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PubMed1993

Dental underemployment: a study of uncontrolled dental manpower immigration.

In the 1980s three studies were conducted in Israel utilising different methods of dental manpower evaluations. All identified a large future surplus of dentists. The current study re-evaluates the manpower supply and discusses possible solutions. A random sample of 800 dentists was approached by three mailings and a telephone call follow-up with a response of 49.7 per cent. Almost 90 per cent of dentists reported an undersupply of patients, with a mean working load of 26.3 hours/week, but being willing to add up to 3.4 working hours/week. The oversupply of dentists has been dramatically affected by the addition of almost 1000 dentists who emigrated to Israel in 1991-92. To prevent a significant unemployment rate among dentists and an uncontrolled free market, it is urgently suggested for the benefit of both provider and consumer that; the demand for services be increased and additional financing of dental care be made available, that the total number of dentists be decreased by various measures and that their geographical distribution be improved. If necessary limits should be placed on the number of practices or the number of patients permitted per practice.

Adult↗
PubMed1996

In Italy, a medical degree often means unemployment or underemployment.

Italy's per capita concentration of physicians is the highest in the Western World, and many of them have to struggle to earn a living as they compete for a decreasing number of prestigious hospital positions. Many Italian doctors have more than one job, and some never find work in medicine.

Employment↗
PubMed2005

Birth weight and mothers' adverse employment change.

Low birth weight has been linked at the aggregate level to unemployment rates and at the individual level to subjective distress. We hypothesize that maternal underemployment, including unemployment, involuntary part-time work, and low wage work predicts decreased birth weight. The relationship of birth weight to maternal employment changes during pregnancy was studied prospectively in 1,165 singleton first births in the National Longitudinal Survey of Youth data set. Controlling for other significant risk factors, women who shifted from adequate employment to underemployment had significantly lighter babies. Plausible mediators of this relationship were explored, including prenatal health care, gestational age, and mother's weight gain, with results varying by type of underemployment. Two interactions also suggested that underemployment reduced the beneficial effect of mother's weight gain on birth weight. These findings were partially replicated for low birth weight (< 2,500 grams), indicating the medical significance of the effect.

Adult↗
PubMed1999

Trends in medical employment: persistent imbalances in urban Mexico.

OBJECTIVES: This study examined the extreme medical unemployment and underemployment in the urban areas of Mexico. The conceptual and methodological approach may be relevant to many countries that have experienced substantial increases in the supply of physicians during the last decades. METHODS: On the basis of 2 surveys carried out in 1986 and 1993, the study analyzed the performance of physicians in the labor market as a function of ascription variables (social origin and gender), achievement variables (quality of medical education and specialty studies), and contextual variables (educational generation). RESULTS: The study reveals, despite some improvement, persistently high levels of open unemployment, qualitative underemployment (i.e., work in activities completely outside of medicine), and quantitative underemployment (i.e., work in medical activities but with very low levels of productivity and remuneration). The growing proportion of female doctors presents new challenges, because they are more likely than men to be unemployed and underemployed. CONCLUSIONS: While corrective policies can have a positive impact, it is clear that decisions regarding physician supply must be carefully considered, because they have long-lasting effects. An area deserving special attention is the improvement of professional opportunities for female doctors.

Employment↗
PubMed1999

The employment status of 1995 graduates from radiation oncology training programs in the United States.

PURPOSE: To quantify the employment status of 1995 graduates of radiation oncology training programs in the United States. METHODS AND MATERIALS: All senior residents (149) and fellows (36) who completed training in 1995 were mailed an employment survey questionnaire by the Association of Residents in Radiation Oncology (ARRO). Telephone follow-up of nonrespondents achieved a 100% response rate. Twenty graduates who chose to continue training and five who returned to their home countries were removed from the study. Of the 160 who attempted to enter the U.S. workforce, 106 were men and 54 were women. Initial job status and job status at 6-8 months following graduation were determined. RESULTS: Unemployment was 6.9% at graduation and 4.4% at 6-8 months. Underemployment (part-time employment) was 10.6% at graduation and 11.9% at 6-8 months postgraduation. Of those working part-time 6-8 months after graduation, 63% (12 of 19) did so involuntarily after unsuccessfully seeking full-time employment. For the 20 graduates who chose to continue training with fellowships, seven (35%) did so solely to avoid unemployment, four (20%) were partially influenced by the job market, and nine (45%) were not influenced by the job market. Adverse employment search outcome was defined as being either unemployed as a radiation oncologist or involuntarily working part-time. Excluding those who chose to work part-time, a total of 19 (11.9%) graduates at 6-8 months following graduation, compared to 22 (13.8%) at graduation, were either unemployed or involuntarily working part-time. In terms of gender, this represented 18.5% (10 of 54) of females and 8.6% (9 of 105) of males. In terms of geographic restrictions in the job search, 56% of males and 70% of females with an adverse employment outcome limited their job search to certain parts of the country. This compares to 62% of all graduates in this study with geographic restrictions in their job search. In terms of perceptions of the workforce and employment opportunities, 95% of all graduates believed there was an oversupply of radiation oncologists and 95.5% believed the job market was worse than what they had anticipated on entering training. Only 42.8% of all graduates were satisfied with the job opportunities available to them. A significant number of private practice positions (41%) did not offer a partnership track, and those that did so had an increased median employment period before partnership (3.25 years) compared to previous years. CONCLUSION: This is the only employment survey for any specialty in which a 100% response rate was achieved. Upon graduation, a significant number of residents and fellows were either unemployed or involuntarily underemployed. The job market absorbed only a fraction of them at 6-8 months. Most graduates, including those employed full-time, were not satisfied with the practice opportunities available to them during their job search. Many private-sector jobs did not offer a partnership track, and those that did required an increased employment period. A higher rate of involuntary part-time employment was seen for female graduates. Geographic restrictions in job search alone could not account for graduates being unemployed or underemployed, and could not account for gender differences. An overwhelming majority of 1995 radiation oncology graduates believed that the job market had deteriorated and that there was an oversupply of radiation oncologists. As one of two major studies tracking the employment status of radiation oncology graduates, we believe this study to be superior in methodology. We also believe this study presents data in a manner useful to medical students, training program directors, and healthcare policymakers.

Employment↗
PubMed1997

Effect of favorable employment change on alcohol abuse: one- and five-year follow-ups in the National Longitudinal Survey of Youth.

Job loss has been linked to adverse outcomes such as alcohol abuse, but improved employment, usually assumed to be beneficial, has seldom been evaluated and may not help with addictive disorders. Using the National Longitudinal Survey of Youth, young adults who were unemployed or underemployed (low income or involuntary part-time) in 1984 were followed up in 1985 and 1989. Controlling for 1984 alcohol abuse, there were no effects of positive employment change on 1985 symptoms, but there were significant restorative effects on 1985 binge drinking among those who were heavy drinkers in 1984. There also appeared to be an indirect link of favorable 1984-1985 employment change to heavy drinking in 1989 via 1989 employment status. Because the effects of underemployment partially resembled those of unemployment, the discussion cautions against the conventional wisdom of promoting any work, including underemployment, as curative for the ills of unemployment.

Adaptation, Psychological↗
PubMed1995

Occupational outcome after temporal lobectomy for refractory epilepsy.

We evaluated employment after temporal lobectomy for refractory epilepsy in 86 patients (3.5 to 8 years of follow-up). Seventy-three patients qualified for the work force before and after surgery. Unemployment rates declined after surgery (18 patients [25%] unemployed before surgery, eight patients [11%] unemployed after surgery), and underemployment also tended to diminish. Improvement in occupational status related strongly to the degree of postoperative seizure relief. Seizure-free patients fared better (no unemployment, little underemployment) than patients with some seizure-free years and some years with seizures after surgery, whose high underemployment level persisted. Patients with seizures in each year after surgery fared worst (despite reduced seizure frequency), with increased unemployment after surgery. Age at surgery also influenced vocational outcome in patients who were unemployed before surgery. Historical, educational, cognitive, and behavioral measures did not correlate with vocational outcome. Employment gains came slowly; unemployed patients took up to 6 years to obtain work after surgery. Of 13 students at the time of surgery, 11 have graduated and nine are now employed. We conclude that seizures play a large role in limiting employment, and that by alleviating seizures, temporal lobectomy improves employability in people with refractory epilepsy. Surgery thereby provides benefit to individuals with epilepsy by increasing financial independence and to society by reducing unemployment.

Adult↗