Making the Cut: Status, Credentials, and Hiring in Medicine

Abstract

Little is known about how employers interpret prestigious and non-prestigious credentials in professional recruitment, or how organizations shape and structure this process. Such research is needed to elucidate how employers and organizations contribute to stratification among professionals based on social class, especially since graduates of less selective schools tend to come from lower-SES backgrounds. Using data from a comparative ethnography of residency recruitment at two hospitals, I ask: 1) how do employers interpret prestigious and non-prestigious professional degrees in recruitment, and 2) how does organizational context influence how employers interpret these credentials? The findings add to a growing literature that focuses on qualitative differences between credentials to understand how employers make sense of elite and non-elite credentials within a single profession. The literature disagrees, however, about how employers interpret credentials. I reframe the debate to show that employers rely on combinations of interpretations in sequence, rather than finding evidence for one interpretation or another. I show how organizational context shapes these interpretations, with different employers interpreting the same credentials differently. The article also demonstrates that the order in which employers use different credential interpretations is heavily shaped by organizational status, with implications for inequality.