Gen Y and global health: Not a match made in heaven

What would you think if a job that you were interested in asked you to work for free for at least six months to a year before even considering applying? And not only work for free, but also work abroad? Would you jump at the opportunity?

This is a basic expectation of most entry level jobs in global health and the entry level jobs that expensive to obtain experience qualifies you for are far from challenging and substantive. Here is an excerpt of responsibilities from a large nonprofit organization that works in global health (portions are redacted that are specific to the organization.)

“• Assist in preparation, review, and editing of reports, scopes of work, papers, manuals and presentations;
• Schedule and coordinate meetings and prepare necessary meeting materials;
• Maintain organization of electronic and paper files;
• Assist with tracking and submission of all project deliverables on two key projects;
• Work with travel agent to coordinate travel logistics for site visits and meetings;
• Assist in preparation of consulting agreements, purchase orders, and/or sub-contracts.”

Global health is definitely one industry where Gen Y has not changed the way the workplace functions. There is a high barrier to entry for recent college graduates who can not afford to pay for their volunteer experience abroad neither during college internships nor after graduation. Unpaid internships are the norm rather than outliers. Global health is an industry where supply outstrips demand, partly due to the advent of high profile organizations such as the Gates Foundations and the Clinton Foundation.

Even when you finally enter the workplace, finding a challenging position is very much about paying dues. Entry level jobs consist almost entirely of administrative work. Management hierarchy and approaches to management are heavily influence by government practices due to the overlap of both personnel and the funding from agencies such as United States Agency for International Development (USAID). These same management practices certainly play a role in the declining interest in government careers.

Millenials generally have two paths to receiving a promotion: work in the mindnumbingly dull entry level job for 2 years or go to graduate school. Promotion is heavily based on seniority of tenure and/or credentials rather than talent and expertise. I would love to spare myself from spending thousands of dollars, however it is not really an option. My decision to live abroad was prompted as much by personal reasons as career considerations.

The future of this field depends on the injection of new ideas and perspectives that Gen Y has to ability and desire to deliver.  I wonder when and if the powers that will be willing to accept and welcome them.


9 comments so far

  1. Jessica on

    I have a friend getting into health care (dietary specifically) and she had to pay $6,000 for her year long unpaid internship, but it was the cheapest of her multiple options. After over one year on a waiting list she finally got it and is having issues dealing with the situation you’re talking about. She didn’t even have to move!

  2. Alanna on

    I think that employers in international health, and international development, are losing a lot of good people through these kinds of barriers to entry. Culling your prospects to only those with the money to work for free reduces your options to a degree which I think will be unsustainable.

  3. Vanessa on

    Jessica – It’s great that she didn’t have to move. You know things are not working well when there is a year-long waiting list for an unpaid internship!

    Alanna – I would have to agree with you about the unsustainability. I wonder when the pressure, external or internal, will be great enough to make changes. The closest analogy that I can think of is the situation with financial aid at Ivy League universities. For years, you would have needed both scholarships and financial aid if your family did not have enough money to pay to attend the school. Things have become more open with recent changes that allow students with a parental income under a certain level. Universities realized they kept accepting the same middle and upper class students and made a change that enabled socioeconomically qualified people the opportunity to attend.

  4. Brandon Carlos on

    Employment in health care is a special case; if you compare the entry-level hardships to the ROI, it’s difficult to wonder why people consider to pursue that career path– unless it’s in your heart.
    The truth is that CEO’s of hospitals, those in health care, communicators and other professionals in not-for-profit’s– these are all professionals who are far underpaid in comparison to similar roles in different fields. There is a reason: PASSION.
    If one is willing to endure these hardships, it’s obvious that the reason they are there is because they want to be. In something as essential as health care, loving your job is a matter of life or death.

  5. Vanessa on

    Brandon – I don’t think that unpaid internships are the appropriate use to test the level of passion. Many other industries seem to do just fine finding passionate employees who they also pay for their passion and expertise. I think what global health has is an abuse of power that disadvantages people my age trying to break into the field.

  6. Brandon Carlos on

    I’m not agreeing with the harships interns have to endure, but there’s no denying the difficulty of a career in health.
    In PR, anyone looking to get into the entertainment industry faces similar struggles. You are expected to intern for free in city’s with a sky-high cost of living. It’s wrong, but the line-up of folks waiting to fill that spot perpetuate this practice.
    Eventually standards will have to change. It’s predicted that in 2010 there will be 10 million more jobs in North America than available bodies to fill them.

  7. Vanessa on

    Yes there will be 10 million more jobs, but many of them will be concentrated in occupations like nursing rather than popular industries such as global health or public relations. I wonder when the standards change without some external pressure threatening the sustainability of the industry as Alanna alluded to.

  8. socialbutterfly4change on


    Great post! I think the ‘unpaid internship’ is often abused. Now that I live in DC, it is more and more clear to me that as a country, I don’t think we’d be able to operate unless we had unpaid interns that were willing to work. There are so many interns (across industries) in DC, that it astounds me!

    I didn’t know the severity of it in public health. In journalism, I know it’s rampant as well. And then entry jobs are in the 20s (or less!) in uber expensive places to live too. And Brandon does bring up a good point, that in PR/Advertising, people are right around the corner, just waiting to take that spot. Such the toils of the new professional =)

  9. Vanessa on

    I came to the same conclusion after being in DC for a year. I just think there should be a better way to to have a learning experience in the workplace without it costing so much money. After all, college is not cheap!

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