Abstract
Objectives Competitiveness is a pivotal psychological construct driving motivation and professional development in medicine. While it can foster lifelong learning, maladaptive competitiveness is linked to physician burnout. Despite its significance, empirical evidence on the competitiveness of physicians in non-Western medical systems remains scarce. This study aimed to examine the distribution of competitiveness across medical specialties and its association with demographic, professional, and socioeconomic factors in a large nationwide cohort of Japanese physicians. Materials and methods We conducted a nationwide cross-sectional study in June 2022 using an online survey platform. A total of 5,441 practicing physicians (median age: 48 years) from various specialties and practice settings were included. Competitiveness was assessed using a validated 20-item scale (possible range: 20-140). Multivariable linear regression analysis was performed to identify independent factors associated with competitiveness scores after adjusting for age, gender, medical specialty, workplace characteristics, and socioeconomic background. Results The mean total competitiveness score was 58.79 (SD: 10.52). Scores differed significantly across specialties: junior residents exhibited the highest scores (M=62.17), followed by plastic surgeons (M=61.94), while psychiatrists showed the lowest (M=57.03) score. Multivariable analysis confirmed that junior residents (β=1.65; 95% CI: 0.06-3.24; p=0.042) had significantly higher scores, while psychiatrists (β=-1.68; 95% CI: -2.83 to -0.51; p=0.005) had lower scores compared to internal medicine practitioners. Other independent correlates of higher competitiveness included older age (β=0.05; p<0.001), male gender (β=2.37; p<0.001), working in large hospitals (≥300 beds: β=1.02; p=0.011), having children (β=0.98; p=0.006), and higher parental household income (β=1.11; p=0.003). Conclusions Physician competitiveness in Japan is a multidimensional construct influenced by career stage, professional culture, and personal background. Although differences across specialties are statistically significant, the overall variation and effect sizes are relatively modest. Given the cross-sectional design, these findings suggest that competitiveness is a widely observed but potentially dynamic characteristic, rather than a fixed or stable professional trait. These findings provide foundational insights for medical educators and policymakers to design career support systems that balance professional excellence with psychological well-being.