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Social dominance theory and medical specialty choice

Abstract

Understanding how medical students select their specialty is a fundamental issue for public health and educational policy makers. One of the factors that students take into account is a specialty’s prestige which hinges partly on its focus on technique rather than whole person. We examine the potential of a psychological framework, social dominance theory, to explain why some students, and not others, are drawn to more prestigious, technique-oriented specialties, based on their desire for hierarchy. We conducted a cross-sectional study among medical students at Institution X (N = 359). We examined the link between medical students’ characteristics i.e. social dominance orientation (SDO), gender, age, and their career intention. We also examined level of medical students’ SDO at different stages of the curriculum. SDO scores were significantly associated with technique-oriented career intentions (OR 1.56; 95 % CI [1.18, 2.06]; p = 0.001). The effect was independent of gender. Medical students’ SDO scores were significantly higher in later stages of the medical curriculum (F = 6.79; p = 0. 001). SDO is a significant predictor of medical students’ career intention. SDO scores are higher in students during the clinical phase of the curriculum. Medical socialization, involving the internalization of implicit and explicit norms, particularly in hospital settings, is likely to underpin our findings. This theory illuminates consistent findings in the literature on specialty prestige and the influence of medical school on career choice.

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Acknowledgments

The first author wishes to thank Vincent Lorant and Stephanie Demoulin for their support and guidance in the study.

Conflict of interest

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Correspondence to Brice Lepièce.

Appendix

Appendix

The 16 item Social Dominance Orientation Scale (Pratto et al. 1994; Appendix C).

  1. 1.

    Some groups of people are simply inferior to other groups.

  2. 2.

    Group equality should be our ideal (R).

  3. 3.

    In getting what you want, it is sometimes necessary to use force against other groups.

  4. 4.

    We should do what we can to equalize conditions for different groups (R).

  5. 5.

    It’s OK if some groups have more of a chance in life than others.

  6. 6.

    Increased social equality is beneficial to society (R).

  7. 7.

    To get ahead in life, it is sometimes necessary to step on other groups.

  8. 8.

    We would have fewer problems if we treated people more equally (R).

  9. 9.

    If certain groups stayed in their place, we would have fewer problems.

  10. 10.

    No group should dominate in society (R).

  11. 11.

    It would be good if groups could be equal (R).

  12. 12.

    All groups should be given an equal chance in life (R).

  13. 13.

    It’s probably a good thing that certain groups are at the top and other groups are at the bottom.

  14. 14.

    Inferior groups should stay in their place.

  15. 15.

    We should strive to make incomes as equal as possible (R).

  16. 16.

    Sometimes other groups must be kept in their place.

Source: Pratto et al. (1994).

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Lepièce, B., Reynaert, C., van Meerbeeck, P. et al. Social dominance theory and medical specialty choice. Adv in Health Sci Educ 21, 79–92 (2016). https://doi.org/10.1007/s10459-015-9612-2

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Keywords

  • Career choice
  • Clinical clerkship
  • Education, medical, undergraduate
  • Hierarchy
  • Medical students
  • Prestige
  • Social dominance