ࡱ> )`\bjbj.{{w(NNNNNNNbƹƹƹ8LJb&L.(VVV111]______$$hV]N11NNVVD NVNV]]]hNNV־ (!Nƹ L0& N,1^L_I111HX111&bbbdƹbbbƹbbbNNNNNN  15.01.2016 Medical Graduates (candidates) 4526, 1972-2014 from the University of Southern Denmark, Odense, 3rd ed. Length of study, postgraduate education, specialties, main occupation, and geographical distribution The Importance of a Medical school for the region. Knud Siboni from the Department of Clinical Microbiology, Odense University Hospital, J. B. Winsloewsvej 21. 2, DK 5000 Odense C, and from the Faculty of Health Sciences, University of Southern Denmark, DK 5000 Odense C Summary. Siboni K.. Medical graduates (candidates), 4526, 1972-2014 from the University of Southern Denmark, Odense, 3rd ed. Length of study, postgraduate education, specialties, main occupation, and geographical distribution The importance of a Medical School for the region Aim. This survey is based on data recorded ultimo 2014. Only essential differences from the previous surveys1 and 2000-20012 are discussed. Materials and Methods. All medical graduates 1972-2014, a total of 4526 have been included. The data recorded in VISUAL Dbase, Borland 1996, version 5.5, may now be transferred to MS ACCESS, version 2003, by way of the ISAM driver Btr 110, or to MS Excel by WINDOWS 7. Results. The duration of the medical study increased till W2005, mostly for the females (table 1) The number and frequency of consultants and of deputy superintendents increased to 50% and 25% respectively (figure 1). Graduates 1989 and later became specialist in general medicine after a median education time of eight years; this education took earlier 14 years (table 2 and figure 3) and they became general practitioners after a median time of eight years, earlier 16 years (figure 4). The most frequent specialty was general medicine,(0613)followed by other specialties of internal medicine(0600-0614) summed up, anaesthesiology(0100), and psychiatry(1700). The number of specialists was 2006 1557, 1/8 of the number of Danish specialists 2005[11]. Thirteen consultants graduated before1992 have changed to practitioners. The ph.d. study yielded increasing numbers of ph.ds at the expense of other postgraduate medical degrees. After its reorganization the students finished this study shortly after medical graduation (Figure 2).. Nine to twelve per cent of the graduates emigrated (Table 2). The reorganization of hospital management 2007 to the five new regions, reducing the Gini index from 0.15 to 0.11, has concealed the sparse provision with physicians in five of the old counties. (This index was 2012 atill 0.11) The candidates from the University of Southern Denmark, Odense, had great affinity to the Region of South Denmark, Gini index 0.47 (Tables 3-6, figures 5 - 8). This Gini index was 2012: 0.45. Conclusion. Neither the length of the medical study nor the prospects of the graduates have reached a stable state, necessitating new surveys, preferably with intervals of three years. Department of Clinical Microbiology, Odense University Hospital. Correspondence to Knud Siboni, Department of Clinical Microbiology, Odense University Hospital, Winsloewparken 21. 2, DK 5000 Odense C, Denmark. E-mail:  HYPERLINK mailto:mksiboni@dadlnet.dk mksiboni@dadlnet.dk Since 1995 data concerning geographical supply and distribution, length of study, postgraduate education, specialties, and main occupation from physicians graduated from the University of Southern Denmark, Odense,(Sdu, Odense) have been collected into DBASE IV. The results from two previous surveys 1997 and 2000 have been published 20001 from 1968 graduates, and 20032 from 2312 graduates. The present survey was made on results from 4526 graduates extant primo 2014 and this report will describe essential differences from the 2000 survey published 2003. The distribution of employed physicians in Denmark and its development 1998-2014 will be used as a background for the geographical distribution of the candidates from Sdu, Odense. An attempt will be made to propose a reasonable interval between the surveys, or prevalence investigations as they are. In addition the technical problems resulting from the rapid development of electronic contraptions and their capacity will be mentioned. The scientific background for the study of medicine at Odense University (OU) was described 1991, 25 years after the start 1966, in "Medical Science at OU3,4 and the conditions extant 2016 after 50 Years may be found in recent publications from the Faculty of Health, University of Southern Denmark  HYPERLINK http://www.sdu.dk www.sdu.dk which is now the name of the university. MATERIALS AND METHODS. The medical graduates 1972-2014 from the University of Southern Denmark (Sdu, Odense), were numbered 1-4526. They were divided into three-year groups of 200-300, the first one S(summer)1972-W(winter)1975, the latest one S2011-W2014. Since 2002 six terms comprise 5-600 graduates. The data from the graduates of S2011-W2014 , 4005-4526 i.e.522, containing no specialists have not been included in the tables. Also, the occupational addresses of these young candidates are in a state of flux and some of them are not yet members of the Danish Medical Association (DMA). Information about specialties, main occupation, and address was taken from the Guide to members of the Danish Medical Association 2012-20135. The data were recorded in VISUAL dBase, Borland 1996, version 5.5, 23 MB, using a small electronic capacity of 774 KB 1972-2014 and working nicely and quickly. This program is being outdated, mostly, it seems, because everybody uses computers with still increasing capacity, 600 GB instead of the 2 GB 15 years ago and >2 GB RAM instead of 40 MB. Luckily an ISAM driver Btrl 10, 70.1 KB(freely provided 2005 by Microsoft Denmark, Personal Support), could translate the data to MS ACCESS (6.5 MB) where they used 500 KB, and 2014 WINDOWS 7 has translated the data to MS Excel ( MB) where they use 826 KB. The file, medcand.xls, may be obtained only with the consent of the Dean, Health Sciences, University of Southern Denmark.  HYPERLINK mailto:Dekan@health.sdu.dk Dekan@health.sdu.dk The National Board of Health has numbered the medical specialties e.g. 0100 anaesthesiology - 0613 general medicine - 1700 psychiatry - 2000 oncology. When these numbers are characters, i.e. "0100", all specialists in a three-year period may be counted as "0" + "1" + "2" (own observation). The present occupational addresses were obtained from the DMA, from Socialstyrelsen, Stockholm, from Norske Legeforeningen, Oslo, and from Helse & Socialforskningsministeriet, Iceland. Data concerning birth place and grammar school were as described 2003 [2]. Of the 4526 candidates 235(192 females) have changed family name. The distribution of employed Danish physicians on the Counties in the last year of these, 2006 (table 3)and after the creation of the larger regions 2007 (table 4)were obtained from the Department of Registration, DMA. For the allocation of the physicians to the new regions6 (table 5) were used the postal codes of their occupational addresses: West Zealand 2650, 2670, 4000-4999. Metropolis 1000-3799 (-2650, -2670). North Jutland 7700-7800, 7900, and >8999. Mid-Jutland 6880-6899, 7340-7699, 7800-7899, 8000-8999. South Denmark 5000-6869, 7000-7330 [4] Faroe Islands 3800-3899 and Greenland 3900-3999 (Figure 8). The skewness of the distributions or maldistributions has been described by Lorenz curves7,8 comparing the observed no. of physicians as a function of the cumulated population with the expected numbers at an even distribution (tables 3-5 and figures 5-8). The area between the two curves, estimated by numerical integration, is the Gini coefficient which increases the more uneven the distribution. For the numerical integration has been used the same formula, a, as in 2000 and 2003 [1, 2], and an improved formula, b. Division with the area of the triangle under the expected curve yields the Gini index which is an abstract and comparable measure of the skewness. Gini, 1912, used his index to characterize the uneven distribution of income and other benefits8. Mortality. For comparison with the Danish population was used an exponential mortality curve with 0.1% per year at 30 years of age , 1% at 55, and 10% per year at 80 years and 2. with 0.1% per year - - - 0.6% at 55, and 3.4% per year - - - - . RESULTS. RECRUITMENT. Since 2003 half of the medical students still come from grammar schools in Funen and Jutland, but an increasing number from abroad, 2008 2014 31% and of these 84 92% from Norway and Sweden. THE DURATION OF THE MEDICAL STUDY AT SDU, ODENSE (Table 1). Since 1980 the duration has increased. Fewer use < 7 years and more use > 9 years. This is pronounced for the female students and adds in the period S96-W99 to the majority of female graduates extant since S93. From S05 modus is again < 7 years. The same intervals harbour the median length of study with the exception of males S02-W05 having median in the next interval. The concept modus - the most frequent length of study - is used because the graduates in the first two columns, < 6 years have come from other universities - up to 1972 mostly from the University of Aarhus, DK 8000 - to finish at Sdu, Odense. This relates the concept mean length of study to Sdu, Odense, and not to the students. MEDICAL SPECIALTIES AND DOCTORS (Figure 1). Figure 1 shows that 16 years after graduation 85% were medical specialists and hereoff 37%(733/1998)in general medicine. The females were up to 10% scarcer except for graduates after 1989 specializing in general medicine, and they were appr. 1 year later than the males. General medicine(0613) was the most frequent, 733(311) and since 1989 with a median length of education of 8 years, followed by other specialties of internal medicine(0600-0612 & 0614), 309(75), anaesthesiology(0100), 137(45), and psychiatry(1700), 125(56) with an average median length of education 9-10 years. (Females in parenthesis). The number of specialists increased from 1997: 848(221) over 2000: 1133(340) and 2003: 1333(431) to 2006: 1557(549), i.e. 285, 200, and 224 per three years , and 441 to a total in 2013 of 1998(784), 15.5% of Danish specialists 20129. Of these 733 were specialists of general medicine, (0613), 37%. The percentages 2000 and 2003 were 40 and 39 resp. The number of candidates increased 1997-2006 from 1968 to 3055 and at 2014 to 4526. The remaining 14% of the graduates are found in table 2, Diverse professions. This multitude has not earlier been described. The well organized and popular ph.d. study for medical graduates at Odense University Hospital, USD, yields increasing numbers of ph.d.s at the expense of prize papers rewarded with gold or silver medals . The duration of the ph.d. study decreased after the reconstruction and renewal of the study 1985 (figure 2). The distribution af this duration with time is best approximated by a parabola as that of a throw, the regression coefficient R = 0.62 and 0,52 resp. One could say that the curve has had the renewal as its "accelleration of gravity" on the "throw". The no. of observations in the diagram must not exceed 245, excluding graduates later than 2010. The 49 drs. of Medical Science are found in figure 3. Females 2-3 years later than males and apparently with increasing distance from graduation. MAIN OCCUPATION (Figure 4 and table 2). .Figure 4. Main occupation shows the results of the surveys 1997, 2006,and ultimo 2012. (2000 and 2009 omitted) The median time to become a consultant was 14-15 years in all three surveys but the maxima of the curves increased from 25% 1997 after 22 years via 35% in 2000 after 20 years to 43% 2006 after 23 years, and to 55% 2012 after 22 years. Maxima for deputy superintendents were obtained after 14 years in all four surveys, 9% in 1997, twice as many 2000, nearly thrice as many, 25%, in 2003, 16% in 2006, and 15% in 2012. With time 45% became practitioners in all three surveys with a median time in the 1997 survey of 14 years. On the curve for the 2012 survey is superimposed a group starting with graduates from 1989 and with a median postgraduate education of eigth years. This shorter education followed the renewal of the specialty 0613 general medicine 1996. Thirteen consultants graduated before 1992 have changed to practitioners. ATE S OF DEATH AND RETIREMENT. The number of deceased before 2013, 86(24 females), was still below the 142,6 expected from an exponential mortality curve no.1 through 0.1% at 30 years, 1% at 55, and 10% at 80 years,.as in the year 20002 (t = 3.75). With a mortality rate of 0.6% at 55 years, and 3.4% at 80, curve no.2, the expected no. of deceased would be 65 (t = -1.7), speaking for medical doctors being priviledged. Retired were 112(51 females) .Only 10 of these graduated after 1989 (Table 2). These figures are minimal, because 208(64) of the candidates were abroad and 140 were not members of the DMA and 405(219) had not their life story recorded. Of these 109(65) and 90(60) came from grammar schools in Norway and Sweden. The maximal figures could be obtained by multiplication with 4004/(4004-(208+109+90) = 1.11, i.e. 95.5(26.6) deceased, still below the 142,6 v.s. (t = 3.1), and 124.3((56.61) retired. CANDIDATES ABROAD. The "Guide to Members of the Danish Medical Association (DMA) 2012-2013"[3] lists 617 members working abroad. Of these, 39 - one sixtenth - were candidates from the Sdu. Table 2 shows the true number being at least 208(64). The explanation is that students from other countries studied and graduated as medical doctors at the Sdu and returned to their home country - and most of them to Norway or Sweden (table 2) - without ever joining the DMA. Of the 405(219) whose occupation ultimo 2012 was not recorded, at least 56(25) came to the Sdu from superior high schools abroad, the 109(65) from Norway and the 90(60) from Sweden. So the number of candidates returning to their home country + Danish emigrants - 91(23) born in Denmark - is between 196(53) + 56(25) = 252(78) and 196(53) + 140(59) = 336(112), i.e. between 9 and 12 per cent of the medical graduates from the Sdu. This is more than five times the frequency recorded by (5) and two times that recorded by Garcia-Prez & al.13. DISTRIBUTION OF PHYSICIANS IN DENMARK. The Danish health system was up to 2007 administrated by 14 counties + the capital. This was 1st of January 2007 changed to five regions6. The Lorenz curve 2006 - the last year of the counties - for the distribution of 19,685 employed physicians a Gini index of 0.1583 as that 1998 for 16,036 employed physicians, but the counties of Vejle, Frederiksborg, and Roskilde had 2006 overtaken North Jutland (Figure 5, table 3). The highest numbers of physicians per 104 inhabitants were found in the counties harbouring medical schools, namely Copenhagen, Aarhus, and Funen (University of Southern Denmark). The difference between Bornholm and Ringkjoebing with 24.5 physicians per 104 inhabitants and Copenhagen with 60 per 104 was as large as the difference between some French Dpartements (Picardie) and le de France11,12 and larger than between provinces in the South and North of Spain, Gini index = 0.10313. The next year, 2007 the same number of physicians were distrubuted to the five new regions . This gave a more even distribution between the regions with extremes 27.54 physicians per 104 inhabitants and 48.65, Gini index = 0.1110 (Figure 6, table 4), hiding sparsely provided counties table 3, no.s 1-5 in the regions. The distribution of the physicians from Sdu, Odense is shown in figure 7 and table 5 resulting in a Gini index of 0.4749, repeated 2012: meaning that the distribution of this benefit is very skew : The low frequencies in regions 1-4 is set up by the two parts 5a. South Jutland and 5b. Funen of region 5. South Denmark (Figure 8). Also, the approximated parabola has R2 = 0.9273, considerably below that of figure 5: 0.999 and of figure 6: 0.9995. This distribution is rather stable. Out of the 2377 physicians from Sdu, Odense ultimo 2003, 562 changed occupational address during the next three years. Of these the 313 remained in the same region and the 206 in South Denmark, 150 moved to other regions and 84 came back; fifteen went abroad. Comparable figures were not available from the health faculties in Copenhagen and Aarhus. But the (postgraduate) education of specialists and their later affiliation is even more determined by their university of graduation14. Discussion. The data concerning the 4526 medical graduates have been used for prevalence investigations. The frequencies with time - c. 22 years - of general practitioners and of consultants, have stabilized at 50 and 41% resp. By 2006 1557 of 3055 candidates were specialists - 1/8 of the Danish specialists 200513. Thirteen consultants graduating before 1992 have changed to practitioners. Without ever asked when they became specialists, practitioners, or consultants, the candidates show the median times from graduation till these events on figures 1 and 4. The interval of three years between the surveys and the grouping of the graduates from six terms = three years has facilitated the finding of differences between the surveys: the increasing frequency of female medical students since 1993 - to some extent caused by the longer duration of their study - the up to 2003 increasing frequency of consultants, and the rationalization and abbreviation of education in general medicine. Nevertheless these specialists now constitute 38%. (2000: 40%, 2003: 39%), similar to Belgian and German figures15. Neither could these differences be predicted before the 2003-2006 surveys, nor can changes be predicted in the future when the number of graduates is increasing from appr.100 to 200 per year. New surveys will, therefore, be necessary and best with intervals of three years. Non-predictable changes such as the change of hospital administration from counties to regions may facilitate management of the health sector but has so far concealed differences of supply with physicians. Data electronics were mentioned in the METHODS section. Fortegnelsens resultater er brugt i debatten om medicin studerendes valg af speciale16 og om betydningen af en lgeskole for regionens bemanding med lger17, en effekt, der er iagttaget rundt om i verden18,19. Postscript. Foreign colleagues have contributed to the postgradute education in clinical microbiology of the medical graduates from the University of Southern Denmark. In the 1970'ies lectures were given by professor Zanen, University of Amsterdam, and by C.G.A. Borghans, head, Streeklaboraorium voor de Volksgezondheid, Nijmegen, and since 1998 by French microbiologists, one or two every year, invited by le Comit franco-danois de microbiologie Paul Horstmann . HYPERLINK http://www.inetuni2dkhomedskm.dk www.inetuni2dkhomedskm.dk References. Siboni K, Hrder M. Medical graduates from Odense University 1972-1998: recruitment and employment (in Danish). Ugeskr Lger 2000;162:1547-51. Siboni K. Medical graduates (candidates) 1972-2001 from the University of Southern Denmark, Odense 2nd ed. Geographical supply and distribution, length of study, postgraduate education, specialties, and main occupation. Dan Med Bull 2003;50:85-89. Siboni K. ed. Medical Science at Odense University , Odense Universitetsforlag 1991, 452 pp. (In Danish with summaries in English). Siboni K. ed. Medical Science at Odense University. New aspects 1993. Odense Universitetsforlag 1993, 227 pp. (In Danish with summaries in English). Lgeforeningens Vejviser 2006/2007 . Kbenhavn, Lgeforeningens Forlag 1056 pp. The Danish municipalities in the new regions. Politiken 1st Jan.2007, Indland p.5. Atkinson AB. On the measurement of inequality. J. Econ. Theory 1970;2:244-63. Gini C. Variabilit e mutabilit. 1912. Reprinted in Pizetti E, Salvemini T(eds). Memorie di metodologia statistica. Rome, Libreria Eredi Virgilia Veschi 1955. National Board of Health. Prognosis for the supply of physicians 2012-35, 2013 , 46 pp. , table 12 p.20 and p.24. Garcia-Prez MA, Amaya C, Otero A. Physicians' migrations in Europe: an overview of the current situation. BMC Health Serv. Res. 2007 Dec 10;7:201-208. Niel X. Les facteurs qui influencent la dmographie mdicale au niveau rgional. Cah.Socio Dmo Mdical 2001;41:141-47. Sandager L. Franske lgerkener. Ugeskr. Lger 2006;168/11:1154-56. Garcia-Prez MA, Amaya C, Lpez.Gimnez MR, Otero A. Physicians' geographical distribution in Spain and its evolution during the period 1998-2007. Rev Esp Salud Publica 2009;83(2):243-55. National Board of Health. Prognosis for the supply of physicians 2004-2025, 01.10.2006, 21 pp. Bourgueil Y, Durr U, Racamora-Houzard S. La rgulation dmographique de la profession mdicale en Allemagne, Belgique, Royaume-Uni, Quebec et tats-Unis. tude monographique. Cah Socio Dmo Md.2001;41:195-220, especially p. 218. Siboni K. Gender difference and choices of medical specialty. Debate. Ugeskr.Laeger 2011;173/43:2743-2744. Hansen C. , minister for By, Bolig og Landdistrikter. Svar 26.06.13 p skrivelse om at bruge yderomraaderne. Snadden D, Bates J,Burns P, Casiro O, Hays R, Hunt D, Towle A. Developing a madical school. Expansion of medical school capacity in new locations. AMEE Guide no. 55. Med Teach. 2011;33(7):518-529. Veitch C, Underhill A, Hays RB. The career aspirations and location intentions of James Cook University's first cohort of medical students. A longitudinal study at course entry and graduation. Rural Remote Health 2006;6:537-544. Table 1 : Duration of the medical study for males and females. S: summer, W: winter. 22.12.15 ks Terms and number of graduates< 4 years4 - 66 - 77 - 88 - 99 - 1010 - 11>11Mat.yr. Not availab.S72-S75 Males: 104 Fem.: 58 9 38 30 2 43 15 20 2 2 1 0 0 0 0W76-S76 Males: 40 Fem.: 17 0 0 5 2 23 6 5 4 3 3 3 1 0 0 1 0 0 1W80-W82 Males: 195 Fem.: 77 4 1 15 7 67 22 70 30 17 10 7 2 0 1 5 1 10 3W83-S83 Males: 48 Fem.: 30 2 0 2 2 10 4 20 16 3 4 3 1 1 1 1 0 6 2W84-S84 Males: 73 Fem.: 38 0 0 0 0 14 5 23 18 23 10 4 5 4 0 1 0 4 0S89-W93 Males: 155 Fem.: 145 4 2 8 6 49 60 56 49 12 18 14 4 7 1 4 5 1 0S93-W96 Males: 93 Fem.: 108 1 2 2 2 20 22 30 44 21 21 6 8 3 3 4 1 6 5S96-W99 Males: 91 Fem.: 145 2 3 4 5 21 20 37 64 16 28 2 13 2 2 5 3 2 7S99-W02 Males: 139 Fem.: 173 6 4 9 10 47 41 49 74 18 26 5 9 3 6 2 3 0 0S02-W05 Males: 194 Fem.: 256 5 7 10 6 80 90 68 111 23 25 3 8 2 3 0 2 3 4S05-S06 Males: 114 Fem.: 115 2 8 26 19 51 46 25 30 5 7 4 4 0 1 1 0 0 0W07-W14 Males: 577 Fem: 881 37 43 132 171 298 433 66 148 22 51 14 18 1 4 14 9 3 4Totals Males: 1833 Fem.: 2035  72 108 243 232 723 764 469 590 165 204 65 73 23 14 38 24 35 26Totals 3868 180 47514871059369138376261 Matriculation (Mat.)years were not available for the rest of the terms. Table 2. Main occupations 2000-2011. Siboni K. , 14.01.12 TermsS72-w2011S72-w2008S72-w2005S72-w02S72-w99Number, n1-40041-33461-28261-23761-2064Females,%4946444139Totals2012Totals2009Totals2006Totals2003Totals2000Practitioner739(311)691(256) 606(217)498(166)430(131)Abroad 43(7) 43(6) 34(4) 33(3) 32(3)City med.officer 23(15) 26(1) 22(16) 12(9) 10(5)Hosp. Physician 9(1) 9(1) 8(1) 13(2) 14(3)Consultant 857(316720(228) 580(158) 478(112)357(67)Abroad 44(11) 46(10) 45(8) 44(7) 43(7)Chief consultant 4(2) 5(2) 4(2) 2(0) 2(0)Head of center 2(0) 2(0) 3(1) 3(0) Dep.superintend. 177(93)149(76) 173(80) 172(74) 135(49)Abroad 5(1) 6(2) 6(1) 7(1) 6(1)Young physicians1468(866)1422(844) 1080(617)886(493) 866(459)Registrar1395(846)1194(657) 1031(589) 825(462)794(420)Ass.chief consult. 0 0 1(0) 1(0) 1(0)Cl.research assist. 15(7) 14(12) 17(12) 24(12) 29(19)Ph.d.student 51(7) 43(24) 27(14) 24(14) 24(14)Scholar 6(6) 3(3) 2(2) 10(5) 16(5)Project manager 1(0) 1(0) 2(0) 2(0) 2(1)Div. professions191(63) 179(61) 182(59) 172(57) 150(48)Acupuncturist0 4(1) 3(1) 4(2) 2(2)Medical officer6(2) 6(2) 7(2) 7(2) 8(3)Indust.med officer2(1) 2(1) 2(1) 3(0) 3(0)Soc.med. officer7(3) 6(2) 7(3) 5(2) 5(3)Airforce phys.1(0) 3(1) 4(1) 3(1) 1(1)Colonel M.C.2(1) 2(0) 0 2(0) 1(0)Major M.C.2(0) 1(1) 0 1(0) 1(0)Junior lecturer1(0) 3(0) 7(3) 6(3) 3(1)Assoc.professor13(4) 7(4) 8(1) 7(3) 8(1)Professor7(0) 7(0) 6(0) 5(0) 3(0)Scientific librarian2(1) 2(1) 3(1) 3(1) 2(1)Data engineer3(0) 2(0) 1(0) 1(0) 1(0)Farmer1(1) 1(1) 1(1) 1(1) 1(1)Director/Advisor26(3) 20(3) 19(4) 25(7) 18(5)Principal1(1) 1(1) 1(1) 1(1) 1(1)City/County Mayor 0 1(0) 1(0) 1(0)  !(0)Abroad122(46) 111(43) 112(40) 97(34) 91(29)Subtotals3460(1667)3203(1470)2658(1151)2236(913)1964(762) Unemployed 144(74) 36(27) 41(30) 36(22) 27(12)Not recorded 400(217) 107(39) 127(59) 104(46) 73(35)Grand totals4004(1954)3346(1536)2826(1240)2376(981)2064(809)Totals abroad 214(68) 206(61) 196(53) 181(45) 172(40)Hereoff in Norway 102(27) 99(28) 94(21) 78(17) 61(14)and in Sweden 67(18) 69(17) 67(16) 66(12) 64(12)Retired 113(52) 30(17) 30(17) 1(1) 0Deceased 93(25) 74(22) 50(15) 44(12) 37(12) Subsidiary occupations 2012 2009 2006 2003 2000 Clinical lecturer 89(20) 78(15) 71(15) 68(13) 71(14)Clinical professor 28(6) 15(3) 10(2) 5(0) 2(0)Practice consultant 0 0 0 2(0) 2(0) Table 3. Distribution of employed physicians in the Danish counties 2006. _______________________________________________________________________________ County Inhabitants Physicians, Per cent of physicians, pi, (cumulated) ni x 104 number per observed expected difference, 104 inhabitants di 1. Bornholm 4.33 24.25 0.53% 0.80% 0.27% 2. Ringkjbing 27.51 24.72 3.99 5.87 1.88 3. Viborg 23.49 25.54 7.04 10.19 3.15 4. Ribe 22.43 25.55 9.94 14.33  4.39 5. South Jutland 25.24 26.15 13.30 18.98 5.68 6. West Zealand 30.72 27.83 17.64 24.64 7.00 7. Storstrmmen 26.28 28.31 21.42 29.48 8.06 8. North Jutland 49.51 28.76 28.66 38.60 9.94 9. Roskilde 24.15 29.98 32.33 43.05 10.7210. Frederiksborg 37.87 30.29 38.16 50.03 11.87 11. Vejle 36.09 31.86 44.00 56.68 12.6812. Funen 47.83 38.41 53.34 65.49 12.1513. Aarhus 66.14 41.57 67.31 77.68 10.3714. Copenhagen 61.85 49.60 82.89 89.07 6.1815. Frederiksberg +Copenhagen city 59.30 56.80 100.00 100.00 0.00Totals542.75 36.27Faroe Islands 4.8 19.17Greenland 5.7 16.14 15 Gini index = ( ni x di / ( x 542.75 x 100) = 4102,3639/27137,5 = 0.1512. i=1 15 b. Gini index = ( ni x (di + di-1) / ( x 542.75 x 100) = 4294.9301/27137,5 = 0.1583. i=1 Table 4. Distribution of employed physicians in the Danish regions 2007. ________________________________________________________________________________ Region Inhabitants Physicians, Per cent of physicians, pi , (cumulated) ni x 104 number per observed expected difference, 104 inhabitants di 1. North Jutland 57.7 27.54 7.81% 10.63 2.82%2. Zealand 81.2 29.62 19.64 25.58 5.943. South Denmark118.6 34.22 39.59 47.43 7.844. Mid-Jutland122.0 35.57 60.92 69.90 8.985. Capital163.4 48.65100.0 100.00 0.00Totals542.9 37.47Faroe islands 4.8 19.58Greenland 5.7 16.67 5 a. Gini index = ( ni x di / ( x 542.9 x 100) = 2670.43 / ( x 542.9 x 100) = 0.09838. i=1 5 Gini index = ( ni x (di + di-1) / x 542.9 x 100) 3013.853/( x 542.9 x 100) = 0.1110, i=1 and 542.9 calculated as +" (100x/542.9 - (0.000118x2 + 0.1184x + 0.4567) dx / ( x 542.9 x 100)= 0.1159. 0 Table 5. Distribution 2007 on the Danish regions of employed physicians graduated from the University of Southern Denmark (USD), Odense. ______________________________________________________________________________ Region Inhabitants Physicians, Physicians Per cent of physicians from USD ni x 104 number and number per pi (cumulated) difference frequency 104 inhabitants observed expected di 1. Zealand 81.2 133(66), 0.055 1.64 5.38 14.95  9.572. Capital 163.4 329(164), 0.041 2.01 18.68 45.05 26.373. NorthJutland 57.7 123(56), 0.077 2.13 23.67 55.68 32.014. Mid-Jutland 122.0 326(145), 0.075  2.67 36.85 78.15 41.305. South Denmark 5a.South Jutland 70.8 532(245), 0.240  7.55 58.37 91.20 32.835b. Funen 47.8 1029(449), 0.560 21.53100.0 100.0 0Totals 542.92472(1125), 0.120 4.55Faroe Islands 4.8 7(3), 0.074 1.46Greenland 5.7 8(1), 0.084 1.40Abroad 197Not recorded 142Totals2826In parenthesis: Females. 6 a. Gini index = ( ni x di / ( x 542.9 x 100) = 14295.88 / 27145 = 0.5266 i=1 6 b. Gini index = ( ni x ( di + di-1 ) / ( x 542.9 x 100) = 12889.85 /27145 = 0.4749. i=1 There are 4.5 times as many Odense candidates to the West of the Big Belt, increasing From 3.North to 5.South, with 298.3 x 104 inhabitants, as to the East of the Big Belt, Metropolis and Zealand with 244.6 x 104 inhabitants. And there are relatively more males, 0.555 compared to 0.502; chi2 = 4.1873, f = 1, 0.02 < P < 0.05, or t = 2.0427, f = 2472, 0.02 < P < 0.05. Table 6, Distribution 2012 on the Danish regions of 4004 employed physicians graduated from the University of Southern Denmark (USD), Odense. ______________________________________________________________________________ Region Inhabitants Physicians, Physicians Per cent of physicians from USD ni x 104 number and number per pi (cumulated) difference frequency 104 inhabitants observed expected di 1. Metropolis 171.5 462(244), 0.054 2.69 13.72 30.73  17.012. Vestsjlland 81.8 242(122), 0.094 2.95 20.91 45.39 24.483. Nordjylland 58.0 178(80), 0.101 3.07 26.19 55.78 29.594. Midtjylland 126.7 413(194), 0.087  3.25 38.45 78.48 40.035. Syddanmark 5a.Sdr.Jylland 71.6 704(354), 0.305  9.83 59.35 91.31 31.965b. Fyn 48.5 1369(665), 0.647 28.23100.0 100.0 0Totals 558.13368(1659), 0.151 6.03Frerne 4.9 10(6), 0.105 2.04Grnland 5.7 13(7), 0.146 2.28Abroad 208(64) Not recorded 405(219)Totals4004In parenthesis: Females. 6 Gini index =  ni x di / ( x 558.1 x 100) = 14295.88 / 27905 = i=1 6 Gini index =  ni x ( di + di-1 ) / ( x 558.1 x 100) = 12486.28 /27905 = 0.4475. i=1 The were 3.8 times as many Odense candidates to the West of the Big Belt, increasing From 3.North to 5.South, with 304.8 x 104 inhabitants, as to the East of the Big Belt, Metropolis and Zealand with 253.3 x 104 inhabitants. The frequencies of males were 0.51 and 0.52. Legends of figures: Figure 1. App. 90% became medical specialists. Females were one year later than males . 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Figure 2. 1974 - 2010 there were 125 male and 78 female doctors on nearly identical paraboles. Figure 3. The females were two - several years later. Figure 4. The maxima for consultants increased 1997 - 2012 and for deputy superintendents 1997-2006 . The median time before becoming a general practitioner was reduced from 15 to eight years for the graduates 1989 and later Figures 5 - 8: See tables 3 - 6.     PAGE 1 PAGE 20 '(2  1235689;<>?JKLXYZ[\h]h&`#$?@FGHIJLMSTVWXZ[\heCJmH sH h,>h(k0JmHnHuhehe0JmHnHu he0Jjhe0JU,&P . 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