性別差異在醫學生與醫師人數以及專科別選擇之10年趨勢探討

Gender Difference in the Manpower and Specialty Selection among Medical Students and Physicians: A Ten Year Trend Study from 1998 to 2007

10.6145/jme.201012_14(4).0001

陳韋君(Wei-Chun Chen)；璩大成(Da-Chen Chu)；陳潤秋(Ran-Chou Chen)；張聖原(Sun-Yran Chang)

性別 ； 醫師人數 ； 醫師專科 ； 醫學教育 ； gender ； physician ； specialty ； medical education

Journal of Medical Education

14卷4期（2010 / 12 / 01）

251 - 261

繁體中文

Physician manpower is considered to be an important index when evaluating medical service quality. Furthermore, gender has become an important topic recently. Variations in the gender profile of physicians may influence outcomes in terms of medical services. As a result, concern has focused lately on differences in the distributions of male and female physicians across specialties. We collected data from the Department of Education, Taiwan, and the National Health Insurance Database, Taiwan, in order to examine the male/female distribution of first year medical students, graduated medical students and new physicians over the years 1998 to 2007. Furthermore, we evaluated the distribution of male and female physicians in terms of their first selected specialty. The study was separated into two 5-year periods and this split was used to estimate the differences in specialty selection between the two periods, which were analyzed statistically using a trend-test. In addition, a chi-square test was used to compare the changes in selected specialties between the two periods. The number of the first year medical students, graduated students, and physicians in terms of manpower increased significantly over the decade, and this growth was more apparent for females than for males (p＜0.001). In general, the top three preferred choices in terms of specialty were internal medicine, surgery, and pediatrics for male physicians and pediatrics, internal medicine, and family medicine for female physicians. When specialty preference over the two study periods is considered, emergency medicine, nuclear medicine, and radiology showed significant growth (p＜0.05), while ophthalmology, ENT, and obstetrics/ gynecology showed a significant decline (p＜0.05), when the first five year period was compared with the second five year period. Medical education needs to focus greater effort on gender specific training in the various specialties. Personalized and advanced courses specifically targeting medical students and physicians of different genders should be arranged in order to improve post-graduate physician development and the quality of patient care.

Physician manpower is considered to be an important index when evaluating medical service quality. Furthermore, gender has become an important topic recently. Variations in the gender profile of physicians may influence outcomes in terms of medical services. As a result, concern has focused lately on differences in the distributions of male and female physicians across specialties. We collected data from the Department of Education, Taiwan, and the National Health Insurance Database, Taiwan, in order to examine the male/female distribution of first year medical students, graduated medical students and new physicians over the years 1998 to 2007. Furthermore, we evaluated the distribution of male and female physicians in terms of their first selected specialty. The study was separated into two 5-year periods and this split was used to estimate the differences in specialty selection between the two periods, which were analyzed statistically using a trend-test. In addition, a chi-square test was used to compare the changes in selected specialties between the two periods. The number of the first year medical students, graduated students, and physicians in terms of manpower increased significantly over the decade, and this growth was more apparent for females than for males (p＜0.001). In general, the top three preferred choices in terms of specialty were internal medicine, surgery, and pediatrics for male physicians and pediatrics, internal medicine, and family medicine for female physicians. When specialty preference over the two study periods is considered, emergency medicine, nuclear medicine, and radiology showed significant growth (p＜0.05), while ophthalmology, ENT, and obstetrics/ gynecology showed a significant decline (p＜0.05), when the first five year period was compared with the second five year period. Medical education needs to focus greater effort on gender specific training in the various specialties. Personalized and advanced courses specifically targeting medical students and physicians of different genders should be arranged in order to improve post-graduate physician development and the quality of patient care.

1. Kao, M.Y.、Chen, H.J.、Lue, B.H.(2009)。Medical students' attitudes toward patient-centered care。J Med Ethic，13，275-286。
   連結：
2. Liu, T.C.、Chen, C.S.、Cheng, Y.C.(2004)。Medical specialty choice under National Health Insurance。Journal of Healthcare Management，5，473-494。
   連結：
3. Website of Department of Health, Executive Yuan,Taiwan (R.O.C.). Available at: [http://www.doh.gov.tw/cht2006/index_populace.aspx]
4. Website of Department of Statistics. Available at: [http://www.edu.tw/statistics]
5. Wedsite of Taiwan Medical Association. Available at: [http://www.tma.tw/]
6. Website of Association of American Medical College (AAMC). Available at: [http://www.aamc.org/data/facts/enrollmentgraduate/table31-women-count.htm]
7. Bertakis, K.D.,Franks, P.,Epstein, R.M.(2009).Patient-centered communication in primary care: Physician and patient gender and gender concordance.J. Womens Health (Larchmt),18,539-545.
8. Chan, Wing P.、Hung, S.T.、Chang, C.Y.(2007)。Supply and demand in relation to diagnostic radiologists in Taiwan over the next 10 years。Chinese Journal of Radiology，32，71-80。
9. Frank, E.,Harvey, L.,Elon, L.(2000).Family responsibilities and domestic activities of US women physicians.Arch Fam Med,9,134-140.
10. Frank, E.,Singh, S.R.(2001).Personal and practice-related characteristics of a subsample of US women dermatologists: Data from the women physicians' health study.Int J Dermatol,40,393-400.
11. Garcia-Retamero,Lopez-Zafra, E(2006).Prejudice against women in male-congenial environments: Perceptions of gender role congruity in leadership.Sex Roles,55,51-61.
12. Gjerberg, E.(2001)。Medical women-towards full integration? An analysis of the specialty choices made by two cohorts of Norwegian doctors。Soc Sci Med，52，331-343。
13. Hojat, M.,Gonnella, J.S.,Nasca, T.J.(2002).Physician empathy: Definition, components, measurement, and relationship to gender and specialty.Am J Psychiatry,159,1563-1569.
14. Hung, C.T.、Lan, C.F.、Sung, W.C.(2001)。Analysis of the methodology used for physician manpower studies in Taiwan。Taiwan Journal of Public Health，20，183-191。
15. Kao, M.Y.、Use, B.H.、Lee, M.B.(2000)。Exploring the specialty preference of medical students and related factors。J Med Educ，4，23-37。
16. Koike, S.,Matsumoto, S,Kodama, T.,Ide, H.(2009).Estimation of physician supply by specialty and the distribution impact of increasing female physicians in Japan.BMC Health Serv Res,9,180-189.
17. Kutner, N.G.,Brogan, D.(1990).Gender roles, medical practice roles, and ob-gyn career choice: A longitudinal study.Women Health,16,99-117.
18. Lin, C.Y.(2010)。Gender mainstreaming in the medical field。Taiwan Med J，53，39-41。
19. Lin, F.Y.、Chen, W.J.(2000)。Special topic: Recent advances in emergency medicine-Introduction。Formosan Journal of Medicine，4，134。
20. Lin, Y.Y.(1999)。National Health Insurance on the impact of specialist distribution。Hospital，32，1-16。
21. More, Ellen S.(1990).The American medical women's association and the role of the woman physician, 1915-1990.JAMWA,46,165-180.
22. Ramirez, A.G.,Wildes, K.A.,Napoles-Springer, A.(2009).Physician gender differences in general and cancer-specific prevention attitudes and practices.J Cancer Educ,24,85-93.
23. Richardsen, A.M.、Burke, R.J.(1991)。Occupational stress and job satisfaction among physicians: Sex differences。Soc Sci Med，33，1179-1187。
24. Tsai, Wen-Chen,Kung, Pei-Tseng,Liao, Kai-Ping(2004).The impact of physician supply on the utilization of ambulatory care under the National Health Insurance.Mid-Taiwan Journal of Medicine,9,27-37.
25. Yang, H.F.、Chie, W.C.(1994)。Trends of location and specialty selection of government Sponsored physicians (GSPs)。Chinese Journal of Public Health，13，405-418。
26. Yang, M.J.、Tsai, J.H.(1999)。Specicalty selection and related factors among medical students in southern Taiwan。J Med Educ，3，147-154。

1. (2024).Comparison of Medical Specialty Selection among Physicians Graduating from Postgraduate or Undergraduate Programs in a Medical School in Southern Taiwan.醫學教育,28(1),9-21.