In this review, we touch on a broad array of ways that work is linked to health and health disparities for individuals and societies. First focusing on the health of individuals, we discuss the health differences between those who do and do not work for pay, and review key positive and negative exposures that can generate health disparities among the employed. These include both psychosocial factors like the benefits of a high status job or the burden of perceived job insecurity, as well as physical exposures to dangerous working conditions like asbestos or rotating shift work. We also provide a discussion of the ways differential exposure to these aspects of work contributes to social disparities in health within and across generations. Analytic complexities in assessing the link between work and health for individuals, such as health selection, are also discussed. We then touch on several contextual level associations between work and the health of populations, discussing the importance of the occupational structure in a given society, the policy environment that prevails there, and the oscillations of the macroeconomy for generating societal disparities in health. We close with a discussion of four areas and associated recommendations that draw on this corpus of knowledge but would push the research on work, health and inequality toward even greater scholarly and policy relevance.

Objectives To better understand the consequences of the premedical years for the character of (future) physicians by critically reviewing the empirical research done on the undergraduate premedical experience in the United States. Methods We searched ERIC, JSTOR, PubMed, Scopus, ISI Web of Science, and PsycINFO from the earliest available date for empirical, peer-reviewed studies of premedical students in the United States. We then used qualitative methods to uncover overall themes present in this literature. Results The initial literature search identified 1,168 articles, 19 of which were included for review. Reviewed articles were published between 1976 and 2010 with the majority published prior to 1990. Articles covered two broad topics: explaining attrition from the premedical track, and investigating the personality traits and stereotypes of premedical students. Self-selection bias and high attrition rates were among the limitations of the reviewed articles. Conclusions There is very little current research on the premedical experience. Given the importance of the premedical years on the process of becoming a medical professional, it is imperative that we do more and better research on how the premedical experience shapes future physicians.

Medical sociologists have long been fascinated with the process through which laypersons are transformed into physicians, uncovering the ways in which one learns, not just the facts of medical science, but also how to be a physician. Despite this abiding focus on socialization, nearly all of the literature on this process in the US is informed by studies of the medical school and residency years, with almost no empirical attention paid to the premedical years. Our study addresses this gap in knowledge. To better understand the premedical years we conducted 49 in-depth interviews with premedical students at a selective, public Midwestern university. We found that students understand and explain decisions made during the premedical years with narratives that emphasize the qualities of achievement-orientation, perseverance, and individualism. We also find that these qualities are also emphasized in narratives employed to account for the choice to collaborate with, or compete against, premedical peers. Examination of premedical narratives, and the qualities they emphasize, enriches our understanding of how premedical education shapes a physician's moral development, and underscores the need to include the premedical years in our accounts of “becoming a doctor.”

Abstract