The Observational Physician and surGEon Automobile Response (TOP GEAR) survey

Buying a car is often a complex decision. Most consumers carefully consider their wants and needs, balancing factors ranging from vehicle safety and reliability to maintenance costs and purchase price. While some cars are bought merely as a barebones transport tool, many purchasers of luxury and exotic vehicles view them as badges of arrival, providing symbolic and experiential benefits, such as increased social standing and impressing Dave from down the street.

Armchair anthropologists and the general media have long debated what your automobile says about your lifestyle and personality.1,2 We were particularly interested in whether surgeons and non-surgeons drive different types of vehicle. We hypothesised that both surgeons and junior doctors who intend to pursue a career in surgery were more likely to own more expensive cars than non-surgeons at corresponding levels of seniority.

Methods

We surveyed practising medical officers at an Australian metropolitan tertiary hospital. A standardised questionnaire was distributed by email to all general trainees, basic physician trainees, surgical residents, and interns, using network global address book distribution lists. To obtain information from staff specialists, executive assistants in each speciality were asked to distribute the survey to all consultants in their respective discipline.

Participants were asked to indicate their current position and area of specialty. To examine the relationship between seniority and car value, participants were categorised into three groups: interns/resident medical officers, registrars/fellows, and consultants. Junior doctors who had not yet specialised were asked to nominate an area of interest. Participants were grouped as surgeons (incorporating Royal Australasian College of Surgeons surgical specialties) and non-surgeons (all remaining medical practitioners).

Survey respondents identified the make, model and year of their vehicle. Cars were valued according to data on the RedBook site (redbook.com.au); search results were listed in ascending price order, and the value for the least expensive automatic model (lower bracket of the “private price guide”) selected for our analysis.

Statistical analysis

Continuous variables are reported as medians with interquartile ranges (IQRs), categorical variables as frequencies and percentages. The statistical significance of between-group differences was assessed in Wilcoxon rank sum and Fisher exact tests as appropriate. Car value was compared by seniority group in Kruskal–Wallis tests. Statistical analysis was undertaken in Stata 13.0 (StataCorp); P < 0.05 (two-tailed) was deemed statistically significant.

Ethics approval

Ethics approval was provided by the Central Adelaide Local Health Network Human Research Ethics Committee (reference, R20180915).

Results

The survey response rate was 17.2%. We received responses from 154 doctors; 96 were men (62%), 52 were women (34%), and three participants elected not to indicate their sex. Half the respondents were interns, residents, or unaccredited registrars (76 of 154, 49%), 27 (18%) were accredited registrars or fellows, and 48 (31%) were consultants.

Of the 151 doctors who owned cars (98% of sample), 61 (40%) were either surgical trainees or consultant surgeons and 90 (60%) were from non-surgical specialties. In the surgical group, 36 of 61 doctors (59%) purchased their car new, compared with 34 of 90 non-surgeons (38%; P = 0.013). The median car value for surgeons was $16 500 (IQR, $9350–$37 000) and for non-surgeons $8500 (IQR, $4400–$14 100; P < 0.001). The median time to replacement was 5–7 years for surgeons and 7–10 years for non-surgeons (P < 0.001) (Box 1).

Thirty doctors in the surgeon group (49%) and 18 in the non-surgeon group (20%) were consultants. Twenty consultant surgeons (67%) purchased their cars new, compared with 14 non-surgical consultants (78%; P = 0.32). In the junior surgeon group (below consultant level), 16 of 31 doctors (52%) purchased their cars new, as did 25 non-surgical junior doctors (28%; P = 0.019).

Box 2 depicts the distribution of car values according to seniority level for surgeons and non-surgeons. Greater seniority was associated with higher car values for both groups, but the median values for current and prospective surgical specialists were higher than for their non-surgical colleagues at all levels, especially registrars and fellows (between groups: P < 0.001). While 30% of surgeons owned cars valued at more than $50 000, this was true for only 6% of non-surgeons (P = 0.025).

Discussion

Traditional models of consumer behaviour assume that the personality of the consumer heavily influences their buying habits.3 Extroversion is one of the five fundamental dimensions of personality and is characterised by venturesomeness, affiliation, positive affectivity, energy, ascendance, and ambition.4 Extroverts classically have an outgoing and gregarious buying style and will opt for products that distinguish the purchaser from their peers. Extroversion has also been directly linked with positive consumption emotions5 and an increased tendency to engage in conspicuous consumption of luxury cars, providing an unambiguous signal of personal affluence.

The surgical personality has been discussed extensively in the literature.6-10 Personality traits commonly attributed to surgeons and prospective surgeons include decisiveness, directness, and extroversion. It remains to be seen whether these characteristics are implicitly taught during surgical training or whether this culture is perpetuated by the recruitment of people with personalities similar to those of the interviewing panel.

We found that significantly more surgeons purchased their cars new (59% v 38% of non-surgeons), that they owned vehicles with a higher median value ($16 500 v $8500), and that they replaced their cars earlier than did non-surgeons. These differences potentially reflect the income gap between surgeons and non-surgeons. However, similar differences were apparent at all levels of seniority, including internship, residency, and the registrar years, during which income should be similar for the two groups as salaries are based on state awards.

The greatest discrepancy between surgeon and non-surgeon groups was for registrars and fellows. For many, this period of training is a life segment before marriage and children, when disposable income is higher than during medical school and entrance to an accredited training program promises future job security.

Our study was limited by its being based on self-reported, anonymised data. The low response rate may also limit the generalisability of our results.

Conclusion

Our findings suggest that doctors attracted to a career in surgery are more likely than their non-surgical colleagues to prefer their cars new and expensive.

Box 1 – Distribution of car values for 151 current and prospective surgical and non-surgical doctors

Box 2 – Distribution of car values for 151 current and prospective surgeons and non-surgeons, by seniority level

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RMO = resident medical officer.