Proactive personality and career crafting in Chinese medical professionals: a conditional process model of occupational stigma and organizational career management.

Background: Against the backdrop of healthcare reforms in China, medical professionals are increasingly required to manage their careers proactively. Proactive personality is associated with proactive career behaviors, while occupational stigma, a prevalent stressor, may shape career perceptions and choices. Despite its potential relevance, it remains unclear whether organizational career management may serve as a supportive contextual factor in such circumstances. This cross-sectional exploratory study examines the mediating role of career exploration and decision-making self-efficacy (CEDSE) in the relationship between proactive personality and career crafting, as well as the joint conditional associations of occupational stigma and organizational career management with this mediating pathway, drawing on Social Cognitive Career Theory and Cognitive Appraisal Theory of Stress. Methods: A convenience sample of 308 medical professionals working at county-level and grassroots healthcare institutions in Southwest China was recruited. Survey data were analyzed via SPSS 24.0, AMOS 22.0, and the PROCESS macro. Results: Proactive personality was positively associated with career crafting. CEDSE mediated the association between proactive personality and career crafting. Although the two-way interaction between occupational stigma and CEDSE reached marginal significance, the positive relationship between CEDSE and career crafting was more pronounced under higher levels of occupational stigma. Further three-way interaction analysis indicated that organizational career management was associated with a stronger conditional pattern. The overall index of moderated moderated mediation was statistically significant, suggesting that the indirect association of proactive personality with career crafting via CEDSE varies jointly with occupational stigma and organizational career management. Conclusion: This study provides preliminary cross-sectional evidence for the association between proactive personality and career crafting mediated by CEDSE. The indirect association tends to be stronger under high occupational stigma, especially when accompanied by sufficient organizational career management support. Building on two complementary theoretical perspectives of individual agency and organizational context, this framework offers tentative theoretical insights and research references for understanding career adaptation among medical professionals. It also provides exploratory implications for healthcare institutions seeking to build supportive working environments and address occupational stigma.