Review Article: Prestige and its significance for medical specialties and diseases

Nørredam, Marie; Album, Dag

doi:10.1080/14034940701362137

Cited by 101 publications

(111 citation statements)

References 26 publications

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“…A number of studies have found perceived prestige, or lack thereof, to be associated with specific career choices. 13,[24][25][26][27] Role models have been found to broadly influence medical career choice. [28][29][30] Given that only 2.3% of students had a close family member or friend practising emergency medicine, it is likely that role models had not yet exerted an influence on career decision-making for most of the study population.…”

Section: ; 11 (3) 201mentioning

confidence: 99%

Emergency medicine as a career choice: a descriptive study of Canadian medical students

Scott

Abu‐Laban

Gowans

et al. 2009

CJEM

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Background: Studies indicate that a student's career interest at medical school entry is related to his or her ultimate career. We sought to determine the level of interest in emergency medicine among students at the time of medical school entry, and to describe characteristics associated with students primarily interested in emergency medicine. Methods: We surveyed students in 18 medical school classes from 8 Canadian universities between 2001 and 2004 at the commencement of their studies. Participants listed their top career choice and the degree to which a series of variables influenced their choices. We also collected demographic data. Results: Of 2420 surveys distributed, 2168 (89.6%) were completed. A total of 6.1% (95% confidence interval 5.1%-7.1%) of respondents cited emergency medicine as their first career choice. When compared with students primarily interested in family medicine, those primarily interested in emergency medicine reported a greater influence of hospital orientation and a lesser influence of social orientation on their career choice. When compared with students primarily interested in the surgical specialties, those primarily interested in emergency medicine were more likely to report medical lifestyle and varied scope of practice as important influences. When compared with students primarily interested in the medical specialties, those who reported interest in emergency medicine were more likely to report that a hospital orientation and varied scope of practice were important influences, and less likely to report that social orientation was important. Conclusion: Students primarily interested in emergency medicine at medical school entry have attributes that differentiate them from students primarily interested in family medicine, the surgical specialties or the medical specialties. These findings may help guide future initiatives regarding emergency medicine education. RÉSUMÉContexte : Des études révèlent l'existence d'un lien entre le domaine professionnel qui intéresse l'étudiant au moment de son entrée à la faculté de médecine et la carrière qu'il choisit au final. Nous avons voulu déterminer le degré d'intérêt à l'endroit de la médecine d'urgence chez les étudiants au moment de leur entrée à la faculté de médecine et décrire les caractéristiques de ceux qui manifestaient un intérêt particulier pour ce domaine. Méthodes : Nous avons réalisé un sondage auprès d'étudi-ants inscrits à 18 cours de médecine de 8 universités canadiennes entre 2001 et 2004, au début de leurs études. Les participants ont dressé la liste de leurs préférences en matière de choix de carrière et indiqué à quel degré une série de variables influait sur leurs choix. Nous avons aussi recueilli des données démographiques. Résultats : Sur les 2420 questionnaires distribués, 2168 (89,6 %) ont été remplis. En tout, 6,1 % (intervalle de confiance à 95 % de 5,1 à 7,1 %) des répondants ont classé la médecine d'urgence au premier rang parmi leurs choix de carrière. Comparativement aux étudiants qui s'intéressaie...

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Section: ; 11 (3) 201mentioning

confidence: 99%

Emergency medicine as a career choice: a descriptive study of Canadian medical students

Scott

Abu‐Laban

Gowans

et al. 2009

CJEM

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“…Hence, surgery, internal medicine and anaesthesiology are at the very top whereas psychiatry and general practice are generally low in prestige. This hierarchy has proved consistent across Norway (Norredam & Album, 2007), the United States (Rosoff & Leone, 1991) and Australia (Creed et al, 2010).…”

Section: Integration Vs Horizontal Segregation In the Labour Marketmentioning

confidence: 91%

Stratification in the Medical profession: Non-Western Physicians in Norway

Drange

Vågan

2013

P&P

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Previous studies of internal stratification in medicine suggest that nonWhite foreign-trained physicians fill the bottom level of the specialist hierarchy. However, in this study we use administrative registers for majority and nonWestern physicians in Norway and find that non-Western physicians acquire specialisation in the same volume as majority colleagues, are equally likely to enter several of the high prestige specialties and are not delayed in their careers. The equal distribution is discussed as a consequence of strong professional closure, bureaucratisation of hiring procedures and hospital organisation and governmental influence. Identified patterns, however, are not unequivocal. First, immigrant physicians have a significantly higher chance of becoming specialists compared to majority physicians. Second, foreign-educated non-Western physicians have a significantly lower likelihood of specialising in surgery fields. The exception from the overall equality may result from exclusionary practices previously identified in surgery, but it could also result from differences in motivation.

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“…Such differences in strategies or capacity may cancel out the differences in observed actual waiting time; for example to give access to less severely ill patients compensated by longer maximum waiting times. Differences in capacity may be associated with variation in funding, 15 or the prestige of different medical disciplines, 16,17 but our study was not designed to explore if this was the case. The Norwegian prioritization guidance documents also allow discretion when it comes to each single patient.…”

Section: Discussionmentioning

confidence: 99%

Norwegian Priority Setting in Practice – an Analysis of Waiting Time Patterns Across Medical Disciplines

Gangstøe

Heggestad

Norheim

2016

Int J Health Policy Manag

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Background: Different strategies for addressing the challenge of prioritizing elective patients efficiently and fairly have been introduced in Norway. In the time period studied, there were three possible outcomes for elective patients that had been through the process of priority setting: (i) high priority with assigned individual maximum waiting time; (ii) low priority without a maximum waiting time; and (iii) refusal (not in need for specialized services). We study variation in priority status and waiting time of the first two groups across different medical disciplines. Methods: Data was extracted from the Norwegian Patient Register (NPR) and contains information on elective referrals to 41 hospitals in the Western Norway Regional Health Authority in 2010. The hospital practice across different specialties was measured by patient priority status and waiting times. The distributions of assigned maximum waiting times and the actual ones were analyzed using standard Kernel density estimation. The perspective of the planning process was studied by measuring the time interval between the actual start of healthcare and the maximum waiting time. Results: Considerable variation was found across medical specialties concerning proportion of priority patients and their maximum waiting times. The degree of differentiation in terms of maximum waiting times also varied by medical discipline. We found that the actual waiting time was very close to the assigned maximum waiting time. Furthermore, there was no clear correspondence between the actual waiting time for patients and their priority status. Conclusion: Variations across medical disciplines are often interpreted as differences in clinical judgment and capacity. Alternatively they primarily reflect differences in patient characteristics, patient case-mix, as well as capacity. One hypothesis for further research is that the introduction of maximum waiting times may have contributed to push the actual waiting time towards the maximum. The finding that the actual waiting time was very close to the maximum waiting time supports this. The lack of clear correspondence between the actual waiting time for patients and their priority status may imply that urgency, described in the referral letter, and severity of illness, according to guidelines, are two separate entities. Keywords: Waiting Lists, Prioritization, Healthcare Sector Copyright: © 2016 by Kerman University of Medical Sciences Citation: Gangstøe JJ, Heggestad T, Norheim OF. Norwegian priority setting in practice -an analysis of waiting time patterns across medical disciplines.

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Review Article: Prestige and its significance for medical specialties and diseases

Cited by 101 publications

References 26 publications

Emergency medicine as a career choice: a descriptive study of Canadian medical students

Emergency medicine as a career choice: a descriptive study of Canadian medical students

Stratification in the Medical profession: Non-Western Physicians in Norway

Norwegian Priority Setting in Practice – an Analysis of Waiting Time Patterns Across Medical Disciplines

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