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Still want to be a doctor? Medical student dropout in the era of COVID-19

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  • Ye, Xiaoyang
  • Zhai, Muxin
  • Feng, Li
  • Xie, A’na
  • Wang, Weimin
  • Wu, Hongbin

Abstract

This research examines the intention of undergraduate medical students to withdraw from the medical profession and pursue a career in a different field upon graduation during COVID-19. We leverage the first and most comprehensive nationwide survey for medical education in China, which covered 98,668 enrolled undergraduate students from 90 out of 181 Chinese medical schools in 2020. We focus on these students’ self-reported intention to leave the healthcare industry (the “dropout intention”) before and after the outbreak of the epidemic. We also designed a randomized experiment to test whether and to what extent medical students dropout intention responded to an information nudge that highlighted the prosociality of health professionals in the fight against the virus. Results from a difference-in-differences model and a student fixed effect model suggest that after the onset of COVID-19, the proportion of Chinese undergraduate medical students with a dropout intention declined from 13.7% to 6.8%. Furthermore, the nudge information reduced the intent-to-drop-out probability by 0.8 additional percentage points for students in their early college years. There was large heterogeneity underneath the treatment effect. Specifically, we find that prior dropout intention and exposures to COVID-19-related information tended to mitigate the nudge effects. Data on students’ actual dropout outcomes support our findings.

Suggested Citation

  • Ye, Xiaoyang & Zhai, Muxin & Feng, Li & Xie, A’na & Wang, Weimin & Wu, Hongbin, 2022. "Still want to be a doctor? Medical student dropout in the era of COVID-19," Journal of Economic Behavior & Organization, Elsevier, vol. 195(C), pages 122-139.
  • Handle: RePEc:eee:jeborg:v:195:y:2022:i:c:p:122-139
    DOI: 10.1016/j.jebo.2021.12.034
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    1. Jean Tirole & Roland Bénabou, 2006. "Incentives and Prosocial Behavior," American Economic Review, American Economic Association, vol. 96(5), pages 1652-1678, December.
    2. Stefano DellaVigna & Elizabeth Linos, 2022. "RCTs to Scale: Comprehensive Evidence From Two Nudge Units," Econometrica, Econometric Society, vol. 90(1), pages 81-116, January.
    3. Arcidiacono, Peter & Nicholson, Sean, 2005. "Peer effects in medical school," Journal of Public Economics, Elsevier, vol. 89(2-3), pages 327-350, February.
    4. Tisamarie B. Sherry & Sebastian Bauhoff & Manoj Mohanan, 2017. "Multitasking and Heterogeneous Treatment Effects in Pay-for-Performance in Health Care: Evidence from Rwanda," American Journal of Health Economics, MIT Press, vol. 3(2), pages 192-226, Spring.
    5. Bo, Shiyu & Chen, Joy & Song, Yan & Zhou, Sen, 2020. "Media attention and choice of major: Evidence from anti-doctor violence in China," Journal of Economic Behavior & Organization, Elsevier, vol. 170(C), pages 1-19.
    6. Matthew Wiswall & Basit Zafar, 2018. "Preference for the Workplace, Investment in Human Capital, and Gender," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 133(1), pages 457-507.
    7. George A. Akerlof & Rachel E. Kranton, 2005. "Identity and the Economics of Organizations," Journal of Economic Perspectives, American Economic Association, vol. 19(1), pages 9-32, Winter.
    8. Nava Ashraf & Oriana Bandiera & Edward Davenport & Scott S. Lee, 2020. "Losing Prosociality in the Quest for Talent? Sorting, Selection, and Productivity in the Delivery of Public Services," American Economic Review, American Economic Association, vol. 110(5), pages 1355-1394, May.
    9. Timothy Besley & Maitreesh Ghatak, 2005. "Competition and Incentives with Motivated Agents," American Economic Review, American Economic Association, vol. 95(3), pages 616-636, June.
    10. Stefano DellaVigna & Eliana La Ferrara, 2015. "Economic and Social Impacts of the Media," NBER Working Papers 21360, National Bureau of Economic Research, Inc.
    11. Tyler Ransom & Esteban Aucejo & Arnaud Maurel & Peter Arcidiacono, 2014. "College Attrition and the Dynamics of Information Revelation," 2014 Meeting Papers 529, Society for Economic Dynamics.
    12. Roland Bénabou & Jean Tirole, 2016. "Mindful Economics: The Production, Consumption, and Value of Beliefs," Journal of Economic Perspectives, American Economic Association, vol. 30(3), pages 141-164, Summer.
    13. Pamela Giustinelli & Matthew D. Shapiro, 2018. "SeaTE: Subjective ex ante Treatment Effect of Health on Retirement," Working Papers wp382, University of Michigan, Michigan Retirement Research Center.
    14. Roland Bénabou & Jean Tirole, 2003. "Intrinsic and Extrinsic Motivation," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 70(3), pages 489-520.
    15. Eleanor Wiske Dillon & Jeffrey Andrew Smith, 2020. "The Consequences of Academic Match between Students and Colleges," Journal of Human Resources, University of Wisconsin Press, vol. 55(3), pages 767-808.
    16. Susan Godlonton & Manuel A Hernandez & Mike Murphy, 2018. "Anchoring Bias in Recall Data: Evidence from Central America," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 100(2), pages 479-501.
    17. Damgaard, Mette Trier & Nielsen, Helena Skyt, 2018. "Nudging in education," Economics of Education Review, Elsevier, vol. 64(C), pages 313-342.
    18. Dan Ariely & Uri Gneezy & George Loewenstein & Nina Mazar, 2009. "Large Stakes and Big Mistakes," Review of Economic Studies, Oxford University Press, vol. 76(2), pages 451-469.
    19. Roland Bénabou & Jean Tirole, 2011. "Identity, Morals, and Taboos: Beliefs as Assets," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 126(2), pages 805-855.
    20. John Bound & Michael F. Lovenheim & Sarah Turner, 2010. "Why Have College Completion Rates Declined? An Analysis of Changing Student Preparation and Collegiate Resources," American Economic Journal: Applied Economics, American Economic Association, vol. 2(3), pages 129-157, July.
    21. Christine Laudenbach & Ulrike Malmendier & Alexandra Niessen-Ruenzi, 2019. "Emotional Tagging and Belief Formation: The Long-Lasting Effects of Experiencing Communism," AEA Papers and Proceedings, American Economic Association, vol. 109, pages 567-571, May.
    22. Aucejo, Esteban M. & French, Jacob & Ugalde Araya, Maria Paola & Zafar, Basit, 2020. "The impact of COVID-19 on student experiences and expectations: Evidence from a survey," Journal of Public Economics, Elsevier, vol. 191(C).
    23. Saurabh Bhargava & George Loewenstein, 2015. "Behavioral Economics and Public Policy 102: Beyond Nudging," American Economic Review, American Economic Association, vol. 105(5), pages 396-401, May.
    24. Iacus, Stefano M. & King, Gary & Porro, Giuseppe, 2012. "Causal Inference without Balance Checking: Coarsened Exact Matching," Political Analysis, Cambridge University Press, vol. 20(1), pages 1-24, January.
    25. Peter Arcidiacono & V. Joseph Hotz & Arnaud Maurel & Teresa Romano, 2020. "Ex Ante Returns and Occupational Choice," Journal of Political Economy, University of Chicago Press, vol. 128(12), pages 4475-4522.
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