title: Student characteristics, professional preferences, and admission to medical school.
abstract: Objectives:A potential new avenue to address the shortage of country doctors is to change the rules for admission to medical school. We therefore study the link between high-school grade point average and prospective physicians' choice to work in rural areas. To further inform the discussion about rules for admission, we also study the effects of other predictors: a measure of students' attitudes towards risk; whether they waited for their place of study (Wartesemester); whether their parents worked as medical doctors; and whether they have some practical experience in the medical sector.Methods:We conducted two internet surveys in 2012 and 2014. In the first survey, the sample comprised 701 students and in the second, 474 students. In both surveys, we asked students for their regional preferences; in the 2014 survey, we additionally asked students for their first, second, and third preferences among a comprehensive set of specializations, including becoming a general practitioner. In both surveys, we asked students for basic demographic information (age and gender), their parents' occupation, a measure of subjective income expectations, a measure of risk attitudes, and their high-school grade point average (Abiturnote), and First National Boards Examination grade (Physikum). In 2014, we additionally asked for waiting periods (Wartesemester) as well as for prior professional experience in the health-care sector.Results:We find that three factors increase the probability of having a preference for working in a rural area significantly, holding constant all other influences: having a medical doctor among the parents, having worse grades in the high-school grade point average, and being more risk averse. Moreover, we find that those willing to work in the countryside have significantly more experience in the medical sector before admission to medical school.Discussion:Our results suggest that a change in the selection process for medical school may increase the supply of country doctors. Instead of focusing on the high-school grade point average, universities could even more intensely screen for study motivation through interviews or by taking into account students' background, extracurricular activities, or waiting periods.
authors.affiliation: University of Leuven, Department of Economics, Leuven, Belgium.
authors.forename: Iris
authors.initials: I
authors.lastname: Kesternich
authors.affiliation: University of Leuven, Department of Economics, Leuven, Belgium.
authors.forename: Heiner
authors.initials: H
authors.lastname: Schumacher
authors.affiliation: University of Munich, Volkswirtschaftliche Fakultät, Seminar für Empirische Wirtschaftsforschung, Munich, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Winter
authors.affiliation: Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Germany.
authors.forename: Martin R
authors.initials: MR
authors.lastname: Fischer
authors.affiliation: Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Holzer
mesh_terms: D002321:Career Choice; D006801:Humans; D009426:Netherlands; D011446:Prospective Studies; D012577:Schools, Medical; D013337:Students, Medical; D011795:Surveys and Questionnaires
keywords: admission to medical school; physician shortages; rural work; specialization choice