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Medical Students

Comparing Millennial and Generation X


Medical Students at One Medical School
Nicole J. Borges, PhD, R. Stephen Manuel, PhD, Carol L. Elam, EdD, and
Bonnie J. Jones, PhD

Abstract
Purpose (399 females and 410 males) who scored higher than Millennials on Self-
Two main generational cohorts matriculated between 1989 94 and Reliance. Millennials also were
comprising students enrolled in medical 2001 04 at the Northeastern Ohio significantly different from Generation
schools today are Generation Xers (born Universities College of Medicine Xers on several other factors. Significant
19651980) and Millennial students completed the 16 Personality Factor differences were noted among Cuspars,
(born 19811999). A subset is Cuspars Questionnaire (16PF). Differences in Generation Xers, and Millennials.
(born 19751980), who share traits with responses to the 16PF among the three
both generations. Population theorists generations were analyzed using Conclusions
ascribe different personal characteristics, multivariate analysis of variance The 16PF is a useful tool to examine
attitudes, and preferences to each group. (MANOVA). differences among these groups and to
The authors examined whether selected help understand the factors that
characteristics describing Generation X Results constitute their personalities. Given
and Millennial students were quantifiable Analyses showed significant differences differences among the generational
using a personality measure. Differences for Generation X versus Millennial groups, the authors forecast possible
among Generation X, Millennial, and students on 10 of the 16 personality educational implications for medical
Cuspar medical students were factors. Millennial students scored school academic affairs and student
investigated. significantly higher than Generation X services, and suggest areas for future
students on factors including Rule- research.
Method Consciousness, Emotional Stability, and
Eight hundred and nine medical students Perfectionism; Generation X students Acad Med. 2006; 81:571576.

Born over a 20-year period that places, or things), as well as events and started entering colleges and universities
approximates the passage from birth to conditions (forces in the environment) in 1999. Various researchers and trend
adulthood, a generation is a peer group that become reference points for them.2 watchers have suggested clear differences
defined by both its demographics and its Because of similar influences and between members of the Generation X
key life events.1 Shaped by their common experiences, individuals within a and Millennial groups.13 Their opinions
history, generational cohorts are generational cohort are likely to possess regarding differences between these two
influenced by common icons (people, shared values and behaviors. groups of students have been formulated
Generational differences among groups through qualitative studies that address
of individuals in employment settings are the preferences, attitudes, and behaviors
Dr. Borges is assistant professor of behavioral a topic of current consideration in the of members of both generations. They
sciences, Northeastern Ohio Universities College of business literature as managers seek
Medicine, Rootstown, Ohio. contend that many of these differences can
insight into ways to motivate, direct, and be traced to the different roles that parents
Dr. Manuel is assistant dean of admissions, reward employees from different
University of Cincinnati College of Medicine, assumed for the two groups.13,6 9 Research
Cincinnati, Ohio. At the time of this study, Dr.
generational cohorts.2,3 Recent work in suggests a number of generalizations that
Manuel was the director of admissions at the academic medicine setting has can be made about the two groups; as
Northeastern Ohio Universities College of Medicine. reviewed differences in work styles and with all generalizations, there are
Dr. Elam is associate dean for admissions and attitudes of multigenerational teams of individuals who do not fit the mold.
institutional advancement, director for medical health care providers, differing values and
education research, and professor, department of Generation X students were largely latch-
expectations across generations, and
Behavioral Science, University of Kentucky College of key children, possibly raised in single-
Medicine, Lexington, Kentucky. challenges in resolving intergenerational
parent households where direct
conflicts in the workplace.4,5
Dr. Jones is adjunct associate professor of supervision and family bonding were
behavioral sciences, Northeastern Ohio Universities challenged. As children, these students
College of Medicine, Rootstown, Ohio and director
The two generational cohorts that
of institutional research and effectiveness at the represent most of the students enrolled in likely spent more time watching
University of South Florida, Sarasota-Manatee, medical schools today are Generation X television than in the company of their
Florida. and Millennial students. According to parents.1,2,6 Alternatively, Millennial
Correspondence should be addressed to Dr. Borges, Lancaster and Stillman, Generation Xers students as children were more likely to
Department of Behavioral Sciences, Northeastern were born between 1965 and 1980; be doted on by overprotective parents
Ohio Universities College of Medicine, 4209 State
Route 44, PO Box 95, Rootstown, OH 44272-0095; Millennials were born between 1981 and who were concerned about their safety,
e-mail: (njborges@neoucom.edu). 1999.2 Millennial students thus first their security, their schooling, and their

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Medical Students

successfulness in the present as well as the empirically tested whether the ascribed during the data collection that occurred
future.1,2,6 differences in personal characteristics can between 1989 and 1994. Because the
be assessed quantitatively. Therefore, to 16PF underwent an update in 1994, we
As a result of their lack of consistency expand the previous research, we had two used the 16PF fifth edition13 for
and structure in an unpredictable goals for this study. First, we sought to subsequent data collection from
environment and their relative isolation explore whether the characteristics used participants who matriculated between
or aloneness as children, as a group to describe Generation X and Millennial 2001 and 2004. Research has shown that
Generation X students are thought to be students were quantifiable using a the fourth and fifth editions of the 16PF
cynical and pessimistic.9,10 They may validated measure of personality. We measure the same traits.14 For purposes
believe they live in troubled times marked chose the Sixteen Personality Factor of data analyses, we converted the 16PF
by intractable problems and have little Questionnaire (16PF)12,13 as an fourth edition scores to the updated 16PF
confidence in the nations social assessment tool because of the similarity fifth edition scores using a regression-
institutions.1,10 They are private, may fear between the descriptors of Generation X based linking formula.15
intimacy, and are likely to take care of and Millennial students and several
their own needs.1,2,7,10 Generation X factors describing personality traits in the The 16PF measures sixteen independent
students are described as culturally 16PF. Second, we sought to examine dimensions associated with personality:
independent and skeptical, but also differences in selected personality Warmth, Reasoning, Emotional Stability,
resourceful.6,10 They are comfortable with characteristics between Generation X and Dominance, Liveliness, Rule-
technology and are attracted to its uses.1,2 Millennial students enrolled in medical Consciousness, Social Boldness,
They are likely to want hard facts, school. Sensitivity, Vigilance, Abstractedness,
expertly delivered, and value variety and Privateness, Apprehension, Openness to
speed.6 Change, Self-Reliance, Perfectionism, and
Method Tension.16 For the 16PF fourth edition,
Millennial students as a group, on the Students who matriculated between the the average test-retest reliability is .80 for
other hand, have been described as years of 1989 1994 and 20012004 in a short-term interval and .52 for long-
optimistic, generous, and practical.8 They either a combined BS/MD degree term,17 whereas for the 16PF fifth edition
are likely to be team oriented, value being program or an MD degree only program test-retest reliability estimates have been
connected with others, and have the at the Northeastern Ohio Universities reported to be approximately .80 for a
ability to organize and mobilize.7,8 They College of Medicine (NEOUCOM) were 2-week interval and .70 for a two-month
are accustomed to having their time invited to complete the 16PF. Based on interval.17 The 16PF fifth edition has been
structured and to following rules.1,2 They the model proposed by Lancaster and noted to have an internal consistency
are likely to be hard working and to have Stillman,2 we first categorized medical average of .74, with a range of .64 .85.18
been raised to aim for success in all they students in our study as either Generation Both editions of the instrument used a
do by their supportive parents. They are Xers, if born between 19651980, or scoring system based on the standard ten
accustomed to being tested, to receiving Millennials, if born in 1981 or after. (STEN) continuum ranging from 110.
feedback, and to achieving set goals.13 Students born on the cusp between two The mean STEN score for each
However, given their extensive generations, called Cuspars by Lancaster personality factor is 5.5, with a standard
participation in planned activities and and Stillman, may identify strongly with deviation of 2 STEN points. The
lack of experience with unplanned time, one generation or another or have personality factors are described on a
they may not be spontaneous or characteristics of both generations,2,p.32 bipolar scale with a STEN of 1 indicating
introspective.6 Having always had access and thus not be clearly differentiated the smallest magnitude of a given trait
to computers, pagers, and cell phones, from either group. In order to account and 10 indicating the greatest magnitude.
they are likely to appreciate how for any differences in the Cuspars, we
technology enables them to do many also classified the entire sample of 809 Using the 16PF and considering the
things at one time and have a high students into three groups to include descriptors that generational researchers
expectation of technologys usefulness Cuspars born from 1975 80, Generation have posited regarding these two
and availability in all settings.1,2,6 8,11 Xers born from 196575, and the generational cohorts, we hypothesized
Millennials born in 1981 or after.2 the following scoring patterns on selected
Researchers have gathered information Participants completed the 16PF during factors measured by this instrument.
about Generation X and Millennial new student orientation at the beginning Compared to Generation X students,
students on undergraduate college of their program or during the first Millennials would score higher on
campuses and in employment settings semester of their program. In accordance Warmth and Sensitivity because of the
through interviews, opinion surveys, and with informed consent procedures, value they place on being connected with
focus groups with students. These student participation in completing the others, Rule-Consciousness due to being
researchers have used the same instrument was elective. The current accustomed to following rules, Emotional
qualitative methods to obtain the study was approved by the institutional Stability for having had strong, stable,
perspectives of faculty and student affairs review board at NEOUCOM. supportive parental influence, and
officers in colleges and universities Perfectionism because of being goal
regarding generational differences, as well We used a standardized format for directed and successful. Generation X
as the perspectives of employers in administering the 16PF for both data students, we hypothesized, would score
various work settings. However, to our collections periods. We administered the higher than the Millennials on
knowledge, no studies to date have 16PF fourth edition12 to participants Dominance because of their preference to

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Medical Students

take care of their own needs first, Consciousness, Social Boldness, entering classes of 1989 94, the
Vigilance due to their skeptical nature, Sensitivity, Vigilance, Abstractedness, preponderance of matriculants was
Privateness for their preference for Privateness, Apprehension, Openness to Generation X students. For the entering
privacy, Openness to Change because of Change, Self-Reliance, Perfectionism, and classes of 2001 04, the preponderance of
their early adoption of technology, and Tension. matriculants was Millennial students.
Self-Reliance for their independence. Across all study years, nontraditional
students (age 26 and older at the time of
We analyzed differences in responses to Results
matriculation) accounted for only 3% of
the 16PF using a multivariate analysis of Eight hundred and nine medical students the class rolls.
variance (MANOVA) model for the (399 females and 410 males) completed
Generation X and Millennials groups, the 16PF; the response rate for all test For purposes of hypothesis testing, we
with the significance level (p value) set at administrations was over 90%. Under the performed a MANOVA to determine if
.01. We also calculated effect sizes two-category analysis, Generation X significant differences existed between
(partial Eta2). A MANOVA and post hoc medical students made up 68% (n 555) Generation X and Millennial medical
analysis were used to analyze the of the study population and Millennial students for personality traits as
differences in responses to the 16PF for medical students constituted 32% (n measured by the 16PF. Results of the
the three generational cohorts: 254). Table 1 displays the characteristics MANOVA (see Table 2) revealed
Generation X, Millennials, and Cuspars. of the two groups of students over the significant differences (p .01) for ten of
The 16PF factors used in the analyses ten-year study period. During this period, 16 factors. Our hypotheses were generally
were Warmth, Reasoning, Emotional the mean age for matriculants in each of supported: Millennial students scored
Stability, Dominance, Liveliness, Rule- the entering classes was 20 years. For the significantly higher than did Generation
X students on Warmth, Rule-
Consciousness, Sensitivity, Emotional
Stability, and Perfectionism.
Table 1 Additionally, as hypothesized,
Characteristics of 555 Generation X and 245 Millennial Medical Students, Generation X medical students scored
Northeastern Ohio Universities College of Medicine, Rootstown, Ohio, significantly higher on Self-Reliance.
1989 1994 and 20012004*
However, Millennials scored significantly
Characteristic No. (%) Generation X No. (%) Millennial higher than Generation Xers on
Age Openness to Change, contrary to our
.........................................................................................................................................................................................................
18 14 (2.5) 1 (0.4) hypothesis. The remaining hypotheses
.........................................................................................................................................................................................................
19 94 (16.9) 10 (3.9) were not supported: Generation X and
.........................................................................................................................................................................................................
20 240 (43.2) 98 (38.6)
Millennial students did not score
......................................................................................................................................................................................................... significantly differently on Dominance,
21 126 (22.7) 86 (33.9)
......................................................................................................................................................................................................... Vigilance, and Privateness. Although our
22 25 (9) 49 (19.3) hypotheses did not include predictions
.........................................................................................................................................................................................................
23 19 (3.4) 10 (3.9) about the 16PF factors of Reasoning,
.........................................................................................................................................................................................................
24 9 (1.6)
.........................................................................................................................................................................................................
Social Boldness, and Apprehension
25 6 (1.1) because those factors were not directly
.........................................................................................................................................................................................................
26 7 (1.3) addressed in generational characteristics
.........................................................................................................................................................................................................
27 7 (1.3) ascribed in earlier work, the Millennial
......................................................................................................................................................................................................... medical students in our study scored
28
......................................................................................................................................................................................................... significantly higher than did Generation
29 1 (0.2)
......................................................................................................................................................................................................... X medical students for those factors.
30 3 (0.5)
.........................................................................................................................................................................................................
31 1 (0.2) We performed a second MANOVA to
.........................................................................................................................................................................................................
32 1 (0.2) examine the differences in responses
.........................................................................................................................................................................................................
33 2 (0.4) given on the 16PF among Generation
Xers (n 331), Millennials (n 254),
Sex
......................................................................................................................................................................................................... and Cuspars (n 224) (see Table 3). The
Male 299 (53.9) 111 (43.7)
......................................................................................................................................................................................................... results across these three groups were
Female 256 (46.1) 143 (56.3) similar to our initial analysis, which
Ethnicity compared only Generation X and
.........................................................................................................................................................................................................
Caucasian 280 (50.5) 150 (60.5) Millennial students. We noted significant
.........................................................................................................................................................................................................
Asian/Pacific Islander 253 (45.7) 86 (34.7) differences (p .01) for the same ten
.........................................................................................................................................................................................................
African American 18 (3.2) 11 (4.4)
factors. Post hoc analysis indicated that
......................................................................................................................................................................................................... Millennials scored significantly higher on
Hispanic 2 (0.4) 1 (0.4)
......................................................................................................................................................................................................... Warmth, Sensitivity, Apprehension, and
Native American 1 (0.2) 0 (0.0) Openness to Change compared to
.........................................................................................................................................................................................................
Unknown 1 (0.2) 6 (2.4) Generation X students and Cuspars and
* Generation X students were born between 1965 and 1980; Millennial students were born between 1981 and significantly lower on Self-Reliance
1999. compared to Generation X students but

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Medical Students

students to be the higher scorers. Further,


Table 2 we found no differences in the two
Multivariate Analysis of Variance Results for the 16 Personality Factor groups scores for Dominance, Vigilance,
Questionnaire (16PF) for 555 Generation X and 254 Millennial Medical Students, and Privateness, factors for which we
Northeastern Ohio Universities College of Medicine, Rootstown, Ohio, expected Generation X students who are
1989 1994 and 20012004*
described by the 16PF as assertive,
Generation X Millennial p Effect skeptical, and discreet and nondisclosing
Personality variable mean (SD) mean (SD) F value size
to have scored higher than Millennials.
Warmth 5.07 (1.92) 5.63 (1.86) 15.18 .000 .02
.........................................................................................................................................................................................................
Reasoning 5.51 (1.90) 7.49 (1.59) 209.07 .000 .21 Reviewing our hypotheses, Millennial
.........................................................................................................................................................................................................
Emotional Stability 4.54 (2.00) 5.48 (1.71) 41.97 .000 .05 students did score higher on all of the
.........................................................................................................................................................................................................
Dominance 5.12 (1.80) 5.11 (1.92) .01 .915 .00 factors we expected them to, yet
.........................................................................................................................................................................................................
Liveliness 6.05 (1.90) 6.24 (1.65) 1.76 .186 .00
Generation X students did not. Why
......................................................................................................................................................................................................... would this be so? Perhaps the 16PF is not
Rule-Consciousness 4.20 (2.03) 5.18 (1.66) 44.84 .000 .05
......................................................................................................................................................................................................... sensitive enough to pick up differences
Social Boldness 4.95 (1.93) 5.67 (1.90) 24.52 .000 .03 among the groups regarding these
.........................................................................................................................................................................................................
Sensitivity 4.55 (1.95) 5.27 (1.94) 24.24 .000 .03 factors, perhaps there are no real
.........................................................................................................................................................................................................
Vigilance 5.97 (1.87) 6.29 (1.84) 5.45 .020 .01
.........................................................................................................................................................................................................
differences among the generations on
Abstractedness 5.71 (1.85) 5.76 (1.89) 1.55 .694 .00 these factors, or perhaps the generational
.........................................................................................................................................................................................................
Privateness 4.97 (1.93) 5.25 (1.92) 3.94 .048 .01 cohort theories need refining. Or,
.........................................................................................................................................................................................................
Apprehension 5.67 (1.92) 6.14 (1.80) 11.07 .001 .01 perhaps Generation X students who
......................................................................................................................................................................................................... attended medical school were a highly
Openness to Change 5.15 (1.85) 5.96 (1.86) 33.37 .000 .04
......................................................................................................................................................................................................... selected sample, and not representative of
Self-Reliance 5.77 (1.60) 5.33 (1.68) 12.91 .000 .02
......................................................................................................................................................................................................... the larger population of that generational
Perfectionism 4.33 (1.98) 5.34 (2.01) 44.50 .000 .05 group. For example, the typical
.........................................................................................................................................................................................................
Tension 5.66 (1.79) 5.37 (1.65) 4.84 .028 .01 Generation X student may have been
* Generation X students were born between 1965 and 1980; Millennial students were born between 1981 and selected out of our medical school, either
1999. The 16PF is scored on a 110 scale with a mean score of 5.5 and standard deviation of 2. df (1, 808). through self-selection in not applying in

Partial Eta squared. the first place or through the interviewing

p .01.
process.

not Cuspars. Furthermore, Generation X, Cuspars as well, we found that they fell We also suspect that selection is the
Millennial, and Cuspar students were between Generation Xers and Millennials reason behind the Millennials scoring
significantly different from each other on on certain personality factors (i.e., higher on abstract reasoning skills than
the five factors of Reasoning, Emotional Reasoning, Emotional Stability, Rule- the Generation Xers in this particular
Stability, Rule-Consciousness, Social Consciousness, Social Boldness, and sample. NEOUCOM made a concerted
Boldness, and Perfectionism. The means Perfectionism), with Generation Xers effort to raise its academic standards of
for each group fell on a continuum for overall scoring lower on these factors and admission over the 15-year period of the
these five factors, with Generation Xers Millennials consistently scoring higher. study. The fact that the Cuspars
having the lowest mean score, Millennials Reasoning scores fell between those of the
having the highest, and Cuspars falling in Generation Xers and those of the
Discussion Millennials further supports the gradual
the middle.
The results of our exploratory study increase in academic standards as an
Using descriptors from the 16PF reveal that personality differences do exist intervening variable. Therefore,
subscales,16 we found that Millennial between Generation X and Millennial Reasoning might not necessarily be a
students are more warm and outgoing medical students as measured by the distinctive trait among generational
(Warmth), more abstract than concrete 16PF, but much more research is needed groups at other medical schools.
(Reasoning), more adaptive and mature before our results can be extrapolated to Replication and extension of this study at
(Emotional Stability), more dutiful (Rule- other medical school students or to other medical schools would help to
Consciousness), more socially bold and society in general. While most of our better define the characteristics of the
venturesome (Social Boldness), more findings confirmed our hypotheses that generational cohorts.
sensitive and sentimental (Sensitivity), were based on the theories of
more self-doubting and worried generational behaviors, some results were Future studies to investigate the
(Apprehension), more open to change and surprising. For example, with regard to personality traits of Millennials and
experimenting (Openness to Change), and Openness to Change, Millennials scored Generation Xers should consider using
more organized and self-disciplined significantly higher than did Generation other validated measures in addition to
(Perfectionism) compared to Generation X students. On the 16PF, the defining the 16PF. We recognize that the
X medical students. Furthermore, we behavior for high scorers on this factor is personality measure we chose may be
found Millennial medical students to be experimenting; defining factors for low considered a limitation of this study.
less solitary and individualistic (Self- scorers are traditional and attached to Although the 16PF was helpful in
Reliance) than their Generation X familiar. Given the literature, we identifying personality differences among
counterparts. When we considered expected the risk-taking Generation X the groups, some of the 16PF factors did

574 Academic Medicine, Vol. 81, No. 6 / June 2006


Medical Students

seem to be in conflict with what


Table 3 Millennials are accustomed tothat is,
Multivariate Analysis of Variance Results for the 16 Personality Factor having their time structured. How might
Questionnaire (16PF) for 331 Generation X, 254 Millennial, and 224 Cuspar an independent learning environment
Medical Students, Northeastern Ohio Universities College of Medicine, affect the academic performance and
Rootstown, Ohio, 1989 1994 and 20012004*
overall student satisfaction of Millennial
Generation X Millennial Cuspars p Effect students? What are the implications of
Personality variable mean (SD) mean (SD) mean (SD) F value size
changing personalities on medical
Warmth 5.08 (1.98) 5.64 (1.86) 5.04 (1.84) 7.93 .000 .02 professionalism or teaching/learning
.........................................................................................................................................................................................................
Reasoning 5.02 (1.74) 7.49 (1.59) 6.24 (1.88) 146.73 .000 .27 pedagogies (e.g., problem-based learning,
.........................................................................................................................................................................................................
Emotional Stability 4.28 (1.86) 5.49 (1.70) 4.91 (2.14) 29.35 .000 .07 team learning approaches, and so forth)?
.........................................................................................................................................................................................................
Dominance 5.07 (1.72) 5.12 (1.92) 5.19 (1.92) .28 .756 .00 How should medical educators revise
.........................................................................................................................................................................................................
Liveliness 5.99 (1.95) 6.24 (1.65) 6.14 (1.82) 1.45 .234 .00
their instructional and evaluation
......................................................................................................................................................................................................... methods? In addition, because of their
Rule-Consciousness 3.96 (1.95) 5.17 (1.66) 4.57 (2.08) 29.27 .000 .07
......................................................................................................................................................................................................... goal orientation and drive to be
Social Boldness 4.76 (1.88) 5.66 (1.89) 5.21 (1.98) 16.73 .000 .04 successful, can educators assume that
.........................................................................................................................................................................................................
Sensitivity 4.54 (1.90) 5.28 (1.95) 4.57 (2.03) 12.10 .000 .03 Millennial students will have different or
.........................................................................................................................................................................................................
Vigilance 5.97 (1.95) 6.30 (1.84) 5.95 (1.74) 2.84 .059 .01
.........................................................................................................................................................................................................
more pressing needs and demands for
Abstractedness 5.79 (1.82) 5.76 (1.89) 5.58 (1.88) .86 .417 .00 academic and student services than did
.........................................................................................................................................................................................................
Privateness 5.03 (1.96) 5.25 (1.93) 4.88 (1.88) 2.30 .102 .00 their predecessors? Will the demands for
.........................................................................................................................................................................................................
Apprehension 5.63 (1.89) 6.14 (1.80) 5.73 (1.97) 5.56 .004 .01 learning specialists, tutors, and other
......................................................................................................................................................................................................... academic services increase as Millennials
Openness to Change 5.01 (1.81) 5.96 (1.89) 5.37 (1.89) 19.16 .000 .04
......................................................................................................................................................................................................... students strive to improve their class rank
Self-Reliance 5.84 (1.63) 5.33 (1.68) 5.65 (1.54) 7.29 .001 .02
......................................................................................................................................................................................................... or board scores? How can advising and
Perfectionism 4.12 (1.95) 5.34 (2.01) 4.65 (1.99) 27.15 .000 .06 mentoring programs be restructured to
.........................................................................................................................................................................................................
Tension 5.72 (1.84) 5.38 (1.65) 5.57 (1.71) 2.82 .060 00 meet the Millennial students needs and
* Generation X students were born between 1965 and 1975; Millennial students were born between 1981 and preferences, while taking into account
1999; Cuspar students were born between 1975 and 1980. The 16PF is scored on a 110 scale with a mean that individuals in the advisory role are
score of 5.5 and standard deviation of 2. df (1, 808). for the most part Baby Boomers and

Partial Eta squared.

p .01.
Generation Xers? What other
ramifications for teaching and advising
Millennial students might exist because
not clearly align with the attitudinal medical school and, therefore, educators and many patients have been
characteristics that researchers have used generalizing the results of this study socialized during one era and students
to define Millennials and Generation should be done with caution. Future have grown up in another? What can
Xers. It is possible that the Five Factor studies seeking to explore generational faculty development do to address these
Model of personality, which combines a differences should include more than one multigenerational challenges and train
variety of theoretical perspectives on medical school and preferably schools faculty to mentor across these
personality, may help to shed further without BS/MD programs to gain a differences?
light on generational differences. The representative sample.
Five Factor Model could be explored It has been posited by population
using the NEO (Neuroticism, Learning about who Millennial students researchers that Millennial students as a
Extraversion, Openness) Personality are, and how this generation may differ group may not be introspective.19 Will
Inventory-Revised or the NEO Five from the previous generation of medical Millennial medical students have more
Factor Inventory. students, may have educational difficulty with self-reflection and self-
implications for both academic and assessment? Could this trait influence the
A recommendation for future studies is student affairs.10,11,19 A host of questions manner in which Millennial medical
to better control for consistency when arises. For example, to what extent students are evaluated and given
administering the personality measures should medical educators take into feedback? What about service learning
to medical students. An inherent consideration the characteristics of projects and other types of service
limitation in our study is that data Millennial students in curriculum design, requirements in the curriculum?
collection for the Generation X students student services, development of Millennials are likely to be interested in
occurred at the beginning of the first year initiatives to foster professionalism, or volunteering and many have done so
of their six-year BS/MD program, specialty choice counseling? prior to entering medical school. Will
whereas for the Millennial cohort data they expect that their service-related
were collected at the beginning of their As a result of curricular revision, some experiences be ones where they can be
first year of medical school. Students medical schools have provided more involved and make significant
enrolled in the BS/MD program usually independent and unstructured learning contributions? Finally, related to
begin medical school two years after time for their medical students. Given physician career development, how will
enrolling in the program. Our study is that the students who are currently Millennial medical students differ in their
also limited by the fact that we collected entering medical school are mostly choices of medical specialties? Will the
data for medical students from only one Millennials, these curricular changes trend for choosing controllable lifestyle

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Medical Students

specialties continue? What residencies Additionally, we recommend that 9 Arnett JJ. High hopes in a grim world:
will Millennial medical students be more characteristics (e.g., values, motives, emerging adults views of their futures and
generation X. Youth Soc. 2000;31 (3):267
likely to enter? Most important, abilities, learning styles,) besides 86.
regarding clinical care of patients, how personality should be explored to help
10 Woodard DB Jr, Love P, Komives SR.
will medical students who represent the medical educators gain a more complete Students of the new millennium. In:
Millennial generation interface and view of our future physicians and how Leadership and Management Issues for a New
communicate with patient populations? they compare to previous generations. Century. San Francisco: Jossey Bass, 2000;92.
Results of a recent study support a link Lastly, the scope of this paper did not 11 Davis DA. Millennial teaching. Academe.
between personality and clinical skills allow for an exploration of personality 2003;89(1):1922.
performance.20 Most of the medical differences between men and women 12 Cattell RB, Eber HW, Tatsuoka MM.
students in this study were Millennials. who are Generations Xers or Millennials. Handbook for the Sixteen Personality Factor
With regard to communication, students We recognize this as an important topic Questionnaire. Champaign, IL: Institute for
Personality and Ability Testing, 1970.
who had higher levels of Warmth, and intend to explore it in future
research. 13 Cattell RB, Cattell AK, Cattell HE. Sixteen
Emotional Stability, and Perfectionism Personality Factor Questionnaire. 5th ed.
also had higher communication skills. Champaign, IL: Institute for Personality and
Interestingly, these factors were among Ability Testing, 1993.
References
the ones identified in the current study 14 Conn SR, Rieke ML. The 16PF 5th edition.
that differentiated Millennials from 1 Howe N, Strauss W. Millennials Rising: The Technical manual. Champaign, IL: Institute
Next Great Generation. New York: Vintage for Personality and Ability Testing, 1994.
Generations Xers; with Millennials, as a Books, 2000.
whole, scoring higher on these factors. 15 Mead AD, Bedwell S. Equating and linking
2 Lancaster LC, Stillman D. When Generations 16PF editions: advice for practitioners with
So, if medical students today are mostly Collide: Who They Are, Why They Clash, fourth and fifth edition data. Unpublished
Millennials, do they already possess some How to Solve the Generational Puzzle at manuscript, 2001.
of the qualities that may incline them to Work. New York: Harper Business, 2003.
16 Russell M, Karol D. The 16PF 5th Edition:
be better at communicating with their 3 Zemke R, Raines C, Fillipczak B. Generations Administrators Manual. Champaign, IL:
patients? Longitudinal studies involving at Work: Managing the Clash of Veterans, Institute for Personality Ability and Testing,
Boomers, Xers, and Nexters in Your
Millennial medical students need to be Workplace. New York: American
1994.
conducted to answer these and other Management Association, 2000. 17 Institute for Personality and Ability Testing
relevant questions. Staff. Administrators Manual for the 16
4 Bickel J, Brown AJ. Generation X: Personality Factor Questionnaire.
implications for faculty recruitment and Champaign, IL: Institute for Personality and
We believe that our study is important in development in academic health centers. Ability Testing, 1986.
that it is the first research on the two Acad Med. 2005;80:2034.
18 Krug SE, Johns EF. The 16 Personality factor
generational cohorts to use a validated 5 Howell LP, Servis G, Bonham A. questionnaire. In: Watkins CE, Campbell BL
personality measure to assess differences Multigenerational challenges in academic (eds). Testing and Counseling Practice.
medicine: U.C. Daviss responses. Acad Med. Mahwah, NJ: Lawrence Erlbaum Associates,
among groups. While the 16PF may serve 2005;80:52732.
as a useful tool to examine the differences 1990:6390.
6 Murray ND. Welcome to the future: the 19 Coomes MD, DeBard R (eds). Serving the
among these groups and to gain a better millennial generation. J Career Plan Employ. Millennial Generation. New Directions to
understanding of the factors that make 1997;57:3640. Student Services. San Francisco: Jossey Bass,
up their personalities, future studies 7 Zemke R. Here come the Millennials. 2004.
should consider other theoretical models Training. 2001;38:4449. 20 Manuel RS, Borges NJ, Gerzina HA.
of personality to better understand the 8 OReilly B, Vella-Zarb K. Meet the future. Personality and clinical skills: any correlation?
differences among the generations. Fortune. 2000;142 (3):14448. Acad Med. 2005;80:S30S33.

Did You Know?


In 1983, researchers at the Stony Brook University School of Medicine discovered the cause of Lyme disease by isolating
spirochetes, the bacteria that cause the disease. This research was made possible through funding from the National
Institutes of Health.
For other important milestones in medical knowledge and practice credited to academic medical centers, visit the Discoveries and Innovations in Patient
Care and Research Database at (www.aamc.org/innovations).

576 Academic Medicine, Vol. 81, No. 6 / June 2006