Gender Gaps in Access to Medical Intern Positions: The Role of Competition

Competitive selection processes can lead to inefficiencies in the labor market when disparities in performance during the selection process are unrelated to differences in job performance among selected candidates. Using data on the universe of candidates in the highly competitive and high stakes mandatory national entry exam into the medical profession in Spain over the past four decades, we first report the evolution of gender differences in exam performance, which translate into important gender gaps in the likelihood of securing a position (ranging from negative 7% up to positive 9% depending on the period), controlling for individual heterogeneity in ability. We then exploit the large variation in the proportion of available positions with respect to the number of candidates, to show that the observed evolution of gender gaps mimics the evolution of the selection process’ competitiveness: the more competitive the process, the higher the underperformance of women compared to men, while when the process shows low competitiveness, women outperform men. Aligning the number of candidates with the available positions based on the system’s needs rather than relying on alternative criteria would yield substantial gains in efficiency, particularly in professions where competitiveness does not play a pivotal role.