, whether it’s optimal for them or not?  Would we be putting our heads in the sand by ignoring the psychosocial differences of these docs-to-be?  What new techniques and technologies is this new Generation Y going to give us as a result of their relationship with digital information? 

I don’t know the answers to these issues, but – to answer the question of where I sit in the spectrum – I must be something in between, perhaps a missing link.  I don’t have the same relationship with technology this generation has.  I still read paper books; I’ll never use the Kindle.  I’ll use my smart phone to access my schedule and ePocrates, but I’ll never text anyone.  I enjoy the Internet, but I use it as a tool to find information, and I know its current limitations.  I still take paper notes, but eventually transcribe everything onto my computer. 

However, I also know that not everyone is like me.  This new generation of podiatrists, Generation Podiatr-Y, has great potential as long as we foster their strengths and remain creative enough to bridge the gap.  I love a challenge, and this one looks like it will evolve over a long time.  Who knows what the next generation will bring?

Keep writing in with your thoughts and comments. Better yet, post them in our eTalk forum. Best wishes.

Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
[email protected]

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