Educational debt and the gender gap: Understanding factors influencing orthodontists’ career decisions

Introduction Orthodontic residents face challenges unparalleled to their predecessors, including competitive marketplaces, rising debt burdens, and changing demographics that have contributed to the shift in initial career choice from owner to employee. We aim to understand factors important to orthodontists at different career stages and the impact on job satisfaction through a sequential mixed methodology study. Methods Semistructured interviews were conducted with 25 orthodontic residents and practitioners. A survey was developed from qualitative findings that explored career decision-making of orthodontic residents and practicing orthodontists, with descriptive and bivariate statistical analyses (n = 343 orthodontists and 185 residents). Results Graduating orthodontic residents are choosing employment over ownership as their initial job, prioritizing high income to offset the educational debt. The majority of residents report thinking about their debt very often to all of the time and find it very to extremely stressful. Current residents have long-term goals of ownership, whereas practicing doctors of both genders became owners at equal frequencies. However, on average, women earn $119,000 less per year and report being the primary family caretaker more often than men. Conclusions Excellent patient care, work-life balance, and sufficient income are the most important drivers for career choices and job satisfaction for orthodontists of all ages. Despite debt, most residents and working orthodontists report a high level of job satisfaction and would recommend the field of orthodontics to others.

引言 正畸住院医师面临着其前辈所没有的挑战，包括竞争激烈的市场、不断增加的债务负担以及人口结构的变化，这些都导致了初始职业选择从所有者转变为雇员。我们旨在通过一项顺序混合方法研究，了解对不同职业阶段的正畸医生重要的因素以及对工作满意度的影响。 方法 对25名正畸住院医师和从业者进行了半结构化访谈。根据定性研究结果编制了一份调查问卷，该问卷探讨了正畸住院医师和执业正畸医生的职业决策，并进行了描述性和双变量统计分析（343名正畸医生和185名住院医师）。 结果 即将毕业的正畸住院医师在初始工作选择上更倾向于受雇而非成为所有者，他们将高收入作为优先考虑因素以抵消教育债务。大多数住院医师表示经常甚至总是考虑自己的债务，并觉得这非常有压力甚至压力极大。目前的住院医师有成为所有者的长期目标，而男女执业医生成为所有者的频率相同。然而，平均而言，女性每年比男性少赚11.9万美元，并且更多地表示自己是家庭的主要照顾者。 结论 出色的患者护理、工作与生活的平衡以及足够的收入是所有年龄段正畸医生职业选择和工作满意度的最重要驱动因素。尽管有债务，大多数住院医师和在职正畸医生都表示工作满意度较高，并会向他人推荐正畸领域。