Vascular surgery has relied upon the pool of general surgical residents for candidates for residency. This has significantly limited the pool of applicants. With the advent of new primary certificate training paradigms, we investigated factors that might alter the career choices for women medical students. A Web-based survey was conducted of third-year and fourth-year medical students at three university-affiliated programs. A total of 140 students completed the survey, which identified the third year of medical school as the primary year when students committed to a final career choice. Lifestyle issues were the primary deterrents, with long work hours and lack of time to see family negatively influencing students' interest in surgery. Eliminating the need for 5 years of general surgery and the opportunity for part-time training were cited as factors that would alter students' decisions to pursue vascular surgery. Ultimately, a positive rotation experience, lifestyle issues, and mentors impacted on final career decisions. To attract the best applicants to the field, we need to continue to be active in mentoring students and exploring alternative training paths and eventual career practices.