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Physician Specialty Choice under Uncertainty

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  • Sean Nicholson

    (Wharton School, University of Pennsylvania)

Abstract

Medical students must receive residency training in a specialty before they can practice medicine in the United States. Since the residents' salaries do not adjust across specialties, residency positions are rationed, and medical students face uncertainty when choosing a specialty. Using a data set with the preferred and realized specialties for 7,200 medical students, I estimate a model where students consider entry probabilities when selecting a specialty. I find that medical students are responsive to expected income differences between specialties, which implies that policies that increase the income of primary care physicians can address shortages in these specialties.

Suggested Citation

  • Sean Nicholson, 2002. "Physician Specialty Choice under Uncertainty," Journal of Labor Economics, University of Chicago Press, vol. 20(4), pages 816-847, October.
  • Handle: RePEc:ucp:jlabec:v:20:y:2002:i:4:p:816-847
    DOI: 10.1086/342039
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    References listed on IDEAS

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    1. Rivo, M.L. & Henderson, T.M. & Jackson, D.M., 1995. "State legislative strategies to improve the supply and distribution of generalist physicians, 1985 to 1992," American Journal of Public Health, American Public Health Association, vol. 85(3), pages 405-407.
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    1. Fernandez, Jose, 2006. "Evaluating the Effect of a Policy Change to Hospital Productivity: 80 Hours Work Restriction on Medical Residents," MPRA Paper 8620, University Library of Munich, Germany.
    2. Sivey, Peter & Scott, Anthony & Witt, Julia & Joyce, Catherine & Humphreys, John, 2012. "Junior doctors’ preferences for specialty choice," Journal of Health Economics, Elsevier, vol. 31(6), pages 813-823.
    3. Arcidiacono, Peter & Nicholson, Sean, 2005. "Peer effects in medical school," Journal of Public Economics, Elsevier, vol. 89(2-3), pages 327-350, February.
    4. Alice J. Chen & Elizabeth L. Munnich & Stephen T. Parente & Michael R. Richards, 2022. "Do Physicians Warm Up to Higher Medicare Prices? Evidence from Alaska," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 41(2), pages 394-425, March.
    5. Schweri, Juerg & Hartog, Joop & Wolter, Stefan C., 2011. "Do students expect compensation for wage risk?," Economics of Education Review, Elsevier, vol. 30(2), pages 215-227, April.
    6. Jeffrey E. Harris & Beatriz G. Lopez‐Valcarcel & Patricia Barber & Vicente Ortún, 2017. "Allocation of Residency Training Positions in Spain: Contextual Effects on Specialty Preferences," Health Economics, John Wiley & Sons, Ltd., vol. 26(3), pages 371-386, March.
    7. Robert Gagné & Pierre Thomas Léger, 2005. "Determinants of physicians' decisions to specialize," Health Economics, John Wiley & Sons, Ltd., vol. 14(7), pages 721-735, July.
    8. Attema, Arthur E. & Galizzi, Matteo M. & Groß, Mona & Hennig-Schmidt, Heike & Karay, Yassin & L’Haridon, Olivier & Wiesen, Daniel, 2023. "The formation of physician altruism," Journal of Health Economics, Elsevier, vol. 87(C).
    9. Pedro Ramos & Hélio Alves & Paulo Guimarães & Maria A. Ferreira, 2017. "Junior doctors’ medical specialty and practice location choice: simulating policies to overcome regional inequalities," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(8), pages 1013-1030, November.
    10. Terence Chai Cheng & Anthony Scott & Sung‐Hee Jeon & Guyonne Kalb & John Humphreys & Catherine Joyce, 2012. "What Factors Influence The Earnings Of General Practitioners And Medical Specialists? Evidence From The Medicine In Australia: Balancing Employment And Life Survey," Health Economics, John Wiley & Sons, Ltd., vol. 21(11), pages 1300-1317, November.
    11. Josep Amer-Mestre and Agnès Charpin, 2022. "Gender Differences in Early Occupational Choices: Evidence from Medical Specialty Selection," Economics Working Papers EUI ECO 2022/01, European University Institute.
    12. Pascal Courty & Gerald R. Marschke, 2008. "On the Sorting of Physicians across Medical Occupations," NBER Working Papers 14502, National Bureau of Economic Research, Inc.
    13. Sean Nicholson, 2005. "How Much Do Medical Students Know About Physician Income?," Journal of Human Resources, University of Wisconsin Press, vol. 40(1).
    14. Peter Arcidiacono & Sean Nicholson, 2000. "Peer Effects, Learning, and Physician Specialty Choice," Econometric Society World Congress 2000 Contributed Papers 1553, Econometric Society.
    15. Alice Chen & Anthony T. Lo Sasso & Michael R. Richards, 2018. "Supply‐side effects from public insurance expansions: Evidence from physician labor markets," Health Economics, John Wiley & Sons, Ltd., vol. 27(4), pages 690-708, April.
    16. Heski Bar‐Isaac & Johannes Hörner, 2014. "Specialized Careers," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 23(3), pages 601-627, September.
    17. Lin, Lee-Kai, 2022. "Effects of a global budget payment scheme on medical specialty workforces," Social Science & Medicine, Elsevier, vol. 309(C).
    18. Juerg Schweri, 2021. "Predicting polytomous career choices in healthcare using probabilistic expectations data," Health Economics, John Wiley & Sons, Ltd., vol. 30(3), pages 544-563, March.
    19. Joshua D. Gottlieb & Maria Polyakova & Kevin Rinz & Hugh Shiplett & Victoria Udalova, 2023. "Who Values Human Capitalists' Human Capital? The Earnings and Labor Supply of U.S. Physicians," NBER Working Papers 31469, National Bureau of Economic Research, Inc.
    20. Sean Nicholson & Nicholas S. Souleles, 2001. "Physician Income Expectations and Specialty Choice," NBER Working Papers 8536, National Bureau of Economic Research, Inc.

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