Does Salary Affect the Choice of Residency in Non-university Teaching Hospitals? A Panel Analysis of Japan Residency Matching Programme Data

Overview

Journal Hum Resour Health

Publisher Biomed Central

Specialty Health Services

Date 2013 Mar 19

PMID 23496935

Citations 7

Authors

Taiji Enari

Hideki Hashimoto

Affiliations

Soon will be listed here.

Abstract

Background: Previous studies have investigated factors that are influential on the choice of training hospitals among residency physicians, but the effect of salary was not conclusive. In this study, we aimed to examine whether a higher salary attracted more residents to non-university hospitals participating in the Japanese Residency Matching Programme.

Methods: Data on 475 hospitals/programmes between 2006 and 2009 were available for analysis. We first conducted an ordinary least squares regression analysis on the ratio of the number of applicants to the residency programme quota as an index of resident's choice, for comparison with previous studies. We further performed panel data analysis to better control for unobserved heterogeneity across hospitals, which could be confounded by the amount of salary. We also performed stratified analysis by the population size of the hospital location.

Results: In ordinary least squares regression, salary showed a positive, but not significant association, with the ratio of the number of applicants to the programme quota, while the results of a fixed effect model exhibited a positive and significant effect of salary (ε= 0.4995, P = 0.015) on the ratio. Analysis stratified by city size showed that the elasticity of salary was comparable (ε= 1.9089, P = 0.016 in large cities versus ε= 1.9185, P = 0.008 in small cities), while that of the number of teaching physicians was larger in large cities (ε= 1.9857, P = 0.009) compared with that in small cities (ε= 1.6253, P = 0.033). The number of teaching physicians had a significant and negative effect modification on salary, implying an antagonistic effect between these two attributes (ε= -1.5223, P = 0.038).

Conclusions: Our results indicate that the amount of salary influences the choice of training hospitals among medical graduates who choose non-university settings. Use of a monetary reward in a residency programme could be a feasible tactic for hospitals to attract residents.

Citing Articles

Characteristics of University Hospitals Implementing the Postgraduate Clinical Training "Tasukigake Method" and Their Correlation with Program Popularity: A Cross-Sectional Study.

Watanabe S, Kataoka K, Sekine M, Aune D, Shikino K, Nishizaki Y Adv Med Educ Pract. 2023; 14:323-332.

PMID: 37026061 PMC: 10072141. DOI: 10.2147/AMEP.S402259.

Annual educational expenses of European urology residents and the role of sponsorship in urology training: a survey-based analysis.

Pereira-Lourenco M, Ucar T, Nikles S, Pang K, Almeida J, Carrion D Cent European J Urol. 2023; 75(4):418-428.

PMID: 36794035 PMC: 9903171. DOI: 10.5173/ceju.2022.173.

Willingness to Select Initial Clinical Training Hospitals Among Medical Students at a Rural University in Japan: A Single-Center Cross-Sectional Study.

Yamashita S, Tago M, Tokushima M, Emura S, Yamashita S Adv Med Educ Pract. 2022; 13:1081-1089.

PMID: 36157378 PMC: 9507290. DOI: 10.2147/AMEP.S374852.

Hospital characteristics preferred by medical students for their residency programs: A nationwide matching data analysis.

Nishizaki Y, Ueda R, Shinozaki T, Tokuda Y J Gen Fam Med. 2020; 21(6):242-247.

PMID: 33304718 PMC: 7689235. DOI: 10.1002/jgf2.370.

Forecasting the regional distribution and sufficiency of physicians in Japan with a coupled system dynamics-geographic information system model.

Ishikawa T, Fujiwara K, Ohba H, Suzuki T, Ogasawara K Hum Resour Health. 2017; 15(1):64.

PMID: 28899406 PMC: 5596465. DOI: 10.1186/s12960-017-0238-8.

References

Thornton J, Esposto F . How important are economic factors in choice of medical specialty?. Health Econ. 2002; 12(1):67-73. DOI: 10.1002/hec.682. View

Rivo M, Kindig D . A report card on the physician work force in the United States. N Engl J Med. 1996; 334(14):892-6. DOI: 10.1056/NEJM199604043341405. View

Rosenthal M, Zaslavsky A, Newhouse J . The geographic distribution of physicians revisited. Health Serv Res. 2005; 40(6 Pt 1):1931-52. PMC: 1361233. DOI: 10.1111/j.1475-6773.2005.00440.x. View

Sempowski I . Effectiveness of financial incentives in exchange for rural and underserviced area return-of-service commitments: systematic review of the literature. Can J Rural Med. 2004; 9(2):82-8. View

Chopra M, Munro S, Lavis J, Vist G, Bennett S . Effects of policy options for human resources for health: an analysis of systematic reviews. Lancet. 2008; 371(9613):668-674. DOI: 10.1016/S0140-6736(08)60305-0. View

Nomura K, Yano E, Fukui T . Gender differences in clinical confidence: a nationwide survey of resident physicians in Japan. Acad Med. 2010; 85(4):647-53. DOI: 10.1097/ACM.0b013e3181d2a796. View

Newton D, Grayson M, Whitley T . What predicts medical student career choice?. J Gen Intern Med. 1998; 13(3):200-3. PMC: 1496924. DOI: 10.1046/j.1525-1497.1998.00057.x. View

Schwartz M, Linzer M, BABBOTT D, Divine G, Broadhead E . Medical student interest in internal medicine. Initial report of the Society of General Internal Medicine Interest Group Survey on Factors Influencing Career Choice in Internal Medicine. Ann Intern Med. 1991; 114(1):6-15. DOI: 10.7326/0003-4819-114-1-6. View

Kozu T . Medical education in Japan. Acad Med. 2006; 81(12):1069-75. DOI: 10.1097/01.ACM.0000246682.45610.dd. View

10.

Hann M, Gravelle H . The maldistribution of general practitioners in England and Wales: 1974-2003. Br J Gen Pract. 2004; 54(509):894-8. PMC: 1326105. View

11.

Tanihara S, Kobayashi Y, Une H, Kawachi I . Urbanization and physician maldistribution: a longitudinal study in Japan. BMC Health Serv Res. 2011; 11:260. PMC: 3204230. DOI: 10.1186/1472-6963-11-260. View

12.

Russo G, Ferrinho P, de Sousa B, Conceicao C . What influences national and foreign physicians' geographic distribution? An analysis of medical doctors' residence location in Portugal. Hum Resour Health. 2012; 10:12. PMC: 3549747. DOI: 10.1186/1478-4491-10-12. View

13.

Adler R, Korsch B, Negrete V . Timing and motivation in pediatric career choices. J Med Educ. 1985; 60(3):174-80. DOI: 10.1097/00001888-198503000-00003. View

14.

Koike S, Yasunaga H, Matsumoto S, Ide H, Kodama T, Imamura T . A future estimate of physician distribution in hospitals and clinics in Japan. Health Policy. 2009; 92(2-3):244-9. DOI: 10.1016/j.healthpol.2009.04.005. View

15.

McMurray J, Schwartz M, Genero N, Linzer M . The attractiveness of internal medicine: a qualitative analysis of the experiences of female and male medical students. Society of General Internal Medicine Task Force on Career Choice in Internal Medicine. Ann Intern Med. 1993; 119(8):812-8. DOI: 10.7326/0003-4819-119-8-199310150-00007. View

16.

Davenport D, Henderson W, Hogan S, Mentzer Jr R, Zwischenberger J . Surgery resident working conditions and job satisfaction. Surgery. 2008; 144(2):332-338.e5. DOI: 10.1016/j.surg.2008.03.038. View

17.

Lehmann U, Dieleman M, Martineau T . Staffing remote rural areas in middle- and low-income countries: a literature review of attraction and retention. BMC Health Serv Res. 2008; 8:19. PMC: 2259330. DOI: 10.1186/1472-6963-8-19. View

18.

Newton D, Grayson M, Thompson L . The variable influence of lifestyle and income on medical students' career specialty choices: data from two U.S. medical schools, 1998-2004. Acad Med. 2005; 80(9):809-14. DOI: 10.1097/00001888-200509000-00005. View

19.

Nomura K, Yano E, Aoki M, Kawaminami K, Endo H, Fukui T . Improvement of residents' clinical competency after the introduction of new postgraduate medical education program in Japan. Med Teach. 2008; 30(6):e161-9. DOI: 10.1080/01421590802047307. View

20.

Girasek E, Eke E, Szocska M . Analysis of a survey on young doctors' willingness to work in rural Hungary. Hum Resour Health. 2010; 8:13. PMC: 2887778. DOI: 10.1186/1478-4491-8-13. View