Weeks William B, Wallace Tanner A
White River Junction VA Medical Center, White River Junction, VT, USA.
J Health Care Finance. 2008 Spring;34(3):34-44.
We wanted to determine whether the type of medical school attended--private US, public US, or foreign medical school--is associated with practice characteristics or incomes of physicians. Therefore, we used survey responses obtained during the 1990s from 10,436 actively practicing white male physicians who worked in one of 13 medical specialties and who graduated from a public US (5,702), private US (3,797), or international (937) medical school. We used linear regression modeling to determine the association between type of medical school attended and physicians' annual incomes after controlling for specialty, work hours, provider characteristics, and practice characteristics. We found that, for most specialties, international medical school graduates worked longer hours, were less likely to be board certified, had practiced medicine for fewer years, and were less likely to work in rural settings than US medical school graduates. After controlling for key variables, international medical school graduates' annual incomes were 2.6 percent higher (95% CI: 0.1%, 4.4%, p = .043) and public US medical school graduates' were 2.2 percent higher (95% CI: -0.9% -6.1%, p = 0.2) than private US medical school graduates' incomes. Because of their lower tuition expenses, international and public US medical school graduates may experience higher returns on educational investment than their counterparts who graduated from private US medical schools.
我们想要确定就读的医学院类型(美国私立医学院、美国公立医学院或外国医学院)是否与医生的执业特点或收入相关。因此,我们使用了20世纪90年代从10436名积极执业的白人男性医生那里获得的调查回复,这些医生从事13个医学专业之一,毕业于美国公立医学院(5702人)、美国私立医学院(3797人)或国际医学院(937人)。我们使用线性回归模型来确定在控制专业、工作时长、提供者特征和执业特征后,就读的医学院类型与医生年收入之间的关联。我们发现,对于大多数专业来说,国际医学院的毕业生工作时长更长,获得委员会认证的可能性更小,行医年限更少,并且与美国医学院的毕业生相比,在农村地区工作的可能性更小。在控制关键变量后,国际医学院毕业生的年收入比美国私立医学院毕业生的年收入高2.6%(95%置信区间:0.1%,4.4%,p = 0.043),美国公立医学院毕业生的年收入比美国私立医学院毕业生的年收入高2.2%(95%置信区间:-0.9%,6.1%,p = 0.2)。由于国际医学院和美国公立医学院毕业生的学费较低,他们可能比毕业于美国私立医学院的同行获得更高的教育投资回报率。