title: Social dominance theory and medical specialty choice.
abstract: Understanding how medical students select their specialty is a fundamental issue for public health and educational policy makers. One of the factors that students take into account is a specialty's prestige which hinges partly on its focus on technique rather than whole person. We examine the potential of a psychological framework, social dominance theory, to explain why some students, and not others, are drawn to more prestigious, technique-oriented specialties, based on their desire for hierarchy. We conducted a cross-sectional study among medical students at Institution X (N = 359). We examined the link between medical students' characteristics i.e. social dominance orientation (SDO), gender, age, and their career intention. We also examined level of medical students' SDO at different stages of the curriculum. SDO scores were significantly associated with technique-oriented career intentions (OR 1.56; 95 % CI [1.18, 2.06]; p = 0.001). The effect was independent of gender. Medical students' SDO scores were significantly higher in later stages of the medical curriculum (F = 6.79; p = 0. 001). SDO is a significant predictor of medical students' career intention. SDO scores are higher in students during the clinical phase of the curriculum. Medical socialization, involving the internalization of implicit and explicit norms, particularly in hospital settings, is likely to underpin our findings. This theory illuminates consistent findings in the literature on specialty prestige and the influence of medical school on career choice.
authors.affiliation: Institute of Health and Society (IRSS), Université catholique de Louvain, Clos Chapelle-aux-Champs 30, B1.30.15, 1200, Brussels, Belgium. brice.lepiece@uclouvain.be.
authors.forename: Brice
authors.initials: B
authors.lastname: Lepièce
authors.affiliation: Institute of Health and Society (IRSS), Université catholique de Louvain, Clos Chapelle-aux-Champs 30, B1.30.15, 1200, Brussels, Belgium.
authors.forename: Christine
authors.initials: C
authors.lastname: Reynaert
authors.affiliation: Institute of Health and Society (IRSS), Université catholique de Louvain, Clos Chapelle-aux-Champs 30, B1.30.15, 1200, Brussels, Belgium.
authors.forename: Philippe
authors.initials: P
authors.lastname: van Meerbeeck
authors.affiliation: Faculty of Medicine, Centre for Medical Education, McGill University, Montréal, Canada.
authors.forename: Valérie
authors.initials: V
authors.lastname: Dory
mesh_terms: D000328:Adult; D002321:Career Choice; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008511:Medicine; D011582:Psychological Theory; D012930:Social Dominance; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Career choice; Clinical clerkship; Education, medical, undergraduate; Hierarchy; Medical students; Prestige; Social dominance