When the Applicant Asks the Questions: What Young Physicians Expect from Documentation

Thursday, 4:15 p.m., the chief physician's office. The applicant for the residency post has good grades, an elective rotation in Switzerland, and three questions of her own. The first: "How many programs do I need at your hospital to admit a patient?" The second: "Do you still dictate onto tape, or do the residents type themselves?" The third: "Can letters be finished from home?"

The chief physician had prepared questions about her clerkships, her motivation, her resilience. The counter-questions briefly throw him, because for two of the three he cannot think of a good answer. Now he notices that two sides are doing the assessing in this interview — and that the other side has prepared better.

The numbers behind the three questions

The applicant's questions have an empirical basis. In 2024, the Hartmannbund — a German physicians' association — surveyed 487 young physicians: an association survey with self-reports and self-selected participation, so a snapshot of sentiment, not a full census [1]. The picture is nonetheless clear:

• 92.4 percent state that technical problems are part of their everyday work; around a fifth experience them several times a day.
• 69.6 percent encounter duplicate documentation at their own employer.
• 53.4 percent work without a fully digitized patient record.
• 94.7 percent have a PC workstation, 49.7 percent a work phone — but only 10.1 percent a tablet.
• 9.7 percent work with AI tools; of these, fewer than half had received training.

The free-text answers make it vivid: ten-minute logins at the ward computer, anesthesia protocols on A3 paper, five programs open in parallel — and the wish that AI would help with the physician letter [1].

Why this is a recruiting question

The same survey shows what is at stake: 55.2 percent of young physicians report unfilled medical posts at their own employer, with physicians in training missing most often [1]. 36.3 percent of all respondents have, because of unsatisfactory working conditions, already considered changing careers or leaving clinical practice [1]. On the Hartmannbund's reading, moreover, only about a quarter can currently imagine continuing to work in a hospital after completing specialist training [2].

The MB-Monitor 2024 — the Marburger Bund physician survey, considerably larger at 9,649 respondents, likewise a membership survey with self-reports — completes the picture: 28 percent of employed physicians are seriously considering leaving curative medicine, up from 25 percent in 2022; 65 percent are dissatisfied with their hospital's IT, and an average of three hours of the working day goes to administration and documentation [3].

The Hartmannbund's press summary adds working conditions beyond IT: 70 percent of the young respondents state they cannot observe statutory break times; for over 40 percent, recording overtime is impossible or only partly possible [2]. Anyone who wants to fill residency posts is thus also competing on the shape of the working day — and a considerable part of that day consists of documentation time.

One can read these findings as generational criticism: demanding, ready to leave, spoiled by software that simply works. One can also read them more soberly: this generation is the first to have a benchmark. That benchmark is rarely the hospital across town; it is the tools with which these cohorts studied, learned and organized their lives. Anyone who came through medical school that way recognizes an imposition when they see one — and, given the vacancy numbers, can choose where to work.

What a department can change

Much of the IT landscape is decided by the hospital: the hospital information system, the networks, the budgets. Some things the department decides itself:

• Map duplicate documentation. Have a resident note for one week which data she enters more than once, and eliminate the two most annoying stretches first. That costs process work and hardly any budget.
• Show the real workplace. The walk-through at the interview, ward computer included, is an honesty test. Whoever hides the login procedure loses the new colleague in her first week on duty — at greater cost.
• Involve young physicians in selection decisions. Those who operate the systems most often see weaknesses that appear in no vendor presentation.
• Schedule training as a fixed item. That fewer than half of AI users had any training is an avoidable mistake; a tool is only as good as its introduction.
• Examine remote workflows. Finishing letters from home is a wish the respondents voiced concretely; where data protection and technology support it, it is an inexpensive retention instrument.
• Make successes visible. When a duplicate stretch disappears, that belongs in the department meeting. Junior staff stay where improvements can be experienced.

Five questions you should have an answer to

The survey numbers translate into interview preparation. Anyone conducting job interviews today should expect the other side to have researched the hospital's tools and asked former final-year students. At the next interview, the questions might run:

1. How many systems does an admission take, and how many of them ask for the same data?
2. How long does the morning login at the ward computer take?
3. What are physician letters written with, and where?
4. What devices does the department provide — is there more than the PC at the ward station?
5. Who trains new colleagues on the tools, and when?

Having a good answer to every one of these questions is unrealistic. An honest one is often enough: young physicians forgive unfinished systems more readily than embellished descriptions, and a credible plan for the next two years weighs more than a polished today.

The good news is in the same surveys: this generation wants to practice medicine. Its expectations are aimed at being able to work — at tools that keep the path between bedside and record short. Departments that take this seriously gain a recruiting argument that money alone cannot buy. What turnover costs when it fails, we have calculated elsewhere: Turnover as departmental economics (in German). And how a department honestly measures its own time distribution before investing: Measuring physician time (in German).

If you want to follow how documentation, IT and junior recruitment are developing in German hospitals: Visite, our weekly briefing — concise, referenced, free (German; English edition Grand Rounds is in preparation).

Sources

1. Hartmannbund. Ergebnisse der Umfrage 2024 unter der jungen Ärzteschaft (n=487). August 2024. https://www.hartmannbund.de/wp-content/uploads/2024/08/2024-08-19_Ergebnisse_Umfrage-2024_junge_Aerzteschaft.pdf
2. Hartmannbund. Assistenzärzt:innen-Umfrage 2024: „Wir brauchen Veränderungen – jetzt!“ (Pressefassung). https://www.hartmannbund.de/berufspolitik/umfragen/weiterbildung/assistenzaerztinnen-umfrage-2024-wir-brauchen-veraenderungen-jetzt/
3. Marburger Bund. MB-Monitor 2024: Hohe Belastung, unzureichende Rahmenbedingungen. https://www.marburger-bund.de/bundesverband/themen/marburger-bund-umfragen/mb-monitor-2024-hohe-belastung-unzureichende