Kesternich Iris, Schumacher Heiner, Winter Joachim, Fischer Martin R, Holzer Matthias
University of Leuven, Department of Economics, Leuven, Belgium.
University of Munich, Volkswirtschaftliche Fakultät, Seminar für Empirische Wirtschaftsforschung, Munich, Germany.
GMS J Med Educ. 2017 Feb 15;34(1):Doc5. doi: 10.3205/zma001082. eCollection 2017.
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 (); whether their parents worked as medical doctors; and whether they have some practical experience in the medical sector. 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 (), and First National Boards Examination grade (). In 2014, we additionally asked for waiting periods () as well as for prior professional experience in the health-care sector. 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. 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.
解决乡村医生短缺问题的一个潜在新途径是改变医学院的招生规则。因此，我们研究了高中平均绩点与未来医生选择在农村地区工作之间的联系。为了进一步为有关招生规则的讨论提供信息，我们还研究了其他预测因素的影响：学生对风险的态度指标；他们是否等待过就读学校的录取（）；他们的父母是否是医生；以及他们是否有医疗领域的实践经验。我们在2012年和2014年进行了两次网络调查。第一次调查的样本包括701名学生，第二次调查有474名学生。在两次调查中，我们都询问了学生的地区偏好；在2014年的调查中，我们还额外询问了学生在一系列全面的专业领域中，包括成为全科医生，他们的第一、第二和第三偏好。在两次调查中，我们都询问了学生的基本人口统计信息（年龄和性别）、他们父母的职业、主观收入期望指标、风险态度指标、他们的高中平均绩点（）以及第一次国家委员会考试成绩（）。在2014年，我们还额外询问了等待时间（）以及医疗保健领域的先前专业经验。我们发现，在其他所有影响因素保持不变的情况下，有三个因素会显著增加选择在农村地区工作的可能性：父母中有医生、高中平均绩点较差以及更厌恶风险。此外，我们发现那些愿意在农村工作的学生在进入医学院之前在医疗领域的经验明显更多。我们的结果表明，医学院招生过程的改变可能会增加乡村医生的供应。大学不必只关注高中平均绩点，甚至可以通过面试或考虑学生的背景、课外活动或等待时间等方式，更严格地筛选学习动机。
