In a recent review I wrote on the subject, “The World: Socio-economically Politically: What you need to know” (Surg. Neurol. Int. 2013;4:139). I cited a recent book by Ed Gordon, (Gordon E. “Future Jobs: Solving the employment skills crisis.” Praeger; 9/12/13), who documented that our educational systems are failing worldwide to provide quality well trained individuals to satisfy the increased complexity of business and societal problems in the 21^st century.

“The economic advantages gained from U.S. educational exceptionalism in the 20^th century have disappeared. Too many younger workers lack both the general education and career skills, let alone a strong work ethic to sustain a middle class standard of living…. The US needs workers, who can think critically and possess intellectual curiosity…. The jobs and skills mismatch is not simply escalating in the United States but also across the globe as well…. Six out of every ten applicants for basic tech jobs do not qualify because they lack a basic liberal arts education in reading, writing, math, and science…. For the remainder of this decade business competition for this scarce talent will be unprecedented… only 10% of Chinese engineering graduates meet the global professional standards of major American and European firms… [In India] talent growth is constricted because academic quality is so poor in many of India's higher educational institutions… [In India] 75% of the technical graduates and 85% of the general college education graduates were considered unemployable…. Although the United States invests more in its schools than any other nation, the results of its general education system largely range from mediocre to downright dismal… the percentage of Americans who are well educated is below average compared to other rich nations…. Only 7% of US students scored at the advanced level in math, in contrast to 48% of eighth graders in Singapore and 47% of South Koreans, the two best performing nations…. In reading and math, the number of low achieving American children exceeds the total combined number of similar students in Germany, France, the United Kingdom, Turkey, and Japan… [In the USA] one million students drop out of school every year….”

This scenario provides young people with the greatest opportunity of their life. In the same publication I quoted Will and Ariel Durant, (Durant W, and Durant A. “The Lessons of History” New York. Simon and Schuster; 1968: pp 109), who were worldly philosophers, studying world history stated,

“… the first biological lesson of history is that life is competition… peaceful when food abounds, violent when the mouths outrun the food…. The second biological lesson of history is that life is selection. In competition for food or mates or power some organisms succeed and some fail…. Utopias of equality are biologically doomed [because humans are not equal in intelligence and abilities-ed] and the best [one] can hope for is an approximate equality of legal justice and educational opportunity… by and large the poor have the same impulses as the rich, with only less opportunity or skill to implement them…”

“… So, we cannot be sure that the moral laxity of our times is a herald of decay rather than a painful or delightful transition between a moral code that has an agricultural basis and another that our agricultural civilization has yet to forge into social order and normalcy….”

Given these principles, while the rest of your colleagues and peers are taking the easy road in life, this is the perfect time to work hard, to read more, to do more, and to learn more to advance yourself so that you become one of the chosen few who will have the opportunity in the 21^st century. You need to differentiate yourself from others, so that you distinguish yourself from your peers. Your peers will not understand this strategy, but you will be so far ahead of the others that they will never catch up, and the world will be yours. You will be sought after for your knowledge and skills. You will become a huge success and have many opportunities open to you. It does not matter if you are in a rich or poor country as long as you have access to the Internet. This is the greatest library in the world from which you can learn anything you want to know. You can teach yourself, watch videos of others doing surgery or other things and continue to elevate yourself compared with your peers.

I have written about the economic crisis facing the countries of the world as people want more than they can afford and want it now. Also politicians, who want to get re-elected, will try to give the public what they want even though that policy will bankrupt any business or economy. But as I look into the future, this problem will be resolved in time. We will have difficult times to overcome the excesses that were created and the government sponsored entitlement systems for all that cannot exist for long without bankrupting nations. And then financial growth will expand. That is the time that doctors who excel will be sought for their expertise. That popularity will be yours if you distinguish yourself from all your peers.

What I see that younger people do not understand is that they are surrounded by mediocrity, bureaucracy, at all levels of society. We live in a world where mediocrity is rewarded. So, some young people have given up. However, in the past year, I met a young woman from a developing country, who has worked hard to overcome the odds of being a woman in a male dominated culture. She wants to come to the USA to study, and is working hard to achieve that goal. She knows she will continue to have to SACRIFICE to obtain that goal and is willing to do it. SACRIFICE is the KEY word. You never see this word today, but it was common when I was a young doctor. People seem to want to satisfy their needs now, whether they can afford them or not. I have no doubt that this woman will achieve her goal. She is differentiating herself from others so that she can succeed. She is putting off some of the pleasures her peers want to get ahead. And she is working hard. She is willing to leave her country to achieve her goal. That is the 21^st century. If you want to succeed there is opportunity everywhere.

I have never seen such an opportunity in my lifetime for young people. Take advantage of it. Yes, you will have to sacrifice to reach your goal. The economic crisis in the world will ultimately be resolved. And for young people you will enter a period of tremendous growth worldwide. When that time comes, if you have prepared yourself properly, you will be incredibly successful. There will be a shortage of 100,000 physicians in the USA by 2025. In other countries, it will be very beneficial to you for the rest of your life.