Abstract
BackgroundMany western countries have problems recruiting and retaining medical specialists. In Sweden there is a lack of primary care doctors and psychiatrists. Despite much research on the topic the shortage remains. We therefore set out to analyse choice of medical speciality using Bourdieu’s theoretical concepts; cultural capital, social background and perceived status.MethodsA cross-sectional questionnaire-based study of 399 alumni from the Medical School at Karolinska Institutet, Stockholm was performed. The response rate was 72% (n = 286); 262 of the respondents were in training to become specialists. Specialties were categorized as primary care, psychiatry, internal medicine, and surgical and hospital service specialties. To study the associations between medical specialties and cultural capital, we used multinomial regression analyses. Variables that showed a significant association with medical specialties were included in an adjusted multivariable model. These results were presented as odds ratios: the odds that a particular speciality is chosen in comparison to a choice of surgery as a speciality, based on perceptions of high status.ResultsThe results were analysed using Bourdieu’s theoretical concepts of cultural capital, in the form of educational capital and social prestige. We found distinctive differences in perceived status for the examined speciality groups, ranging from 70% high status for surgery down to 6% high status for geriatrics and primary care. Perceived status was also associated with respondents’ own speciality choice, presented as an odds ratio. Our data did not show any associations between speciality choice and educational capital. We also included sociodemographic data.ConclusionThe field of medicine is according to Bourdieu an arena for power struggles. Knowledge of the distinctive differences in perceived status between medical specialties can be an asset particularly in relation to recruitment and retainment of specialist doctors. Our results could be used to identify specialities where perceptions of low status may be contributing to a shortage of specialists.
Highlights
Many western countries have problems recruiting and retaining medical specialists
We found distinctive differences in perceived status for the examined speciality groups, ranging from 70% high status for surgery down to 6% high status for geriatrics and primary care
We found no significant associations between doctors’ speciality choice and inherited or acquired educational capital
Summary
Many western countries have problems recruiting and retaining medical specialists. In Sweden there is a lack of primary care doctors and psychiatrists. We set out to analyse choice of medical speciality using Bourdieu’s theoretical concepts; cultural capital, social background and perceived status. There is a need for a greater understanding of factors such as social background and educational capital which underlie doctors’ choice of speciality. Bourdieu’s theoretical framework is useful in better understanding the underlying characteristics that influence the individual in her or his choice of speciality. It challenges both the idea of choice as something entirely rational and the idea that individuals are completely trapped within social structures [4]. In this study we investigate doctors’ speciality choice by applying Bourdieu’s concepts of medical field, cultural and symbolic capital, in the forms of inherited and acquired educational capital, and perceived prestige of different medical specialties [5]
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