New Graduates Are Not The Problem. Our Systems Are.

What Allied Health leaders need to rethink about recruitment, burnout and retention

Introduction: the wrong conversation keeps repeating

Conversations about new graduates in Allied Health tend to go off track very quickly.

They slide into hand-wringing about “this generation”, complaints about resilience, or vague claims that graduates are not ready for the realities of work. “Gen Z” becomes a convenient shorthand for frustration, rather than a serious examination of the systems we have designed for people entering the workforce today.

That framing is easy. It also avoids harder questions.

Much of Allied Health practice is still shaped by legacy structures and long-standing assumptions. Phrases like “back in my day” or “this is how we’ve always done it” are often treated as settled wisdom, rather than starting points for enquiry. Experience is frequently elevated to authority, and that authority is then used to close down challenge.

This shows up not as attitude, but as system design. Arbitrary thresholds before someone can be considered “senior”. Rigid role definitions that reward time served over demonstrated capability. Supervision and credentialing models that prioritise hierarchy over learning.

None of this diminishes the value of experience. Experience matters deeply in Allied Health. But when experience becomes immune from scrutiny in a workforce, funding and regulatory environment that has changed materially, it starts shaping systems that no longer fit the reality of modern practice.

I recently took part in a panel discussion hosted by Estus Health on new graduate employment in Allied Health. The panel included founders, a recruiter, a university academic and clinicians completing their new graduate year. The discussion stayed focused on recruitment design, supervision, flexibility, burnout and the growing role of AI, rather than generational stereotypes.

The full conversation is available on YouTube and Spotify and is well worth your time if you want to hear the nuance and lived experience behind these issues.

What follows is not a summary. It is an extension of that discussion, viewed from the employer and leadership perspective.

From that lens, many of the problems currently attributed to “Gen Z” are better understood as signals that our operating models have not kept pace with the workforce we now rely on.

Recruitment is where most retention problems begin

One of the clearest themes from the panel was that many retention problems are created well before someone resigns. They begin with the expectations set at recruitment.

The Allied Health labour market remains candidate-led. Graduates have choice. In response, organisations have largely converged on the same recruitment language: flexibility, support, culture and career progression. Almost every organisation claims to offer the best job, yet many struggle to deliver on those claims once a clinician is actually in the role.

The issue is not that these things are unimportant. They are exactly what candidates care about.

The issue is that they are often described in broad, generic ways, without sufficient attention to whether the underlying operating model can consistently deliver them.

Graduates take recruitment messaging at face value. When the lived reality of caseloads, supervision, autonomy or systems does not match what was implied — the gap does not usually surface immediately. It emerges months later as disengagement, burnout or exit.

By that point, the problem is framed as a retention issue, even though the failure occurred much earlier, when expectations were first set.

Recruitment is not just about filling roles. It is also where organisations lock in the conditions for success or failure later on.

Hiring for fit is leadership work

A closely related theme from the panel was that “fit” is often misunderstood or dismissed as subjective. In practice, it is structural.

Two clinicians can look identical on paper and be entirely incompatible in the same organisation. That incompatibility does not imply bad intent or poor capability. It reflects differences in how people communicate, manage uncertainty, regulate energy, and operate within systems.

Several panellists described shifting their recruitment approach in response. Less emphasis on clinical grilling or panel interrogations, and more focus on values, motivation, communication style, and how someone actually functions within a team.

Universities already screen for baseline clinical competence. The real hiring decision is not whether someone can practice safely. It is whether they can learn, reflect, tolerate ambiguity, and grow inside your specific operating model.

You can teach clinical skills. You cannot teach attitude, initiative, curiosity, or alignment.

This is also where rigid ideas about seniority quietly undermine capability. When time served becomes the primary pathway to influence or authority, organisations miss opportunities to recognise skill, judgement and leadership where they actually exist. Fit is not about age or years post-graduation. It is about how someone thinks, learns and contributes.

Good systems create leaders

I am conscious of this because I lived it.

During my new graduate year, I applied for an Area Manager role. I did not get it. But the fact that I was encouraged to apply, taken seriously and given clear feedback mattered. By the end of that same year, I had stepped into a site “senior” role. The following year, in my second year out of university, I moved into the Area Manager position I had previously applied for. By my third year of practice, I had co-founded my previous business.

I am aware that this is not a typical trajectory. I was an exception to the traditional timelines most clinicians are expected to follow. But that is precisely the point.

Capability alone does not create progression. Opportunity, stretch, sponsorship and system design do. I worked in an environment that was willing to recognise potential early, invest in development and allow early-career clinicians to grow into responsibility rather than wait for an arbitrary number of years to pass.

High-performing organisations are explicit about who they are for, and just as importantly, who they are not for. They design roles and expectations for a specific type of clinician, then recruit accordingly.

Graduate burnout is a leadership signal

Burnout featured heavily in the conversation, but not in the way it is often discussed.

The panel drew a clear distinction between healthy challenge and harmful overload. The first year of practice is demanding. Graduates are learning how to be clinicians, employees and professionals at the same time. That stretch is normal.

What is not normal is sustained distress driven by unsupported caseloads, administrative overload, unclear expectations or poor supervision.

When new graduates describe burnout early in their career, the panel was unequivocal. That is a leadership signal.

It usually points to one or more system failures: poorly staged workload ramp-up, transactional supervision, KPIs applied without regard for learning stage, administrative burden crowding out clinical time, or a gap between promised and actual support.

High-performing organisations monitor these signals closely. They intervene early. They adjust caseloads. They remove tasks. They normalise leave and recovery.

Burnout is not an individual failure. It is a systems problem.

Flexibility is no longer a perk. It is non negotiable

On flexibility, the panel was unanimous.

Flexibility is not a benefit to be earned. It is an operational requirement.

Allied Health is a workforce managing complex lives. Caring responsibilities, neurodiversity, health needs and fluctuating energy are the norm — not the exception. Rigid hours and presenteeism belong to a different labour market.

Flexible organisations do not simply allow alternative schedules. They design for them. That may include reduced or compressed work weeks, remote admin and report writing, asynchronous communication and trust-based autonomy rather than time-based monitoring.

It also includes how organisations handle capacity and recovery. Normalising mental health days, actively encouraging leave, and allowing unpaid or extended breaks when needed are part of the same system design.

These are not indulgences. They are pressure valves.

Where flexibility is framed as a privilege, clinicians conserve energy for self-protection rather than client care. From a systems perspective, flexibility is one of the strongest predictors of retention and a key determinant of who is willing to work for you at all.

AI is now part of your employee value proposition

AI emerged as one of the most future-facing themes in the discussion.

Universities are embedding it. Graduates are already using it. Progressive providers are building workflows around it. Organisations that prohibit or ignore AI are increasingly out of alignment with contemporary practice.

The panel was clear. AI is a tool, not a substitute for clinical reasoning or human connection. Used well, it reduces friction, particularly around documentation and administrative load.

For new graduates, AI is not about shortcuts. It is about bandwidth. It allows cognitive energy to be spent on clinical thinking, rapport and learning rather than repetitive administration.

This is not an argument for uncritical adoption. Concerns about privacy, governance and clinical responsibility are legitimate. The issue is blanket prohibition rather than intentional experimentation. How an organisation approaches AI often mirrors how it responds to change more broadly.

AI literacy is now part of your employee value proposition, whether you like it or not.

Supervision is a design problem

The panel returned repeatedly to supervision, but not in the generic sense.

Effective supervision was described as relational, reflective and adaptive. Not a checkbox.

High-quality supervision systems share common features: clear structure without rigidity, psychological safety to admit uncertainty, focus on decision-making rather than documentation, adaptation to learning style and integration of reflection into daily work.

Where supervision breaks down, it often reflects the same legacy assumptions seen elsewhere. Seniority is conflated with competence. Experience is used to close conversations rather than open them. Early-career clinicians are expected to absorb “how things are done” instead of being supported to think critically about how things could be done better.

Supervision that feels rushed, inconsistent or purely corrective contributes directly to attrition, particularly for clinicians still forming their professional identity.

The uncomfortable conclusion

The panel did not blame new graduates for the challenges facing the workforce. It challenged leaders to look harder at the systems they have built.

When graduates leave quickly, it is rarely because they lack resilience. When they disengage, it is rarely because they are entitled. When they burn out, it is rarely because of individual fragility. More often, it reflects roles, expectations and operating models that no longer fit the reality of modern Allied Health work.

That conclusion is uncomfortable because it removes easy scapegoats. It also creates agency.

None of this is easy in a pricing-constrained, compliance-heavy environment. But constraint does not remove choice. It makes design decisions more consequential.

In practice, this shows up in a small number of leadership decisions: how recruitment sets and reinforces expectations, how supervision supports learning and confidence, how flexibility is designed and protected and how AI is enabled or resisted.

These are not peripheral considerations. They are core leadership responsibilities.

The question for leaders is not whether new graduates are ready.

It is whether our organisations are.