- Swiss residents' speciality choices – impact of gender, personality traits, career motivation and life goals
Study design, sample development, and study sample
The present study is part of an ongoing prospective survey of a cohort of graduates of the three medical schools in German speaking Switzerland, beginning in 2001 (T1). Of the 1004 registered final-year students, 715 (71%) participated in the first assessment (T1, in 2001) . Subjects were re-evaluated after two years in 2003 (T2) [18,19]. The present paper refers to results of the third assessment (T3), conducted in the fourth year of residency (in 2005). Table 1 shows the sample development from T0 (questionnaires sent to all registered graduates at the medical schools of Basel, Bern, and Zurich) to T1, T2, and T3 for participants, non-participants and dropouts. There are no significant differences between the 193 dropouts (T1 – T3) and the 522 subjects participating at the third measurement with regard to socio-demographic data, personality traits, and career-related variables at T1.
Table 1. Development of the study sample
Of these 522 residents there were 281 females (53.8%) and 241 males (46.2%). The mean age was 31.3 years (SD 2.4 y, range 27 – 46 y). Of the residents 428 (82.0%) had a stable partnership, of whom 125 were married (65 females and 60 males). Only 26 (9.3%) of the females, but 36 (14.9%) of the males had own children (p = 0.03). 94.7% worked full-time, 5.3% part-time. The mean working hours per week were 55.4 hrs (SD 8.2 hrs, range 30 – 80 hrs).
Speciality training and residencies in Switzerland
There are 43 registered speciality qualifications in Switzerland. Most of the specialities require at least a six-year residency, and a final speciality qualification exam. One major problem with most of the speciality training courses is the lack of structured and time-limited residency programmes. Young doctors usually only get contracts for a year, i.e. they have to arrange and organize their residency posts every one to two years.
The main characteristics of the applied instruments are given in Table 2. All instruments are self-assessment scales. In the following, it is described what constructs are measured by the instruments:
Table 2. Characteristics of the applied instruments
• Questions concerning socio-demographic data and choice of medical speciality
• Sense of Coherence Scale, SOC-13 , is a measure of a person's resistance to stress and his/her ability to manage stress (measure of traits, stability in this study T1 – T3: 0.56).
• Rosenberg-Self-Esteem-Scale, RSE , assesses general self-esteem and includes items that express a general favourable or unfavourable attitude towards oneself (measure of traits).
• Personal Attributes Questionnaire, GE-PAQ, German Extended Personal Attributes Questionnaire , is a self-rating instrument for the assessment of gender-role orientation (measure of traits). The Instrumentality (PAQ-I) scale contains instrumental traits (e.g. 'independent', 'decisive') that are considered to be socially desirable to some degree in both sexes but stereotypically more characteristic of males. The Expressiveness (PAQ-E) scale contains so-called 'feminine' items that describe socially desirable expressive, communal traits (e.g. 'helpful') that are stereotypically more characteristic of females.
• Career Motivation Questionnaire, CMQ , consists of 3 scales (measure of traits): Intrinsic Career Motivation CMQ-I (i.e. enjoyment of and interest in professional activities) (stability in this study T1 – T3: 0.57), Extrinsic Career Motivation CMQ-E (i.e. striving for promotion, income, prestige) (stability 0.58) and Extraprofessional Concerns CMQ-EC (i.e. prioritising family, convenient working hours, job security) (stability 0.60).
• Life Goals Questionnaire, GOALS , assesses 24 general, long-term life goals pertaining to six major life domains (measure of traits): intimacy (close relationships based on mutual trust and affection), affiliation (spending time with other people, common activities), altruism (acting for the welfare of others), power (asserting oneself, seeking social status), achievement (improving on oneself, meeting standards), and variation (seeking new experiences and excitement). Each goal is rated in regard to the importance (How important is it for you to reach this goal in your lifetime?). Importance ratings indicate which goals are desirable and valuable for the person and indicate the strength of his/her commitment to a goal.
All analyses were carried out with SPSS for windows, release 12.0. Descriptive statistics were given in terms of counts and percentages, means and standard deviations respectively. Gender-different speciality choice was tested by Chi2-test. Study hypotheses were tested by univariate analyses of variance, followed by Scheffé-tests, and multivariate analyses of variance and covariance.
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