Utiliza este identificador para citar o vincular este elemento: http://hdl.handle.net/10553/35751
Títulos: Allocation of residency training positions in Spain: contextual effects on specialty preferences
Autores/as: Harris, Jeffrey E.
González López-Valcárcel, Beatriz 
Barber Pérez, Patricia 
Ortún, Vicente
Clasificación UNESCO: 531207 Sanidad
Palabras clave: Medical residency
Mixed logit
Physician income
Professional prestige
MIR system
Independence of irrelevant alternatives
Fecha de publicación: 2017
Resumen: In Spain's `MIR' system, medical school graduates are ranked by their performance on a national exam and then sequentially choose from the available residency training positions. We took advantage of a unique survey of participants in the 2012 annual MIR cycle to analyze preferences under two different choice scenarios: the residency program actually chosen by each participant when it came her turn (the 'real') and the program that she would have chosen if all residency training programs had been available (the 'counterfactual'). Utilizing conditional logit models with random coefficients, we found significant differences in medical graduates' preferences between the two scenarios, particularly with respect to three specialty attributes: work hours/lifestyle, prestige among colleagues, and annual remuneration. In the counterfactual world, these attributes were valued preferentially by those nearer to the top, while in the real world, they were valued preferentially by graduates nearer to the bottom of the national ranking. Medical graduates' specialty preferences, which we conclude, are not intrinsically stable but depend critically on the 'rules of the game'. The MIR assignment system, by restricting choice, effectively creates an externality in which those at the bottom, who have fewer choices, want what those at the top already have.
URI: http://hdl.handle.net/10553/35751
ISSN: 1057-9230
DOI: 10.1002/hec.3318
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