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
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
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
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
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
The authors wish to dedicate this paper to Wilma O’Halloran whose passion for education
touched everyone she selﬂessly reached.
Received 18 November 2004
Revised 3 May 2006
Accepted 4 June 2006
International Journal of Manpower
Vol. 27 No. 7, 2006
q Emerald Group Publishing Limited