A Growing Trend of Females and Dermatologists Among Top Medical Graduates in 30 Years
40 Pages Posted: 19 Mar 2019More...
Background: Career outcomes of top medical graduates are seldom studied. The Tsungming Tu Foundation (TTF) has awarded the number one graduate from each medical school in Taiwan since 1981. We studied whether top medical graduates (TMG) differ from other medical graduates (OMG) in gender, specialty, and geographic regions decades in the last 30 years.
Materials & Methods: Overall, 322 TMG and 40,075 OMG were identified from 1981-2017 from TTF and Taiwan healthcare public data. Subjects were further grouped by graduation year: 1981-1994, 1995-2001, 2002-2011, and after 2012. Ranges were based on implementation dates of new health policies.
Results: The percentages of female OMG increased from 10•9% before 1994 to 32•6% after 2012 (linear trend, P<0•001). Similarly, the percentages of female TMG increased from 23•1% before 1994 to 42•4% after 2012 (linear trend, P=0•003). In contrast to 2% of OMG, the percentage of TMG who became dermatologists increased from 11%-20•5% (linear trend, P=0•024). TMG favored dermatology, ophthalmology, and neurology, and avoided general surgery (P<0•001). While still more likely than OMG, the percentage of TMG working in medical centers dropped significantly from 58% during 1981-1994 to 33•3% during 1995-2001 (P=0•035). This coincides with the launch of National Health Insurance in 1995. Finally, though more than half of TMG previously worked in Northern Taiwan, they have recently shifted to Mid-Taiwan.
Conclusions: The percentages of female OMG and TMG reached 32•6% and 42•4%, respectively, after 2012. TMG more often chose dermatology, ophthalmology, and neurology, but avoided general surgery. Changes in health policy, reimbursement policy, and medical education affected both OMG and TMG career choices.
Funding: The authors declared that the study receives no funding.
Declaration of Interest: The authors declare that there are no conflicts of interest regarding the
publication of this paper.
Ethical Approval: The list of awardees of the Dr. Tsungming Tu Award, which represents the list of top medical graduates, is made publicly accessible as honors in the website of Tsungming Tu Foundation. Therefore, the study is exempted from ethical review board approval.
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