Gender difference in preference of specialty as a career choice among Japanese medical students.
BACKGROUND
In Japan, the absolute deficiency of doctors and maldistribution of doctors by specialty is a significant problem in the Japanese health care system. The purpose of this study was to investigate the factors contributing to specialty preference in career choice among Japanese medical students.


METHODS
A total of 368 medical students completed the survey giving an 88.2 % response rate. The subjects comprised 141 women aged 21 ± 3 (range, 18-34) years and 227 men aged 22 ± 4 (range, 18-44) years. Binary Logistic regression analysis was performed using specialty preferences as the criterion variable and the factors in brackets as six motivational variables (e.g., Factor 1: educational experience; Factor 2: job security; Factor 3: advice from others; Factor 4: work-life balance; Factor 5: technical and research specialty; and Factor 6: personal reasons).


RESULTS
Women significantly preferred pediatrics, obstetrics & gynecology, and psychology than the men. Men significantly preferred surgery and orthopedics than the women. For both genders, a high odds ratio (OR) of "technical & research specialty" and a low OR for "personal reasons" were associated with preference for surgery. "Technical & research specialty" was positively associated with preference for special internal medicine and negatively for pediatrics. "Work-life balance" was positively associated with preference for psychology and negatively for emergency medicine. Among the women only, "technical & research specialty" was negatively associated with preference for general medicine/family medicine and obstetrics & gynecology, and "job security" was positively associated for general medicine/family medicine and negatively for psychology. Among men only, "educational experience" and "personal reasons" were positively, and "job security" was negatively associated with preference for pediatrics. For both genders, "work-life balance" was positively associated with preference for controllable lifestyle specialties.


CONCLUSIONS
We must acknowledge that Japanese medical students have dichotomized some motivations for their specialty preference based on gender. Systematic improvements in the working environment are necessary to solve these issues.
Department of Community Medicine, Ehime University Graduate School of Medicine, Toon-city, Ehime-ken, 791-0295, Japan. rykawamo@m.ehime-u.ac.jp.|Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo-city, Ehime-ken, 797-1212, Japan. rykawamo@m.ehime-u.ac.jp.
Ryuichi
R
Kawamoto
Department of Community Medicine, Ehime University Graduate School of Medicine, Toon-city, Ehime-ken, 791-0295, Japan.|Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo-city, Ehime-ken, 797-1212, Japan.
Daisuke
D
Ninomiya
Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo-city, Ehime-ken, 797-1212, Japan.
Yoshihisa
Y
Kasai
Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo-city, Ehime-ken, 797-1212, Japan.
Tomo
T
Kusunoki
Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo-city, Ehime-ken, 797-1212, Japan.
Nobuyuki
N
Ohtsuka
Department of Community Medicine, Ehime University Graduate School of Medicine, Toon-city, Ehime-ken, 791-0295, Japan.
Teru
T
Kumagi
Department of Community Medicine, Ehime University Graduate School of Medicine, Toon-city, Ehime-ken, 791-0295, Japan.
Masanori
M
Abe
D000328:Adult; D002321:Career Choice; D003430:Cross-Sectional Studies; D004504:Education, Medical, Undergraduate; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D009042:Motivation; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data; D012737:Sex Factors; D013038:Specialization / Q000706:statistics & numerical data*; D013337:Students, Medical / Q000523:psychology* / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
Career choice; Gender difference; Japanese medical students