Jenkins, Tania M. In PressDoctors’ Orders: The Making of Status Hierarchies in an Elite ProfessionNew York: Columbia University Press 


Brief description: The US does not have enough doctors. In fact, every year since the 1950s, the nation has had to rely on internationally-trained and osteopathic medical graduates to fill between one-fifth and one-half of residency positions because there are too few American-trained MDs. These international and osteopathic graduates, however, often end up in lower-tier "rank-and-file" training programs, despite often having better track records than their American MD counterparts, who tend to occupy elite training programs. Some programs are even fully segregated, accepting exclusively US medical graduates or non-US medical graduates, depending on the program’s prestige. How do international and osteopathic medical graduates end up so marginalized, particularly given the absence of formal regulations prioritizing American-trained MDs? And what allows American-trained MDs to remain elite despite importing about a third of the US medical workforce—including some of the world's best and brightest?

Doctors’ Orders offers a rare glimpse at the construction and consequences of professional status distinctions before, during, and after residency training. Tania Jenkins spent years observing and interviewing American, international, and osteopathic medical residents to reveal the unspoken and taken-for-granted “rules of the game” that lead to status hierarchies among supposed equals in the same specialty. In the end, she finds that the US does not need formal policies to prioritize American-trained MDs; by relying on informal status distinctions that equate status with merit, and eclipse structural disadvantages, the American medical profession is successfully able to recruit and retain osteopathic and international graduates who willingly participate in a system that subordinates them to American-trained MDs.

Peer-reviewed articles (asterisk beside name denotes student coauthors)

Jenkins, Tania M., Grace Franklyn*, Joshua Klugman, and Shalini Reddy. In press. “Separate but Equal? The Sorting of USMDs and non-USMDs in Internal Medicine Residency Programs.” Journal of General Internal Medicine.

Fischer, Jonathan, Kimberly Clinite, Eric Sullivan, Tania M. Jenkins,…Shalini Reddy. In press. “Specialty and Lifestyle Preference Changes during Medical School.”  Medical Science Educator.

Jenkins, Tania M., Jenny Kim*, Chelsea Hu*, John Hickernell*, Sarah Watanaskul*, John Yoon. 2018. “Stressing the Journey: Using Life Stories to Study Medical Student WellbeingAdvances in Health Sciences Education. 23(4), 767–782. doi:10.1007/s10459-018-9827-0


Jenkins, Tania M. 2018. “Dual Autonomies, Divergent Approaches: How Stratification in Medical Education Shapes Approaches to Patient Care.” Journal of Health and Social Behavior. 59(2): 268–282.

Mueller, Anna S., Tania M. Jenkins, Melissa Osborne*, Arjun Dayal*, Daniel O’Connor*, and Vineet Arora. 2017. Gender Differences in Attending Physicians' Feedback for Residents in an Emergency Medical Residency Program: A Qualitative Analysis.Journal of Graduate Medical Education, 9(5): 577-585 doi: 10.4300/JGME-D-17-00126.1

Jenkins, Tania M. and Susan E. Short. 2017. "Negotiating intersex: A case for revising the theory of social diagnosis." Social Science & Medicine. 175: 91-98. doi:10.1016/j.socscimed.2016.12.047

Jenkins, Tania M. and Shalini T. Reddy. 2016. "Revisiting the Rationing of Medical Degrees in the United States." Contexts, 15(4), 36-41. doi:10.1177/1536504216684820.

Jenkins, Tania M. 2015. “’It’s Time She Stopped Torturing Herself:’ Structural Constraints to Decision-Making about Life-Sustaining Treatment by Medical Trainees.” Social Science & Medicine, 132: 132-140.

Jenkins, Tania M. 2014. “Clothing norms as markers of status in a hospital setting: A Bourdieusian analysis.” Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 18(5): 526–541.

Short, Susan E., Yang Yang, and Tania M. Jenkins. 2013. Sex, Gender, Genetics, and Health.” American Journal of Public Health, 103 Suppl 1: S93-S101, PMC3786754.

Quesnel-Vallée, Amélie, Emilie Renahy, Tania Jenkins, and Helen Cerigo. 2012. “Assessing barriers to health insurance and threats to equity in comparative perspective: The Health Insurance Access Database.” BMC Health Services Research, 12. doi: 10.1186/1472-6963-12-107, PMC3393626.

Brown, Phil, Mercedes Lyson, and Tania Jenkins. 2011. “From Diagnosis to Social Diagnosis.” Social Science & Medicine, 73(6): 939-943 .

Jenkins, Tania M. 2008. “Patients, Practitioners and Paradoxes: Responses to the Cuban Health Crisis of the 1990s.” Qualitative Health Research, (18)10: 1384-1400.

Book chapters

Jenkins, Tania M. 2014. “Who’s the Boss? Diagnosis and Medical Authority.” Pp. 105-119 in Jutel, Annemarie and Kevin Dew (eds.), Social Issues in Diagnosis: An Introduction for Students and Clinicians. Baltimore: Johns Hopkins University Press.

Quesnel-Vallée, Amélie, Jean-Simon Farrah, and Tania M. Jenkins. 2011. “Population aging, health systems and equity: Shared challenges for the U.S. and Canada.” Pp. 563-581 in R. A. Settersten & J. L. Angel (Eds.), The Handbook of Sociology of Aging. New York: Springer.

Quesnel-Vallée, Amélie and Tania M. Jenkins. 2010. “Social Policies and Health Inequalities.” Pp. 455-484 in Cockerham, William C. (Ed), The New Blackwell Companion to Medical Sociology. Oxford: Blackwell Publishing.

Quesnel-Vallée, Amélie and Tania Jenkins. 2008. “Vieillissement et utilisation des soins: comment départager les coûts?” Pp. 69-77 in Béland, F., A.P. Contandriopoulos, A. Quesnel-Vallée, L. Robert (Eds), Le privé dans la santé: un débat sans fin? Presses de l’Université de Montréal: Montréal.

Other publications

Jenkins, Tania M. and Shalini T. Reddy. 2017. "Unmatched U.S. Seniors and Residency Placement Fever.Academic Medicine, 92(11): 1510.

© 2019

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