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Study: More Than 60% of Nursing and Medical Students Don’t Plan to Treat Patients After Graduation

Genevieve Carlton, Ph.D.
Updated November 8, 2023
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    Most nursing students are considering non-patient-facing roles. What’s behind that startling number, and what does it mean for healthcare?
    Scientists in medical research lab focusingCredit: Getty Images
    • A majority of U.S. nursing students are considering non-patient-facing roles.
    • Nursing burnout, unreasonable workloads, and excessive stress may contribute to this problem.
    • Nearly all nursing and medical students say improving people’s lives is their top priority.

    On a typical shift, nurses spend more than half their time on direct patient care, according to a 2023 McKinsey survey. Yet, over 60% of nursing students and medical students believe their education will lead to healthcare careers that do not involve directly treating patients, according to the 2023 Clinician of the Future report.

    The results surprised even the study investigators themselves.

    “I know this might evolve as they go through their education, but six out of 10 in school, when we hope that they’re most excited about that career, are looking at it with skepticism. That is surprising to me,” said Dr. Sanjay Desai, M.D., chief academic officer at the American Medical Association, professor of medicine at Johns Hopkins Medicine, and a member of the U.S. roundtable that helped develop the report.

    Why are so many nursing and medical students not planning to treat patients? Digging into the data reveals a core problem for the healthcare system.

    Nursing Students After Graduation: What the Study Data Show

    The Clinician of the Future report surveyed more than 2,200 nursing and medical students from 91 countries.

    In total, 58% of students, including 62% of nursing students, saw roles outside of patient care in their futures.

    And the number is even higher when factoring in only U.S. students, with 63% of med students and 60% of nursing students agreeing.

    Rather than patient-facing roles, these students want to work in public health management, research, and business consultancy.

    “Instead of treating patients, I would like to create awareness and focus on more health education, prevention, and disease control,” said a Nigerian healthcare student quoted anonymously in the report.

    To be clear, roles outside patient care still make a difference for patients –– but through broader research and public health contributions rather than direct clinical care.

    The survey points to a possible explanation for the high number of students considering roles without direct patient contact. Globally, 60% of students surveyed worried about their mental health, indicating that healthcare students are not insulated from the pressures facing healthcare providers.

    While burnout has been a major concern for nurses, it also affects nursing students. And it has broad implications for the healthcare system.

    In the U.S., 70% of clinicians ranked the nursing shortage as the highest priority for their field. Unfortunately, the number of nursing school applications has declined in recent years. Even more troubling, 1 in 5 students reported they are considering quitting nursing or medical school.

    Improving Nurse Retention

    Since 2020, an estimated 100,000 registered nurses left the workforce. That number may grow to more than 600,000 by 2027.

    Improving nurse retention –– both in nursing school and the workforce –– can help ensure enough clinicians to meet patient needs. Addressing the problem requires understanding the pressures pushing nurses out of patient care.

    Retention problems start in nursing school, where 21% of U.S. nursing students are considering dropping out.

    Even a fraction of that number would pose a massive problem for the healthcare system, according to Dr. Lois Margaret Nora, M.D., JD, MBA, professor of neurology and president and dean emeritus at Northeast Ohio Medical University.

    [I]n terms of health workforce issues in the United States, 5% is still one out of 20 nurses or one out of 20 physicians not completing their studies,” Nora stated in the report. “That’s really disastrous because, as we all know, what comes into an entering class is what you’ve got for that year. Especially for the U.S., the figure is quite high.”

    Why do nursing students drop out? Mental health is a major concern. The survey found that 60% of students worry about their mental health. Providing additional support to nursing students could help address nurse burnout and stress.

    “I see this as an opportunity because if our students are concerned about their mental health, as educators, our way to respond to that is to imbue our programs with opportunities to thread self-care and really to utilize effective debriefing techniques in moments of crisis for our students,” said study roundtable member Diane Evans-Prior, dean of the Central New Mexico Community College School of Nursing and Patient Support.

    For RNs in the workforce, an increase in workload and burnout rank at the top of reasons for high turnover, according to a 2023 Journal of Nursing Regulation study. Addressing mental health and work-life balance can provide the support nurses and nursing students need to work effectively.

    The Clinician of the Future study does contain some hopeful news. Of the students surveyed, 89% said they are devoted to improving patients’ lives.

    “I’m encouraged by the positivity of the respondents, and I think that is really reflective of the nursing population as well. They come in very optimistic, you know, ‘I’m gonna change the world, one patient at a time,’” Evans-Prior said. “And that’s what we want.”