Social Origin, Professional Socialization, and Labor Market Dynamics: the Determinants of Career Preferences Among Medical Interns in Mexico.

This dissertation examines preferences for types of medical activity, site, and institution as a function of five independent variables: social origin, medical school, place of internship, assimilation to the internship hospital, and perception of the medical labor market. The data for the analysis came from a survey of 923 Mexican interns that was conducted during 1978. In the context of a medical care system where salaried employment of physicians in governmental organizations predominates, the appearance in recent years of medical unemployment in Mexico made labor market issues particularly salient. Thus, the study offered an appropriate occasion to test the relative strengths of economic versus sociological theories of career choice. The great majority of the interns expressed a preference for specialty practice, hospitals, and the social security sector of the medical care system. Further, extensive analysis of bivariate tables and of a multiple regression model revealed that the role of social origin was to selectively direct students into different medical schools. From then on, the structural attributes of the school itself and of the place of internship, as well as the socialization experiences that took place there, emerged as the most important factors in the determination of career preferences. This process, however, tended to produce a "social specialization" of interns in terms of their preferred future careers. With regard to perception of the medical labor market, the analysis consistently revealed a differential impact whereby the effect of such perception on preference was most marked for the alternative career options represented by general practice, ambulatory sites, and private or public assistance institutions. This result suggested that the minority of interns who preferred these alternatives did so largely because they were aware of the difficulties of finding jobs in the dominant options. The dissertation concludes with a discussion of the implications of the findings for the further underst and ing of career preferences, for applied aspects of health manpower policy, for conceptions of rational choice, and for the development of innovative views about the process of professionalization. In this last respect, the present study is placed in the context of a broader strategy of cross-national comparative research into the social organization of professional work.PhDPublic policyPublic healthUniversity of Michiganhttp://deepblue.lib.umich.edu/bitstream/2027.42/159677/1/8328999.pd