Factors Influencing a Medical Student's Choice of Specialty

Background: Specialty selection by medical students is a complex decision driven by many factors. The goal of this study was to understand and quantify factors of primary importance as assessed by the students themselves when choosing a medical specialty. Materials and Methods: One hundred and forty five of 230 (63%) medical students in Year 2 at Texas College of Osteopathic Medicine completed an online survey using Qualtrics. The 38 question survey was used to collect demographics and most desired specialty choices at time of survey. Students were also asked to rate the importance of 27 pre-selected factors involved in specialty choice. Responses were measured on a likert scale of 0 (very uninfluential) to 10 (very influential). The same online survey was dispersed in Year 3 after clinical rotations were complete (n=92, 40% response rate). Principal factor analysis with promax rotation was conducted to calculate eigenvalues and generate scree plots for determining the most appropriate factor solution. Results: Seventy three participants completed the pre-rotation survey and a subsequent post-rotation survey. Over half (59%) were female, 63% were Caucasian, and ages ranged from 22 to 38 years old. The top specialty choices prior to Year 3 rotations was Dermatology and Neurology; choices changed to Family Practice and OB/GYN or Pediatrics after Year 3 rotations. The highest ranking factor influencing choice of specialty was having a positive Year 3 rotation followed by the ability to do major and minor procedures within their field of choice. Ten of 25 factors assessed decreased in importance significantly after post rotation. Four factors with eigenvalues [greater than] 1 accounted for 85.4% of common variance. These factors explained the largest variances across the 25 factors and included academic performance, personal value, early role model, and future time investment. Conclusions: Factors influential in determining specialty choice change after year 3 clinical rotations. The results of this research can be utilized by medical schools as a platform to adapt to the education of this generation of medical students.