Changes in U.S. medical students' specialty interests over the course of medical school

J Gen Intern Med. 2008 Jul;23(7):1095-100. doi: 10.1007/s11606-008-0579-z.


Background: Studies have examined factors affecting medical students' specialty choice, but little research exists on stability of these specialty interests.

Objective: To describe patterns of change in specialty interests during medical school and examine associations between specialty change patterns and gender, desire for a high-prestige career, and interest in prevention.

Design: Medical students (Class of 2003) at 15 representative US schools were invited to complete surveys during freshman orientation, entry to wards, and senior year.

Participants: This analysis used data from 942 students who completed all 3 surveys.

Measurements: In addition to a number of other items, students were asked to choose the 1 specialty they were most interested in pursuing.

Results: The most common specialty choices among freshman students were pediatrics (20%) and surgery (18%); least common choices were psychiatry and preventive medicine (1% each). General internal medicine was the initial specialty choice for 8%. Most students changed their specialty choices, regardless of initial interest. Only 30% of those initially interested in primary care (PC) remained interested at all 3 time points, compared to 68% of those initially interested in non-PC. Female versus male students were more commonly interested in PC at all 3 time points. Senior students interested in non-PC specialties were more likely to desire a high-prestige career (48%) than those interested in PC (31%).

Conclusions: Medical students may benefit from more intensive introduction to some specialties earlier in pre-medical and medical education. In addition, increasing the prestige of PC fields may shape the physician workforce.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Career Choice*
  • Data Collection
  • Female
  • Humans
  • Male
  • Primary Health Care*
  • Students, Medical*
  • United States