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Prestige affects important choices

Ideas regarding status and prestige contribute to a shortage of doctors within certain specialities, according to a new doctoral thesis from Karolinska Institutet.

Name and title: Caroline Olsson, PhD, who recently defended her doctoral thesis at the Department of Clinical Science and Education, Södersjukhuset (South General Hospital in Stockholm).

Thesis: Medical doctors’ specialty choice in relation to personality, cultural capital and social background

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The medical profession has a high status, but can also be hard work. Caroline Olssons is interested in whether the status of doctors will remain the same in the future or not. Credit: Sofia Nahringbauer.

A relatively small number of doctors specialise in psychiatry, geriatrics and primary care – areas where there is a large shortage of doctors. In her thesis, Caroline Olsson has looked at the factors that influence doctors when choosing a speciality. She has been working with equal opportunities and broadened recruitment for the first-cycle programmes at Karolinska Institutet for a long time.

“I wanted to find out what happens in the next step, as the doctors continue their training,” she says.

One conclusion is that the choice of speciality cannot be explained by social background.

“The reason is that the medical profession as such is unevenly recruited; most medical students have highly educated parents,” says Caroline Olsson.

Personality traits

Their personality may be a factor on the other hand – a sub-study showed that surgeons scored high in personality traits relating to meticulousness, and lower in cooperativeness. But the most prominent pattern was the hierarchical divisions between different specialities. In the rankings produced by the doctors, surgery stood out as an area of high social status, whereas psychiatry and geriatrics were considered low status.

The realisation that this can be important was the highest in the low-status groups.  A psychiatrist who was interviewed in one of the studies said that they prefer to introduce themselves as a doctor rather than as a psychiatrist.

“I find that absurd, feeling that way after completing a five-year specialist programme. It just isn’t okay,” says Caroline Olsson.

Success within psychiatry

The explanations offered in the interviews included success within psychiatry being considered difficult to measure and the subject being presented as something of a deviation in the training.  The choice is made after completing the basic training. But according to Caroline Olsson, it is important to understand that it is preceded by a long process.  

“A recruitment process is more than publishing an ad; you have to work proactively throughout the medical programme to raise the status of specialities where there is a shortage. Otherwise we will never be able to cope with the challenges within healthcare,” says Caroline Olsson.

Text: Ola Danielsson, first published in Swedish in Medicinsk Vetenskap No 2/2019

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