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.