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受阻的道路,不平等的轨迹:按种族、性别和教育地点审视卫生专业毕业生的职业成果。

Blocked paths, unequal trajectories: Examining the career outcomes of health professions graduates by race, gender, and place of education.

作者信息

Schut Rebecca Anna

机构信息

Department of Sociology, Case Western Reserve University, Mather Memorial Building, 11220 Bellflower Road, Cleveland, OH, 44106, USA.

出版信息

Soc Sci Med. 2025 Jan;364:117522. doi: 10.1016/j.socscimed.2024.117522. Epub 2024 Nov 16.

Abstract

Despite the need for more - and more diverse - health professionals to meet the U.S.' growing healthcare needs, qualitative research suggests that many health professions school graduates (HPGs) are tracked away from pursuing a health professions career. To what extent do HPGs' career trajectories vary across race, gender, and place of education (i.e., whether one received their health professions education in the U.S. or abroad)? Drawing on the National Survey of College Graduates, I identify that among 5,966 HPGs (medical, dental, veterinary, optometry, and podiatry school graduates), foreign-educated HPGs are less likely than U.S.-educated HPGs to become health professionals in the U.S. However, not all foreign-educated HPGs experience equal degrees of disadvantage; racially minoritized foreign-educated HPGs - and most strikingly, Asian foreign-educated men and women HPGs - demonstrate the lowest likelihoods of matriculating to a health professions career. Moreover, structural barriers, including initial U.S. visa status, significantly disadvantage foreign-educated HPGs on their path towards becoming practicing health professionals. Together, results suggest that the stunted career trajectories of foreign-educated HPGs might further stall the diversification of the health professions and limit the potential of immigrant HPGs to draw on their unique human capital post-migration. Findings both improve understanding of the contributors to the U.S. health professional shortage and advance sociological knowledge around how the health professions serve as key sites in the reproduction of inequality across axes of race, gender, and place of education.

摘要

尽管需要更多样化的医疗专业人员来满足美国日益增长的医疗需求,但定性研究表明,许多医疗专业院校毕业生(HPGs)被引导远离医疗职业追求。HPGs的职业轨迹在种族、性别和教育地点(即一个人是在美国还是国外接受医疗专业教育)方面的差异程度如何?利用全国大学毕业生调查,我发现,在5966名HPGs(医学、牙科、兽医、验光和足病学专业毕业生)中,在国外接受教育的HPGs在美国成为医疗专业人员的可能性低于在美国接受教育的HPGs。然而,并非所有在国外接受教育的HPGs都经历同等程度的劣势;在种族上被边缘化的国外受教育HPGs——最明显的是,亚洲国外受教育的男性和女性HPGs——进入医疗职业的可能性最低。此外,包括初始美国签证身份在内的结构性障碍,在国外接受教育的HPGs成为执业医疗专业人员的道路上使其处于明显劣势。总之,结果表明,国外受教育的HPGs发育不良的职业轨迹可能会进一步阻碍医疗专业的多样化,并限制移民HPGs在移民后利用其独特人力资本的潜力。这些发现既增进了对美国医疗专业人员短缺原因的理解,也推进了关于医疗专业如何成为种族、性别和教育地点等不平等轴再生产关键场所的社会学知识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56ff/11898113/3b50e75521f2/nihms-2038474-f0001.jpg

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