Fra loddtrekning til søknadsbasert opptak: Har endret praksis for tildeling av turnusstillinger til nyutdannede leger ført til sosial ulikhet?

Abstract

Medical students have high social origins and a high rate of social reproduction. Yet, in the labour market, physicians are an egalitarian occupational group, with minor internal differences. Hence, high social origins provide a compet-itive advantage in admission to medical school, but not in the medical labour market. After years with a shortfall of physicians, the prospect is an oversupply of physicians, putting pressure on the internship arrangement. In response, the health authorities changed the rules for internship training. From 2013 onwards, the distribution of internships is through job listings, applications and hires. This replaces the previous arrangement, which used a lottery system. An application-based system can provide physicians from high social origins with an advantage in the transition from education to work. The rule change introduces a natural experiment into the medical labour market. I use theories about social inequality and discrimination theories to deduce three hypotheses concerning unequal access to internship positions according to candidates’ social background, gender and foreign background. I use administra-tive register data in my inquiries. The results show a significantly higher likelihood for university hospital employment among doctors with higher social background, and a clear tendency towards increased inequalities according to demographic characteristics.