ESSAYS ON THE INFLUENCE OF DOCTORS’ SOCIO-DEMOGRAPHIC CHARACTERISTICS ON MEDICAL SPECIALTY ALLOCATION

Medical workforce planning is a key element of any health care system, however factors influencing medical career choice are poorly understood. This thesis contains three essays on the influence of doctors’ socio-demographic characteristics on their medical specialty in both the UK and Spain. This thesis aims at understanding the drivers of the occupational segregation between socio-demographic groups, with the objective of helping regulators and policy makers in the design of interventions aimed at reducing the undesired consequences associated with the occupational segregation. Chapter 2 constitutes a descriptive exercise of the socio-demographic composition of the new cohorts of junior doctors in the UK by analysing their distribution across specialties. The findings show large disparities in that distribution. This chapter provides a discussion of the possible sources of the observed disparities and relates the occupational segregation with the literature on statistical discrimination. Chapter 3 seeks to disentangle the origins of the outcomes observed in Chapter 2. It develops a conceptual framework that acknowledges the sequential, two-sided nature of the process and that serves as a base for the empirical analysis. The focus of the latter is the estimation of how doctors’ socio-demographic characteristics affect their application strategies and specialty choices and selectors’ valuations of candidates. Chapter 4 focuses on the Spanish resident market and explores two of the possible causes leading to the persistent gender gap in surgical specialties. The first focus is on the role of social interactions in shaping doctors’ decisions to specialize, more specifically whether female role models constitute an attractor factor for female doctors. The second analyses the functioning of the specialty allocation system and tests whether a policy change has had the unintended consequence of reducing the probability of female doctors accessing highly demanded specialties, including surgical specialties.