Stratification in the medical profession: non-western physicians in Norway

Abstract

Previous studies of internal stratification in medicine suggest that non-White foreign-trained physicians fill the bottom level of the specialist hierarchy. However, in this study we use administrative registers for majority and non-Western physicians in Norway and find that non-Western physicians acquire specialisation in the same volume as majority colleagues, are equally likely to enter several of the high prestige specialties and are not delayed in their careers. The equal distribution is discussed as a consequence of strong professional closure, bureaucratisation of hiring procedures and hospital organisation and governmental influence. Identified patterns, however, are not unequivocal. First, immigrant physicians have a significantly higher chance of becoming specialists compared to majority physicians. Second, foreign-educated non-Western physicians have a significantly lower likelihood of specialising in surgery fields. The exception from the overall equality may result from exclusionary practices previously identified in surgery, but it could also result from differences in motivation.