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.