Abstract
BackgroundAn imbalance of physician supply by medical specialty has been observed in most countries. In Korea, there is a greater tendency to avoid surgical specialties and specialty choices in nonclinical medicine, such as the basic science of medicine. In this study, we identified factors affecting the specialty choice of physicians in order to provide a basis for policies to address this problem.MethodsWe used the results of a 2013 nationwide survey of 12 709 medical students (82.7 % responded) to analyze the data of 9499 students after excluding missing data. Descriptive analyses of all students’ specialty choice were performed. Logistic regression was performed by selecting gender, age, grade level, type of medical school, hometown, and the location of the medical school as the independent variables. Medical specialty was the dependent variable. The dependent variable, or specialty of medicine, was categorized into three groups: nonclinical/clinical medicine, surgical-medical specialty, and controllable lifestyle specialty.ResultsThe order of preferred medical specialties was internal medicine, psychiatry, and pediatrics; for surgical specialties, the order was orthopedic surgery, general surgery, and ophthalmology. Medical specialties were most favored by women and students in the third (men) and second (women) year of the medical program, whereas surgical specialties were most preferred by men and students in the first year of the program. Students in the third year mostly favored nonclinical medicine. Medical college students had a stronger preference for nonclinical medicine (odds ratio [OR] 1.625, 95 % confidence interval [CI] 1.139–2.318) than graduate medical school students. Surgical specialties were more favored by men (OR 2.537, 95 % CI 2.296–2.804) than by women. However, they were favored less by medical college students (OR 0.885, 95 % CI 0.790–0.991) than by graduate medical school students and by medical students in metropolitan areas (OR 0.892, 95 % CI 0.806–0.988) than by medical students in nonmetropolitan areas. A controllable lifestyle specialty was less favored by men (OR 0.802, 95 % CI 0.730–0.881) than by women.ConclusionsBased on these results, we can evaluate the effectiveness of the government’s educational policies for solving the imbalance of physician supply and provide empirical evidence to understand and solve this problem.
Highlights
An imbalance of physician supply by medical specialty has been observed in most countries
We aimed to identify factors affecting students’ specialty choices and provide evidence for related policies to solve the imbalance in the physician supply
The results showed that women, older students, students originally from a metropolitan area, students currently attending a nonmetropolitan medical school, and fourth year students had a stronger preference for a controllable lifestyle specialty
Summary
An imbalance of physician supply by medical specialty has been observed in most countries. In Korea, there is a greater tendency to avoid surgical specialties and specialty choices in nonclinical medicine, such as the basic science of medicine. The imbalance of the supply of physicians has been reported among different specialties and regions and between the public and private sectors. In Korea, nonclinical medicine, such as the basic science of medicine, and certain surgical specialties are traditionally avoided for economic reasons. Other than the economic aspects, the basic science of medicine is known to be avoided because of the instability of the position [5], and surgical specialties are avoided due to the high demand of physical intensity and stress [6]. It is impossible to measure the stability and stress of these positions, they are factors that significantly affect specialty choice [7] and downgrade lifetime utility [8]
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