Attracting Adolescents to Become Doctors and Nurses: Differential Importance of Personal and Environmental Factors in 61 Economies

Abstract

Abstract Background Doctors and nurses play a fundamental role in maintaining global health systems and achieving universal healthcare coverage. However, significant shortages persist, and little is known about the popularity of these careers among young people in various economies, nor the relative impact of personal inputs and contextual factors. Methods Using the large-scale Programme of International Student Assessment (PISA) 2018, we showed the recent distribution of adolescents’ doctor and nurse career expectations in 61 economies. With multilevel logistic regression and hierarchical linear regression, we examined the relative importance of economic indicators, health work conditions, and personal background factors in shaping adolescents’ health career expectations. Results Additional health expenditure (with the impact of gross domestic product [GDP] controlled) and health work environment explained one-third of the variance in adolescents’ doctor and nurse career expectations. In contrast, personal background factors (gender, social status, and academic ability) were less influential. Specifically, work safety was crucial in attracting adolescents to doctor careers in high-GDP economies, while salaries mattered more for nurses in less developed economies. Conclusions In government planning, it is critical to increase health expenditure and improve health working conditions to enhance young people’s motivation to pursue doctors and nursing careers. Specifically, high-GDP economies should provide a safer work environment for health workers to attract adolescents to doctor careers, whereas, in less developed economies, offering better salaries is more essential in filling their nursing workforce shortages. Trial registration No human participants were involved in this study.