Early career medical professionals report that they have enhanced their digitalization knowledge in various settings—particularly during their studies, in their professional roles, and in their personal lives.

During their studies, early career medical professionals were introduced to digitalization through curriculum-based teaching, dissertation projects, and self-directed learning. However, digitalization is still relatively underrepresented in the medical curriculum—even at UWH. When addressed, it is typically limited to foundational courses within the selection area, offering just a broader overview of digitalization potential, digital apps, or basic technical tools.

Consequently, early career medical professionals receive limited formal preparation to increase their digital knowledge within their medical study programs. Furthermore, early career medical professionals report that they familiarize themselves with digital tools through intense self-studies, particularly during exam preparation. In addition to that, some respondents acquired their foundational digital skills through past high school activities.

Sometimes, digitalization is explored in medical research, especially during dissertation projects.

In their professional roles, early career medical professionals develop digital skills through an inherently digital work environment and related collaboration models. As a result, they frequently gained experience with digital programs, including advanced AI-based tools, which they encounter as part of their daily practice. Throughout this process, early career medical professionals passively acquired new digital skills, shaped by the demands and technologies prevalent in their specific environments. Additionally, early career medical professionals had to acquire deeper digital skills to perform specific job-related tasks and activities, especially to solve emergent entrepreneurial challenges. Therefore, the required skills were often developed through a hands-on learning-by-doing-approach.

In their private lives, early career medical professionals report that they have developed digital skills through constant confrontation with digitalization over the years. Regular interaction with digital technologies in everyday activities—often since childhood—has fostered an intuitive and ongoing engagement with a variety of digital elements. Thus, this passive yet consistent immersion has naturally shaped their digital competencies over time. Beyond this passive acquisition, many early career medical professionals have actively developed digital skills through various personal initiatives. Here, some graduate students learned coding or programming during their leisure time, which broadened their technical and digital understanding in depth, enabling them to take on special professional tasks in practice later. Driven by personal interest, some early career medical professionals also pursued self-study through courses and training programs, deepening their engagement with overlapping digital megatrends.

Early career medical professionals report that they have applied their digital skills in different ways—especially in administrative, strategic, or communicative paths. Consequently, there are different approaches to bringing their digital knowledge into practice and sharing it with others.

An administrative application occurs when early career medical professionals leverage their digital skills to manage simple and existing tasks or processes. In their workplaces, most early career medical professionals use digital software, tools, or communication platforms that have already been integrated—both in everyday clinical practice and in office-related settings.

Due to their strong digital affinity, early career medical professionals report that they can intuitively understand and incorporate these tools into their daily routines. The overarching goal of these efforts from the early career medical professionals’ perspective is to save time and ultimately improve the quality of work by enhancing workflow and coordination within their professional settings. In addition to that, some early career medical professionals take on other roles regarding digitalization, that is, acting as key users for a digital app.

A strategic application occurs when early career medical professionals harness their digital skills to creatively and entrepreneurially advance digitalization initiatives. Thus, some digitally affine early career medical professionals even enhance internal processes by introducing new software, communication tools, or workflows, that is, digital lean management. Furthermore, early career medical professionals have also engaged in various entrepreneurial ventures, either independently or in the respective organization they are working at. In this context, they pursue a variety of different initiatives, such as developing digital business models or founding digital health-tech start-ups to address emerging market opportunities. As an example, some early career medical professionals have developed digital knowledge tools, providing easy access to relevant medical knowledge. Ultimately, these creative endeavors have enabled early career medical professionals to generate entrepreneurial value while actively contributing to the overall advancement of digitalization.

A communicative application occurs when early career medical professionals share their digital skills with others through various means. In this context, especially early career medical professionals in a clinical practice pass on their digital expertise by organizing training sessions and engaging in dialogues with colleagues, where they inform them about emerging digital opportunities and recommend best practices. Consequently, some early career medical professionals also serve as multipliers, facilitating the adoption and integration of digital solutions. Furthermore, early career medical professionals also apply their digital skills in different management and negotiation contexts, using their expertise to enhance final work results.

Early career medical professionals possess personal attributes and professional conditions that enable them to advance digitalization. These encompass organizational characteristics, personality traits, professional skills, and social skills.

Organizational characteristics encompass the advantages that early career medical professionals derive from their specific roles within their respective organizations. Therefore, early career medical professionals perceive that their needs are increasingly recognized as important by their employers, particularly considering demographic shifts that make these young professionals a valuable future resource. Aware of their value, some early career medical professionals report that they actively advocate for digital offers and, in some cases, even consider leaving employers who fail to meet their digital expectations. Additionally, early career professionals perceive themselves to benefit from a form of entry-level protection, where mistakes are more readily accepted. Furthermore, their perceived risks of failure remain relatively low. As a result, young early career medical professionals possess considerable potential to advance digitalization through their unique starting position.

Personality traits encompass the personal characteristics that many early career medical professionals possess, supporting their ability to drive digitalization forward. In this context, early career medical professionals report that they bring an unbiased perspective, allowing them to notice dusty aspects, challenge organizational blind spots, and approach longstanding problems in a different way of doing. In this context, early career medical professionals perceive themselves as maintaining an outsider’s perspective that enables them to tackle problems with their fresh insights.

Furthermore, their intrinsic motivation and genuine commitment to drive meaningful change in health care, combined with a strong enthusiasm for digitalization, position them—from their perspective—as key agents of digitalization. Moreover, early career medical professionals perceive themselves as highly resilient. In this context, many early career medical professionals report that, having not yet assumed family responsibilities, they face fewer constraints than established leaders within their organizations. This relative flexibility allows them to devote more time and energy to exploring additional topics, such as advancing digitalization. Moreover, they demonstrate a high willingness to implement new digital solutions, as they point out to perceive the high potential of digitalization for real practical improvements. On top of that, they report their adaptability, pragmatism, and a certain degree of naivety as further advantages helping them to contribute to the advancement of digitalization.

Professional competencies include the technical and subject-specific skills that many early career medical professionals possess, enabling them to advance digitalization. Therefore, early career medical professionals point out a strong affinity for and interest in digitalization, having mostly grown up in a digital environment where they learned to navigate through digital topics with ease. They possess foundational digital knowledge and, in some cases, also specialized expertise—especially in comparison to older generations. Their enthusiasm for digitalization extends beyond theory, as they describe themselves as actively identifying practical opportunities for digital improvements. Furthermore, early career medical professionals note that they approach data protection with a pragmatic mindset. Additionally, early career medical professionals indicate that their proximity to academic studies could allow them to be specifically trained in digitalization right before entering the workforce, enabling them to immediately apply what they have learned.

Professional competencies include the interpersonal skills that many early career medical professionals possess, enhancing their ability to drive digitalization forward. Here, early career medical professionals perceive themselves tending to question the status quo, seeking ways to improve or optimize existing digital structures. Consequently, early career medical professionals report that they often adopt a critical perspective, questioning whether things are truly effective or necessary. Additionally, they describe themselves as open to compromise, which enables them to collaboratively find solutions when implementing digital solutions.

But early career medical professionals also face general and target group-specific challenges—especially organizational, personal, and subject-specific hurdles.

Organizational challenges encompass all obstacles that arise within the organization itself. As an example, some early career medical professionals state that they face challenges in gaining recognition within their organizations at all—especially in clinical settings. In this context, they report that they have limited influence and that driving digitalization is not perceived as one of their core responsibilities—both by their employers and by themselves. Thus, their initial priority is to establish their role and to integrate into existing structures, a process further complicated by frequent transitions between different workplaces. Consequently, early in their careers, they often focus on fulfilling assigned tasks and hesitate to step into a shaping role, fearing mistakes or drawing too much attention. Diverging perspectives within the workforce present additional obstacles that early career medical professionals describe. While some professionals advocate for digitalization, others—particularly senior staff—remain committed to analog practices, exhibiting limited openness to change. Hierarchical dynamics further exacerbate this issue, as decision-making power over digital initiatives rests primarily with established professionals, who—from the perspective of early career medical professionals—often resist transformation to maintain existing structures.

Furthermore, early career medical professionals report that organizational constraints overall also impede digital progress. In this context, limited personnel resources, inflexible institutional frameworks, and the inability to disrupt ongoing health care operations create barriers to a successful digital improvement—especially in clinical settings. Moreover, early career medical professionals report a lack of incentives to engage in digitalization efforts, as neither formal support nor tangible rewards are provided. Likewise, technical limitations prevent the seamless implementation of digital solutions. Additionally, the existing functionality of analog systems diminishes the perceived urgency for digital changes.

Personal challenges encompass all obstacles stemming from the individual characteristics and circumstances of early career medical professionals. Here, not all early career medical professionals are intrinsically motivated to drive digitalization. While some prioritize efficiently fulfilling their true core responsibilities, others find digitalization less engaging or are reluctant to invest additional effort, particularly when it requires extra work or overtime. Additionally, some early career medical professionals do not feel as digitally inclined. Furthermore, they identify certain personality traits they feel they lack, which hinder their ability to contribute to digitalization. In this context, some exhibit a strong aversion to risk, some a lack of confidence, and some a lack of entrepreneurial mindset. Furthermore, early career medical professionals highlighted several knowledge gaps that hinder the adoption of digital tools, such as limited technical expertise, limited digital knowledge, and difficulties in navigating organizational processes.

Professional challenges include all obstacles that are rooted in specific content-related issues. First, even at the beginning of their career, health care professionals report that they are still overburdened, leaving little time and energy to engage in shaping digitalization. This was reported only by employees in a clinical setting.

Second, early career medical professionals argue that implementing digital solutions also requires significant financial investments, which are often hard to justify in the cost-sensitive health care sector. Furthermore, many early career medical professionals face bureaucratic processes and an outdated infrastructure. Third, early career medical professionals report that strict regulations prevent digital progress—especially due to strict data protection regulations. On top of that, early career medical professionals report that limited interconnectivity among health care institutions further impedes digital progress, as the lack of standardized digital collaboration systems prevents seamless data exchange.

Early career medical professionals point out potential solutions to solve existing challenges, focusing on enhanced education, improved practice conditions, and changed political regulations.

The area of education encompasses potential education-oriented measures. In this context, early career medical professionals emphasized the need for more comprehensive digital education and continuous professional development—especially during their medical study programs and, in some cases, also during high school. They suggested that universities should not only provide foundational digital courses but also offer practical, hands-on experiences that reflect real-world challenges and best practices, preparing students to actively contribute to advancing digitalization in health care practice. This preparation should focus on the specific content of digitalization, but also on the organizational challenges they will face, such as resistance to change. Therefore, universities should provide medical students with strategies on how to navigate these as a recent alumnus effectively. Furthermore, early career medical professionals report that fostering a digital and entrepreneurial mindset is crucial for early career medical professionals to solve a variety of challenges.

Thus, teaching students to think critically about how digitalization can be integrated into health care and different business models is a critical success factor from early career medical professionals’ perspective. Furthermore, early career medical professionals state that continuous workplace training is also essential to keep professionals up to date with rapidly evolving digitalization.

Additionally, from the participants’ perspective, policy reforms are crucial to reduce bureaucratic hurdles, streamline processes, and provide more flexibility for digital initiatives. Therefore, reforms should aim to balance data security with the freedom to push digitalization, allowing for a safe but agile development of digital solutions. Furthermore, the state should establish a robust infrastructural framework to support the development and implementation of digital initiatives.

Existing research emphasizes the lack of appropriate digital training in medical curricula [55,58]. This study confirms these findings, showing that even at progressive institutions such as UWH, students acquire digital skills mostly informally—through extracurricular activities or on-the-job learning. In this context, participants reported a clear gap between the digital demands of health care practice and the content of their former education, regardless of their year of graduation. Despite being digitally socialized and confident in the use of digital offers [31,32], students expressed frustration over the absence of a structured and practice-oriented digital education. These findings support the calls of the early career medical professionals for integrating digital competencies more and more into national frameworks such as the National Competence-Based Learning Objectives Catalogue for Medicine. At UWH, the demands of Neumann et al [55] and Sorg et al [59] also become evident: early career medical professionals seek a digital education, but this potential remains largely untapped. However, the actual conditions could also enable universities to go in new ways, setting their own digital priorities. This perspective aligns with the arguments of Khafizova et al [54] and Monteiro and Leite [75], who emphasize that universities could play a greater role in preparing students for the upcoming digital reality across various practical settings. This is particularly important because, to date, early career medical professionals appear to have developed their digital competencies primarily through informal means—such as extracurricular learning or on-the-job experiences, with an immediate application process. However, it is important to critically acknowledge that the majority of learning processes are occurring outside the traditional classroom, driven by experience and social interaction [76,77]. Nevertheless, as further research pointed out, universities could play an even more important role and make their own contribution to ensure that early career medical professionals enter the workplace digitally prepared [43,44,78]. In this context, digitalization has a transformative potential in education [79]. Consequently, in medical education, it is essential for universities to rethink their approach to teaching digital competencies and to prepare early career medical professionals for a changing job market [80,81]. In this context, universities should incorporate hands-on digital skills training that focuses not only on technical proficiency but also on how to apply these tools in real-world health care settings.

This study has made evident the diverse potentials of early career medical professionals, which are likewise addressed in the existing literature.

First, the perceived relevance of recent early career medical professionals for the future of health care organizations reflects broader demographic and workforce trends. As experienced professionals retire and the “war for talent” intensifies, early-career physicians are increasingly regarded as a strategic asset [82,83]. The literature confirms this development, highlighting projected personnel shortages in the health care sector and the growing importance of attracting and retaining qualified talent—including early career medical professionals [84-86]. In light of these trends, health care organizations must adapt more deliberately to the expectations of this target group—for example, by providing the desired digital infrastructure [87-89]. Taken together, these arguments suggest that the digital expectations of recent early career medical professionals alone can serve as a catalyst for change, particularly as organizations have to respond to these demands, keeping the skilled labor shortages in mind. This finding aligns with Burnes’s perspective, which conceptualizes external stakeholder expectations as key drivers of organizational change [90]. In this context, both external pressures—such as the demographic shift—and internal resources—such as early career medical professionals’ digital readiness and intrinsic motivation—interact to position early career medical professionals as important agents of digitalization. Building on Burnes’s view, this implies that health care organizations must not only acknowledge these expectations but also actively respond by implementing targeted solutions for early career medical professionals. These may include investing in talent development programs, establishing supportive digital infrastructures, or fostering a work culture that empowers early career professionals to contribute meaningfully to digital initiatives.

Second, participants in this study emphasized that early career medical professionals possess a diverse set of professional competencies and personal attributes that position them well to contribute to the advancement of digitalization. However, these characteristics are not fixed. As Asselmann and Specht [91] and Pataki-Bittó and Kapusy [92] note, early career professionals continue to develop essential traits—such as conscientiousness, assertiveness, or team orientation—during their initial years in practice. While these studies support the notion of a developmental trajectory, they also highlight its variability, as not all early career medical professionals display the same levels of confidence, initiative, or digital affinity. It is therefore critical to avoid reductive assumptions based on generational stereotypes [93,94]. Instead, intragroup differences and individual circumstances must be acknowledged, particularly when designing support systems intended to empower recent early career medical professionals to lead digital initiatives. Here, early career medical professionals’ individual strengths must be understood in relation to both their specific work environments and their individual characteristics.

This study also surfaces substantial structural, personal, and regulatory barriers that restrict the actualization of early career medical professionals in making their own contribution to the advancement of digitalization. As in previous studies by Kakale [95] or Nawroth et al [96], this study also points out a lack of formal authority, hierarchical resistance, time constraints, or a fragmented regulatory environment. These findings resonate with broader critiques of the German health care system, particularly concerning overly strict data protection frameworks and their chilling effect on digitalization and innovation [97-99]. Furthermore, participants’ references to bureaucratic overload, outdated infrastructure, and the difficulty of implementing digital solutions in analog-dominated settings align with the observations made by Wendling [100], who also emphasizes the systemic nature of these obstacles. It is therefore evident that early career medical professionals face still-documented and persistent challenges within the entire health care system, dampening their intrinsic motivation to act as key drivers of digitalization.

To address these limitations, this study also highlights potential enablers of digitalization and emerging solutions. In particular, structured mentorship, leadership support, and a receptive organizational culture are frequently identified as critical success factors [101], aligning with participants’ calls for greater top-down encouragement. Such indirectly acting measures may contribute to creating an environment that increasingly supports the digital initiatives of early career medical professionals. Moreover, consistent with the change management frameworks proposed by Glasl and Lievegoed [102] and Mizrak [103], the findings emphasize the necessity of coordinating diverse stakeholder interests. Early career medical professionals alone cannot be expected to navigate the often conflicting expectations of all different stakeholders alone. Here, effective professional leadership seems to be essential. As Burnes [90] notes, change is not a linear process, but rather a dynamic and ongoing interaction between internal capabilities and external pressures. This perspective is also reflected in the views of the study participants, who call on their organizations to manage emerging change processes systematically in order to respond professionally to evolving and changing conditions. In this context, it may be beneficial for organizations to implement structured change management approaches, as suggested by Mento et al [104], and to adopt targeted interventions at the individual, team, and organizational levels [105]. Using such established reference models may help to meet the growing demand for structured and sustainable change processes, impacting, in the end, also the opportunities for early career medical professionals in advancing digitalization in practical settings. Finally, the political dimension of digitalization cannot be overlooked. The literature highlights a central dilemma: fostering innovation while ensuring robust data protection [106,107]. This tension is also frequently emphasized by participants in this study, underscoring the need for appropriate and balanced solutions by policymakers.

The findings can be interpreted through professional identity development, which conceptualizes early career as a phase in which early career medical professionals internalize professional norms and negotiate who they are as practitioners [108,109]. In this transition, identity is shaped through participation in workplace communities; newcomers often remain in more peripheral positions until they gain legitimacy and influence [110,111]. This helps explain why participants—despite strong digital affinity—report limited recognition, restricted influence, and that advancing digitalization is not perceived as part of their core role, leading them to prioritize integrating into existing structures and avoiding a shaping role. Early career medical professionals’ hesitation is further reinforced by hierarchical decision-making and fear of drawing attention, as well as workload and overtime constraints that crowd out discretionary innovation work. Recent research on digital implementation also suggests that professional identity threats, time pressure, workflow fit, and organizational structures shape clinicians’ willingness to engage with digital change [112]. From a professional identity development perspective, digital change agency may therefore require identity-supportive conditions: visible role models and mentoring, plus organizational legitimation (eg, protected time and formal roles) so that being a digital physician becomes a valued identity rather than an extracurricular add-on [109,113]. This aligns with participants’ emphasis on mentorship, leadership support, and receptive culture as key enablers of a new role.

Overall, it becomes evident that a diverse range of stakeholders are playing a crucial role in enabling early career medical professionals to contribute meaningfully to the advancement of digitalization in practice. Considering this, the main recommendations for action are summarized below:

Here, without coordinated reform across policy, education, and health care governance, the transformative potential of digitally competent early career medical professionals is likely to remain underused. In sum, a multilevel approach is therefore imperative; early career medical professionals alone cannot bear the burden of driving digital initiatives without supportive structures and an appropriate ecosystem.