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Individual and hospital-specific factors influencing medical graduates' time to medical specialization


  • Johannessen, Karl-Arne
  • Hagen, Terje P.


Previous studies of gender differences in relation to medical specialization have focused more on social variables than hospital-specific factors. In a multivariate analysis with extended Cox regression, we used register data for socio-demographic variables (gender, family and having a child born during the study period) together with hospital-specific variables (the amount of supervision available, efficiency pressure and the type of teaching hospital) to study the concurrent effect of these variables on specialty qualification among all 2474 Norwegian residents who began specialization in 1999–2001. We followed the residents until 2010. A lower proportion of women qualified for a specialty in the study period (67.9% compared with 78.7% of men, p < 0.001), and they took on average six months longer than men did to complete the specialization qualification (p < 0.01). Fewer women than men entered specialties providing emergency services and those with longer working hours, and women worked shorter hours than men in all specialties. Hospital factors were significant predictors for the timely attainment of specialization: working at university hospitals (regional) or central hospitals was associated with a reduction in the time taken to complete the specialization, whereas an increased patient load and less supervision had the opposite effect. Multivariate analysis showed that the smaller proportion of women who qualified for a specialty was explained principally by childbirth and by the number of children aged under 18 years.

Suggested Citation

  • Johannessen, Karl-Arne & Hagen, Terje P., 2013. "Individual and hospital-specific factors influencing medical graduates' time to medical specialization," Social Science & Medicine, Elsevier, vol. 97(C), pages 170-175.
  • Handle: RePEc:eee:socmed:v:97:y:2013:i:c:p:170-175
    DOI: 10.1016/j.socscimed.2013.08.026

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    References listed on IDEAS

    1. Gjerberg, Elisabeth, 2001. "Medical women -- towards full integration? An analysis of the specialty choices made by two cohorts of Norwegian doctors," Social Science & Medicine, Elsevier, vol. 52(3), pages 331-343, February.
    2. Steven Simoens & Jeremy Hurst, 2006. "The Supply of Physician Services in OECD Countries," OECD Health Working Papers 21, OECD Publishing.
    3. Susan Ettner, 1995. "The impact of “parent care” on female labor supply decisions," Demography, Springer;Population Association of America (PAA), vol. 32(1), pages 63-80, February.
    4. Heiligers, Phil J. M. & Hingstman, L., 2000. "Career preferences and the work-family balance in medicine: gender differences among medical specialists," Social Science & Medicine, Elsevier, vol. 50(9), pages 1235-1246, May.
    5. Linna, Miika & Hakkinen, Unto & Magnussen, Jon, 2006. "Comparing hospital cost efficiency between Norway and Finland," Health Policy, Elsevier, vol. 77(3), pages 268-278, August.
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