Association for Public Policy Analysis & Management

Highly-skilled men and women are increasingly likely to marry each other, and yet men and women in dual-career couples remain highly likely to report that the man’s career takes precedence. The tendency for dual-career couples to report that the man’s career is primary is often said to be explained by relative differences in the occupations and labor market experience among men and women. This paper challenges such gender-neutral explanations of career compromise and prioritization patterns, focusing on medical student couples applying for residency through an official process known as “couples match.” This process, by which couples translate their individual residency program rankings into a joint ranking that binds their individual outcomes, allows for an objective measurement of career prioritization. Two major limitations within existing data have prevented researchers from better understanding the patterns of traditional career prioritization. First, few studies could sufficiently isolate the effect of gender on household decisions. Earlier career decisions, earnings, and employment, as well as future expectations for childbearing and childcare, can all influence whose career is prioritized. Second, it is difficult to uncover motivations and social norms using traditional survey questions that illicit strong social desirability biases. This study instead relies on experimental analyses to address these data limitations.

Using factorial survey analysis, a method that combines survey research with a multidimensional experimental design, I causally estimate whether gender moderates the effect of economic resources when determining medical student couples’ joint migration decision. Students in a consortium of top medical schools are presented with hypothetical descriptions of several medical student couples with conflicting residency program preferences. Each vignette systematically varies individual and family-level bargaining factors, and respondents are asked to advise the couple on how to resolve their geographic conflict. The fixed-answer questionnaire further allows for the assessment of how respondent-level characteristics influence outcomes. Using a multilevel model, I evaluate how differences in attitudes and expectations of career primacy can be explained by the economic resources each partner holds. Preliminary results suggest that gender effects on career outcomes are present both in the attitudes respondents hold and their own personal experiences. Respondents are more likely to think the couple will prioritize the man’s career than the woman’s career, regardless of the career goals and academic qualifications of the hypothetical partners.

By testing whether there are systematic gender differences in career compromise among couples who are equally educated and entering the same profession, this paper contributes to research that evaluates how expectations of family and career roles drive persistent inequalities among men and women in medicine and other human-capital-intensive professions. If socially constructed roles regarding work, marriage, and childcare influence how men and women perceive the relative importance of their career and the career compromise they make for their family, this will have drastic and enduring impacts on women’s professional achievement. This experimental approach provides an innovative means for measuring whether implicit biases influence perceptions of career prioritization among medical students, in order to develop effective policy interventions early in couples’ careers.