Personal values of male and female doctors: gender aspects

Personal values as early predictors of emotional and cognitive empathy among medical students

The present study contributes to the literature by examining the association between personal values (PVs), assessed with the Schwartz’s Portrait Values Questionnaire, and empathy, assessed with the Davis’ Interpersonal Reactivity Index, in a sample of first-year medical students. We also examined medical students’ PVs profile and gender differences in terms of PVs. All participants (N = 398) were Italian, young (average age = 19.62 years, SD = 1.22), and unmarried; none had children. Zero-order correlations and hierarchical multiple regression models were performed to verify the association between PVs and empathy; in contrast, t-tests were run to explore gender differences in scoring on PVs. Benevolence and Universalism correlated positively with both the emotional and cognitive dimensions of empathy, whereas Power, Achievement, Hedonism, and Security were negatively associated with empathy. The three most important PVs in the whole sample were Benevolence, Self-Direction, and Universalism. Male medical students outscored their female counterparts on Power, Achievement, and Hedonism, whereas female students outscored the males on Benevolence, Universalism, Conformity, and Tradition. Our findings highlight the importance of fostering self-transcending PVs and discouraging self-enhancing PVs in medical students during the early years of medical school, as a means of supporting other-oriented responses such as empathy in future doctors.

Women Physicians: Gender and the Medical Workplace

Background: Understanding the work habits, attitudes, and experiences of women physicians is critical for optimal patient care. In a gendered work environment, obstacles faced hinder women physicians from contributing to their full ability. This study investigated how women physicians' work habits are viewed, in the context of women's attitudes and experiences. Methods: An analysis of the medical literature (1990-2017) was undertaken. Published studies were located using search engines, article references, consultation with experts, and relevant Mesh terms. Of 1185 listings, 354 studies were evaluated and 44 articles, selected by three reviewers, were analyzed in detail. Results: Four themes emerged-practice styles, productivity, prevailing attitudes, and the workplace environment. Comparing women physicians to male colleagues as a standard for evaluating performance, for example, undervalues distinctive characteristics women bring to medical practice. Productivity models that focus on work hours, procedures, and publications do not encompass the full scope of patient care. Conclusions: Solutions offered mainly have been designed to help women physicians fit into existing workplace environments, but traditionally available "adapt or exit" options in response to challenges faced appear insufficient. A gender equity perspective helps to explain findings and suggests ways to reshape the health care workplace to better understand, utilize, and retain women physicians.

Factors important in the choice of a medical career: a Finnish national study

BACKGROUND

Applying for medical school is the first and also one of the most important career choices a physician makes. It is important to understand the reasons behind this decision if we are to choose the best applicants for medical schools and enable them to pursue satisfying careers.

METHODS

Respondents to the Finnish Junior Physician 88, Physician 1998 and Physician 2008 studies were asked: "To what extent did the following factors influence your decision to apply for medical school?" In 1998 and 2008 the respondents were also asked: "If you were starting your studies now, would you start studying medicine?" and had to answer "Yes" or "No". The odds ratios for the answer "No" were tested using logistic regression models.

RESULTS

"Interest in people" was the main motive for starting to study medicine. "Good salary" and "Prestigious profession" were more important motives for males and "Vocation" and "Interest in people" for females. There were some significant changes in the motives for entering medicine in the 20-year period between studies. "Vocation" and "Wide range of professional opportunities" as important motives for entering medicine predicted satisfaction with the medical profession.

DISCUSSION

Strong inner motivation may indicate the ability to adapt to the demands of work as a physician.

CONCLUSIONS

Medical schools should try to select those applicants with the greatest vocational inclination towards a medical career.

Gender differences in the learning and teaching of surgery: a literature review

OBJECTIVE

To explore evidence concerning gender differences in teaching and learning in surgery to guide future initiatives.

METHODS

This systematic review was conducted searching in the following electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Web of Science, Scopus and PubMed. All studies related to gender differences in surgical education, teaching or learning of surgery at an undergraduate level were included. Data was extracted and critically appraised. Gender differences in learning, teaching, skills acquisition, perceptions and attitudes, interest on surgery, personality and factors influencing interest in surgical careers were differentiated.

RESULTS

There is an underrepresentation of women in surgical academia, due to lack of role models and gender awareness. It is not clear whether or not gender itself is a factor that affects the learning of surgical tasks. Female students pursuing a surgical career had experienced sexual harassment and gender discrimination that can have an effect on the professional identity formation and specialty choice. There are differences in personality among female and male students interested in surgery. Gender is a determining factor to choose surgery, with a consistent lower proportion of women compared interested in pursuing a surgical career. Mentoring and personality fit are important in medical student's specialty selection. Female students are more likely to be discouraged from pursuing a surgical career by a lack of female role models.

CONCLUSIONS

Bias against women in surgery still exists. There is a lack of studies that investigate the role of women in the teaching of surgery.

How do doctors choose where they want to work? - motives for choice of current workplace among physicians registered in Finland 1977-2006

Though there are a number of studies investigating the career choices of physicians, there are only few concerning doctors' choices of workplace. A random sample (N=7758) of physicians licensed in Finland during the years 1977-2006 was surveyed. Respondents were asked: "To what extent did the following motives affect your choice of your current workplace?" Respondents were grouped based on several background variables. The groups were used as independent variables in univariate analysis of covariance (ANCOVA). The factors Good workplace, Career and professional development, Non-work related issues, Personal contacts and Salary were formed and used as dependent variables. There were significant differences between groups of physicians, especially in terms of gender, working sector and specialties. The association of Good workplace, Career and professional development, and Non-work related issues with the choice of a workplace significantly decreased with age. Female physicians were more concerned with Career and professional development and Non-work related issues. Since more females are entering the medical profession and there is an ongoing change of generations, health care organizations and policy makers need to develop a new philosophy in order to attract physicians. This will need to include more human-centric management and leadership, better possibilities for continuous professional development, and more personalized working arrangements depending on physician's personal motives.

Value priorities and their relations with quality of life in the Baby Boomer generation of Lithuanian nurses: a cross-sectional survey

BACKGROUND

The understanding of the values of nurses is especially important, since nurses constitute 80% of workforce in the healthcare system in Lithuania. In addition to that, nursing is one of the major constituents of healthcare. The aim of this study was to determine what values predominate in the cohort of Baby Boomer nurses, and to evaluate the relation of these values with quality of life using M. Rokeach's terminal and instrumental values scale. M.Rokeach distinguished terminal values (such as world peace, wisdom, and happiness), which are preferred end-states of existence, and instrumental values (such as responsibility and cooperation), which are preferred modes of conduct.

METHODS

We performed a representative anonymous questionnaire-based inquiry of nurses working in regional hospitals of Lithuania. The nurses who participated in the study were distributed into four work cohorts: the Veterans, the Baby Boomers, the Generation Xers, and the Generation Nexters. The majority of the nurses belonged to the Baby Boomers and the Generation Xers cohorts. Since in Lithuania, like in the whole Europe, the representatives of the Baby Boomers generation are predominating among working people, we selected this cohort (N = 387) for the analysis. The survey data was processed using the SPSS statistical software package

RESULTS

The main values in life were family security, tranquility, and a sense of accomplishment. However, such values as true friendship, equality, and pleasurable and leisured life were seen as rather insignificant. The most important instrumental values were honesty, skillfulness, and responsibility. Our study showed a statistically significant (albeit weak) correlation between the QOL and terminal values such as the sense of accomplishment, tranquility, equality, and pleasure, as well as the instrumental value - obedience. We detected a statistically significant relationship between good QOL and satisfaction with oneself, relationships with the surrounding people, and friends' support.

CONCLUSION

The findings of our study showed that, although Lithuania was under a totalitarian regime for 50 years, both the terminal and the instrumental values of the Baby Boomers generation are very similar to those of the same generation in other countries.

Job satisfaction, work ability and life satisfaction among Finnish anaesthesiologists

BACKGROUND

Organizational changes and relative growth of the ageing population together with related health problems seem to have increased stressfulness in the work of anaesthesiologists. However, little is known about their work-related well-being and the factors through which their situation could be improved.

METHODS

A cross-sectional questionnaire study of the level and the determinants of job satisfaction, work ability and life satisfaction among female and male anaesthesiologists involved 258 Finnish anaesthesiologists working full time (53% men).

RESULTS

The respondents had fairly high job satisfaction, work ability and life satisfaction. No gender differences appeared in these well-being indicators, but their determinants differed by gender. Job satisfaction was only associated with work-related factors in both genders: with job control in women and with job control and organizational justice in men. Work ability correlated with job control and health in both genders and with family life in women. Life satisfaction correlated with individual- and family related factors such as social support and family problems in both genders. Life satisfaction correlated with physical workload in men and health in women. Women had less job control, fewer permanent job contracts and more domestic workload than men.

CONCLUSIONS

Job control and organizational justice were the most important determinants in work-related well-being. Work-related factors were slightly more important correlates of well-being in males, and family life seems to play a larger role in the well-being of female anaesthesiologists. Organizational and gender issues need to be addressed in order to maintain a high level of well-being among anaesthesiologists.

Women in medicine--is there a problem? A literature review of the changing gender composition, structures and occupational cultures in medicine

BACKGROUND

Internationally, there are increasing numbers of women entering medicine. Although all countries have different health care systems and social contexts, all still show horizontal (women concentrated in certain areas of work) and vertical (women under represented at higher levels of the professions) segregation. There is much discussion and competing explanations about the implications of the increasing numbers of women in the medical profession.

AIMS

The purpose of this review was to explore the evidence, issues and explanations to understand the effects of the changing composition of the medical profession.

CONCLUSIONS

This review identified evidence that delineates some of the effects of gender on the culture, practice and organisation of medicine. There are problems with some of the research methodologies and we identify areas for further research. To understand the effects of the changing gender composition of medicine it will be necessary to use more sophisticated research designs to explore the structural, economic, historical and social contexts that interact to produce medical culture. This will provide a basis for exploring the impact and implications of these changes and has immediate relevance for workforce planning and understanding both the changing nature of health professions' education and health care delivery.

The generation and gender shifts in medicine: an exploratory survey of internal medicine physicians

Background

Two striking demographic shifts evident in today's workforce are also apparent in the medical profession. One is the entry of a new generation of physicians, Gen Xers, and the other is the influx of women. Both shifts are argued to have significant implications for recruitment and retention because of assumptions regarding the younger generation's and women's attitudes towards work and patient care. This paper explores two questions regarding the generations: (1) How do Baby Boomer and Generation X physicians perceive the generation shift in work attitudes and behaviours? and (2) Do Baby Boomer and Generation X physicians differ significantly in their work hours and work attitudes regarding patient care and life balance? Gen Xers include those born between 1965 and 1980; Baby Boomers are those born between 1945 and 1964. We also ask: Do female and male Generation X physicians differ significantly in their work hours and work attitudes regarding patient care and life balance?

Methods

We conducted exploratory interviews with 54 physicians and residents from the Department of Medicine (response rate 91%) and asked about their perceptions regarding the generation and gender shifts in medicine. We limit the analyses to interview responses of 34 Baby Boomers and 18 Generation Xers. We also sent questionnaires to Department members (response rate 66%), and this analysis is limited to 87 Baby Boomers' and 65 Generation Xers' responses.

Results

The qualitative interview data suggest significant generation and gender shifts in physicians' attitudes. Baby Boomers generally view Gen Xer physicians as less committed to their medical careers. The quantitative questionnaire data suggest that there are few significant differences in the generations' and genders' reports of work-life balance, work hours and attitudes towards patient care.

Conclusion

A combined qualitative and quantitative approach to the generation shift and gender shift in medicine is helpful in revealing that the widely held assumptions are not necessarily reflective of any significant differences in actual work attitudes or behaviours of Boomer and Gen X physicians or of the younger generation of women entering medicine.

Factors associated with physicians' choice of working sector: a national longitudinal survey in Finland

OBJECTIVE

To analyse factors affecting physicians' choice to work in either the public or the private sector.

METHOD

We undertook a longitudinal data analysis in the years 1988, 1993, 1998 and 2003 (n = 12 909) using a multilevel modelling technique. Factors related to economic factors, physician identity, appreciation as well as demographic factors were hypothesised to influence sector choice.

RESULTS

Physicians seem to make their career choices prior to graduation, at least to some extent. Wage levels, the physician's personal characteristics and whether or not the physician knew his or her place of work before graduation were the key factors affecting the decision-making process in the years 1988, 1993, 1998 and 2003. Physicians for whom wages were important were less likely to choose the public sector. Also, physicians who regarded themselves as entrepreneurial preferred to work in the private sector. If a physician had worked in the public sector during his or her medical training before graduation, the probability of applying for a vacancy in the public sector was higher.

CONCLUSION

It is not only economic factors, such as salary, that are involved in the physician's decision to choose the working sector.

Factors Associated with the Nature, Timing and Stability of the Specialty Career Choices of Recently Graduated Doctors in European Countries, a Literature Review

The aim of this study was to identify factors that are associated with the choice of a spe-cialty, the moment of the definitive choice, and the stability of the choice over time. The focus was on recently graduated doctors in European countries. A review of the literature from October 1994 to October 2004 was conducted. Most of the identified studies were of good quality. Enthusiasm, self-appraisal of skills, human interest and domestic circumstances were the main factors associated with the choice for medical specialization. Female doctors paid a great deal of attention to reasonable working hours and part-time jobs. They were also less certain about their career choice, and made this choice later than men. Most doctors with a preference for general practice at the time of qualification as a medical doctor achieved their aim. Women, who preferred a clinical specialization, had less opportunity than men to achieve their career satisfactorily.

Why don’t female medical students choose diagnostic radiology? A review of the current literature

While the number of women entering medical schools is approaching 50% nationally, women continue to be underrepresented in a number of specialties including diagnostic radiology. While diagnostic radiology has many characteristics that might be desirable to women, such as reasonable call hours, flexible scheduling, and high salaries, women still do not choose diagnostic radiology as a career. This article examines the literature to discern possible reasons for why women are entering diagnostic radiology at a lower rate. We address trends among women in academic medicine, which resemble trends among women in diagnostic radiology, and examine the effects of gender and socialization in medical school on specialty choices among women. The current literature suggests a constellation of factors may be responsible for the gender differences in diagnostic radiology. We suggest that further research is needed to elucidate why women do not seem to be choosing diagnostic radiology as frequently as one might predict based on the lifestyle of diagnostic radiologists and the numbers of women currently entering medical school. Once these reasons are made clear, it will be possible for residency program directors and medical schools to ensure that women are making informed specialty choices, whatever those choices may be.

To resuscitate or not: a dilemma in terminal cancer care

One of the difficult dilemmas in terminal care is the decision on whether to start or withhold cardiopulmonary resuscitation (CPR). Is this decision made on purely medical grounds, or is it also influenced by the physician's personal characteristics or education? The aim of this study was to look at factors affecting this decision. A questionnaire was sent out to a stratified sample of 1180 Finnish doctors. The response rate was 62%. The physicians were asked whether they would (a) start CPR or (b) withhold CPR in a scenario describing the unexpected death of a young terminal cancer patient. Data were also collected on demographics, post-graduate training, experience of terminal care, general life values and attitudes, and experiences of severe illness in the family. The proportion of surgeons, internists, GPs and oncologists who said they would have started CPR was 16, 10, 19 and 14%, respectively. Among physicians aged under 35 years, from 35 to 49 years and over 49 years, the proportions of physicians choosing active CPR were 29, 14 and 13%, respectively (P<0.001). As for those with personal experience of terminal care, 13% indicated they would have started CPR compared with 23% of those who had no experience (P<0.01). Those who made a decision in favour of CPR showed a significantly (P<0.001) more negative attitude to withdrawing life-sustaining treatment and valued length of life to a much greater extent (P<0.01).