US physician board certification
and labor market returns
Patrick L. O’Halloran
Monmouth University, West Long Branch, Monmouth, New Jersey, USA, and
David J. Bashaw
Center for Economic Education, University of Wisconsin-Whitewater,
Walworth, Wisconsin, USA
Abstract
Purpose – This paper aims to determine the characteristics of board certification among US
physicians and to test whether accounting for the expected gains to certification alters the pattern of
the determinants of board certification.
Design/methodology/approach – Splitting the sample into sub-samples by characteristics
associated with certification/non-certification identified in a probit, the incremental gain to
certification from log-earnings equations is identified. Realizing that these methods are susceptible to
sample selection, correction is made for it using the Heckman approach. Using the sample selection
corrected equations, the expected gain to certification among those who certify is then predicted and
those who do not certify is then predicted and this difference is included as a proxy for the expected
gain in the original probit to ascertain whether including the expected gain alters the determinants of
certification.
Findings – Accounting for the expected gain alters the pattern of the determinants of certification.
Although some groups such as blacks appear less likely to certify, after accounting for their expected
return to certification, they are not as less likely. This is explained in terms of the expected marginal
return to certification, market structure and practice setting.
Research limitations/implications – The data used in the analysis apply only to young
physicians in the USA. Also, these results may be applicable only to the particular cohort used in this
analysis.
Practical implications – The findings help to explain the absence of minority board certified
physicians within the USA.
Originality/value – This paper is the first to simultaneously estimate the returns to physician board
certification and the decision to obtain certification.
Keywords Qualifications, Human capital, Labour market, Race relations
Paper type Research paper
Introduction
This paper simultaneously estimates the returns to physician board certification and
the decision to obtain certification. We confirm that those physicians with the highest
expected returns to certification are more likely to obtain certification. These
physicians operate in competitive environments, are married, white, experienced and
within a specific subset of specialties. Critically, we identify the importance of sample
selection on certification in estimating physician earnings and show that accounting
The current issue and full text archive of this journal is available at
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The authors wish to dedicate this paper to Wilma O’Halloran whose passion for education
touched everyone she selflessly reached.
IJM
27,7
624
Received 18 November 2004
Revised 3 May 2006
Accepted 4 June 2006
International Journal of Manpower
Vol. 27 No. 7, 2006
pp. 624-646
q Emerald Group Publishing Limited
0143-7720
DOI 10.1108/01437720610708257