What I think your underlying point is: it's no longer seen as the most straightforward pipeline path to high salary, career stability, social status, and dating prospects. I'm not convinced it's true (or not true) that this is fading, but I think that's the core of the matter you bring up. I also suspect that this varies significantly from country to country. I.e. it's central to US and Canadian MDs, but less so in other places.