Gender difference in preference of specialty as a career choice among Japanese medical students

Background: In Japan, the absolute deficiency of doctors and maldistribution of doctors by specialty is a significant problem in the Japanese health care system. The purpose of this study was to investigate the factors contributing to specialty preference in career choice among Japanese medical students. Methods: A total of 368 medical students completed the survey giving an 88.2 % response rate. The subjects comprised 141 women aged 21 +/- 3 (range, 18-34) years and 227 men aged 22 +/- 4 (range, 18-44) years. Binary Logistic regression analysis was performed using specialty preferences as the criterion variable and the factors in brackets as six motivational variables (e.g., Factor 1: educational experience; Factor 2: job security; Factor 3: advice from others; Factor 4: work-life balance; Factor 5: technical and research specialty; and Factor 6: personal reasons). Results: Women significantly preferred pediatrics, obstetrics & gynecology, and psychology than the men. Men significantly preferred surgery and orthopedics than the women. For both genders, a high odds ratio (OR) of technical & research specialty and a low OR for personal reasons were associated with preference for surgery. Technical & research specialty was positively associated with preference for special internal medicine and negatively for pediatrics. Work-life balance was positively associated with preference for psychology and negatively for emergency medicine. Among the women only, technical & research specialty was negatively associated with preference for general medicine/family medicine and obstetrics & gynecology, and job security was positively associated for general medicine/family medicine and negatively for psychology. Among men only, educational experience and personal reasons were positively, and job security was negatively associated with preference for pediatrics. For both genders, work-life balance was positively associated with preference for controllable lifestyle specialties. Conclusion: We must acknowledge that Japanese medical students have dichotomized some motivations for their specialty preference based on gender. Systematic improvements in the working environment are necessary to solve these issues.