Factors Influencing the Choice of Specialty by Medical Students in a new University in Rwanda

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Understanding the factors influencing these preferences is essential for shaping career guidance, aligning education with national health priorities, and mitigating gaps in critical specialties. Methods: A cross-sectional study was conducted among all medical students at the University of Global Health Equity, Rwanda, between March and April 2025 using a self-administered questionnaire. The questionnaire explored participants' specialty preference and factors influencing their choice of specialty. Results A total of 197 respondents completed the survey. Seventy-six (42%) of the participants indicated that they had made their decision and 109 (58%) had not yet fully decided on the specialty of choice. Surgery (27.6%) and pediatrics (19.4%) were the top two specialties preferred by the respondents. Four factors that were seen as important in determining their choice of specialty were: 1) personal interest, 2) work-life balance, 3) job opportunities, and 4) financial rewards in the specialty. Most decisions were made during clinical years. Conclusion A significant number of students remained undecided about their specialty, with personal interest being the most influential factor. Surgery and pediatrics were the most preferred specialties, while critical fields like psychiatry and emergency medicine were underrepresented. These findings highlight the need for early career guidance and alignment medical training with national health priorities. specialty preference specialty choice factors medical students UGHE Rwanda Background The specialty preferences and choices of medical students have direct implications on future workforce composition, future healthcare delivery, workforce distribution, and policy planning ( 1 ). Identifying the factors that shape these preferences is critical for informing career guidance, aligning training programs with national health priorities, and addressing imbalances in specialty distribution ( 2 , 3 ). The choice of a medical specialty is influenced by a complex interplay of personal motivation and contextual factors. Intrinsic drivers such as intellectual interest, clinical engagement, and perceived fulfillment are often weighed alongside extrinsic considerations such as income expectations, job security, work-life balance, mentorship and societal norms ( 4 ). Demographic variables such as age, gender, clinical exposure, competitiveness of specialties, and availability of residency training programs further contribute to decision-making ( 5 , 6 ). These factors often vary by context. In Rwanda, a study has shown that intellectual challenge, interaction with residents, and core clerkship experiences significantly influenced students’ choices, with gender differences also evident in how students valued research opportunities or responded to negative training experiences ( 7 ). Such findings highlight the importance of local context in shaping medical career trajectories. The Rwandan healthcare system has experienced notable transformation in recent years, marked by ambitious initiatives such as the "Four by Four" program, which seeks to quadruple the number of healthcare providers within four years ( 8 ). This effort emerged in response to Rwanda's continued shortfall relative to the WHO-recommended healthcare worker density of 4.45 per 1,000 population ( 9 ); at present, Rwanda has approximately 1 healthcare worker per 1,000 people ( 8 ). In parallel, institutions like the University of Global Health Equity (UGHE) are contributing to workforce development by training physicians through a curriculum that emphasizes social medicine, health equity, and global health. These national and institutional efforts may shape medical students’ specialty preferences in ways that are distinct from those in other contexts. This study explored the specialty preferences and influencing factors among UGHE medical students. The findings aimed to inform educational strategies, guide workforce development, and contribute to evidence-based health planning in Rwanda. Methods Objectives of the study were to : Determine the preferences of medical specialty by medical students at UGHE Determine the factors that influence the choice of medical specialty by medical students at UGHE Study setting and design The University of Global Health Equity (UGHE) offers a dual-degree Bachelor of Medicine, Bachelor of Surgery/Master in Global Health Delivery (MBBS/MGHD) program designed to train medical professionals committed to serving underserved and remote communities. The medical curriculum is divided into four main phases: a preparatory phase designed to help students manage the transition into a rigorous medical curriculum, a biosocial foundations of medicine phase where students acquire foundational knowledge and skills in the basic medical sciences, a clinical and health delivery phase consisting of two and a half years of hands-on clinical rotations that focus on the application of this knowledge in real-world patient care, and a final Exploration and development phase. UGHE emphasizes community engagement, social medicine, and global health principles, reflecting its mission to prepare graduates to address health disparities in resource-limited settings A cross-sectional quantitative study design was used in this study, utilizing a self-administered online questionnaire. Sample A census sampling was conducted to invite all 214 medical students at UGHE in 2025 to the survey. Data collection tool The online survey used in this study consisted of three sections. Section A included basic demographics and background information; section B assessed students preferred medical specialties; and section C examined the factors influencing their choices. The questionnaire was developed specifically for this study based on a review of relevant literature and expert input. Data collection procedure An online survey was emailed to all medical students enrolled at UGHE and was open for two months from March to April 2025. Key measures Our study had two key measures: Specialty preferences – the percentage of the respondents’ specialty of choice for the already decided and not fully decided participants. The factors that influenced the preference of specialty. The percentage of respondents choosing “important” and “very important”, as well as the percentage of choosing “slightly important” and “not important” for each factor. Data analysis Descriptive statistics were used to summarize the demographics and all key measures. Chi square test was used to analyse the association between key measures and demographic variables. All statistical analyses were conducted using SPSS version 24, with P-value set at 0.05. Results A total of 197 respondents completed the survey, translating to a 92% response rate. The mean age was 22 (range 18–30), 146 (74.1%) were female, 66 (33.5%) were in their second year of medical school, and 172 (87.3%) were from Rwanda. One hundred fifty-five (78.7%) came from middle-income families, 170 (86.3%) were the first to study medicine as a profession amongst their first-degree relatives, and 123 (62.4%) came from urban settings. Eighty-five (52.8%) prefer to specialize outside of Rwanda, while 71 (44.1%) are comfortable with training either in Rwanda or outside Rwanda. One hundred fourteen (72.2%) are either very confident or somewhat confident in choosing the right specialty and 132 (85.2%) reported feeling very comfortable working in rural or underserved areas after their specialization (Table 1 ). Table 1 Sociodemographic and background information N (%) Sample 197 Sex Male 51 (25.9%) Female 146 (74.1%) Year of study Sixth 29 (14.7%) Fifth 29 (14.7%) Fourth 33 (16.8%) Third 40 (20.3%) Second 66 (33.5%) Nationality Rwanda 172 (87.3%) International* 24 (12.2%) Income High 33 (16.8%) Middle 155 (78.7%) Poor 9 (4.6%) First in family study medicine No 27 (13.7%) Yes 170 (86.3%) Family location Urban 123 (62.4%) Rural 74 (37.6%) Time participants started considering their future specialty Before med school 63 (37.1%) Pre-clinical 44 (25.9%) Clinical 56 (32.9%) Internship 7 (4.1%) Preferred location of specialty training Rwanda 5 (3.1%) Abroad 85 (52.8%) Either 71 (44.1%) Confidence in their selection (Very/somewhat) confident 114 (72.2%) (Very/somewhat) uncertain 14 (8.9%) Would you consider working in rural or underserved areas Yes 132 (85.2%) No 23 (14.8%) * Burundi, DRC, Lesotho, Tanzania, Uganda, Liberia, Malawi, Sierra Leone While all respondents provided their specialty preference, 76 (42%) indicated that they had made their decision and 109 (58%) had not yet fully decided. The top two specialties preferred by the respondents were surgery (n = 52, 27.6%) and pediatrics (n = 36, 19.4%) (Table 2 ). Table 2 Specialty preferences of the participants Decided Not fully decided Total Surgery 28 (36.8%) 24 (22.6%) 52 (28.6%) Pediatrics 18 (23.7%) 18 (17%) 36 (19.8%) Global Health 2 (2.6%) 19 (17.9%) 21 (11.5%) Internal Medicine 5 (6.6%) 12 (11.3%) 17 (9.3%) Dermatology 5 (6.6%) 11 (10.4%) 16 (8.8%) Oncology 2 (2.6%) 8 (7.5%) 10 (5.5%) Ophthalmology 3 (3.9%) 6 (5.7%) 9 (4.9%) Obstetrics and gynecology 6 (7.9%) 2 (1.9%) 8 (4.4%) Radiology 2 (2.6%) 1 (0.9%) 3 (1.6%) Emergency 2 (2.6%) 0 (0%) 2 (1.1%) Dentistry 2 (2.6%) 0 (0%) 2 (1.1%) ENT 1 (1.3%) 0 (0%) 1 (0.5%) Anesthesiology 0 (0%) 1 (0.9%) 1 (0.5%) Psychology 0 (0%) 1 (0.9%) 1 (0.5%) Other 0 (0%) 3 (2.8%) 3 (1.6%) Total 76 (42%) 109 (58%) 185 More than 60% of respondents identified four key factors that were important or very important in influencing their specialty choice: 1) personal interest (75.2%), 2) work-life balance (66.5%), 3) job opportunities (66%), and 4) financial rewards in the specialty (61.9%). While two factors were seen as least influential to their specialty choice, less than 30% of respondents indicated they were important or very important: 1) family expectations (22.8%), and 2) prestige associated with the specialty (24.9%) (Table 3 ). Table 3 Factors that influence the specialty preference Not important/slightly important Important/very important Personal interest in the specialty 2 (1%) 148 (75.2%) Work-life balance 12 (6.1%) 131 (66.5%) Job opportunities 7 (3.5%) 130 (66%) Financial rewards in the specialty 17 (8.6%) 122 (61.9%) Length of training required 24 (12.2%) 103 (52.3%) Influence of mentors/supervisors 39 (19.8%) 79 (40.1%) Opportunity to work in rural/underserved areas 51 (25.9%) 60 (30.5%) Availability of the program 81 (50.3%) 80 (49.7%) Prestige associated with the specialty 55 (28%) 49 (24.9%) Family expectations 77 (39.1%) 45 (22.8%) Students in clinical years had 4.5 higher odds than those in pre-clinical years in making the decisions on the specialty of their preference (Unadj OR = 4.5, P < 0.001). Students who have more confidents in their ability to choose the specialty were 6.4 times more likely to have made their decisions compared to those who were not confident (Unadj OR = 6.4, P = 0.01) (Table 4 ). Table 4 Association between decision status and year of study and confidence in choosing a specialty Decided Not decided Unadj OR P-value Year of study Pre-clinical years 25 (32.9%) 75 (68.8%) Ref < 0.001* Clinical years 51 (67.1%) 34 (31.2%) 4.5 Confidence in choosing a specialty Not confident 2 (14.3%) 12 (85.7%) Ref 0.01* Confident 59 (51.8%) 55 (48.2%) 6.4 No significant statistical differences were found whether they are first to study medicine in family or not in determining the time they considered the specialty (P = 0.577) or their confidence in choosing the specialty (P = 0.521) (Table 5 ). Table 5 Association between the first in family to study medicine status and time to consider specialty and confidence First in family to study medicine Other family members studied medicine P-value When considered Before med school 56 (37.8%) 7 (31.8%) 0.577 Pre-clinical 40 (27.0%) 4 (18.2%) Clinical 46 (31.1%) 10 (45.5%) Internship 6 (4.1%) 1 (4.5%) Confidence in choosing a specialty Confident 15 (93.8%) 99 (88.4%) 0.521 Not confident 1 (6.3%) 13 (11.6%) No significant statistical differences were found between their year of study and their confidence in choosing the specialty (P = 0.209) (Table 6 ). Table 6 Association between year of study and confidence in choosing a specialty Year of study P-value Pre-clinical years Clinical years Confidence in choosing a specialty Not confident 9 (64.3%) 5 (35.7%) 0.209 Confident 53 (46.5%) 61 (53.5%) Two factors were found to have significant difference between male and female medical students in deciding their specialty of preference: 1) male students were less likely to found the length of training as an important factor in deciding the specialty compared to female (unadj OR = 0.32, P = 0.012), and 2) male students were 2.75 times more likely to found the influences of mentors or supervisor as an important factor in deciding the specialty compared to female (unadj OR = 2.75, P = 0.044) (Table 7 ). Table 7 Association between gender and importance of factors that influence the choice of specialty M F Unadj OR P-value Personal interest in the specialty Not important/slightly important 0 (0%) 2 (1%) NA > 0.999 Important/very important 41 (0.277%) 107 (0.723%) Work-life balance Not important/slightly important 4 (33.3%) 8 (66.7%) NA 0.416 Important/very important 30 (22.9%) 101 (77.1%) Job opportunities Not important/slightly important 3 (43.9%) 4 (57.1%) NA 0.281 Important/very important 32 (24.6%) 98 (75.4%) Financial rewards in the specialty Not important/slightly important 6 (35.5%) 11 (64.7%) NA 0.388 Important/very important 31 (25.4%) 91 (74.6%) Length of training required Not important/slightly important 12 (50%) 12 (50%) Ref 0.012* Important/very important 25 (24.3%) 78 (75.7%) 0.32 Influence of mentors/supervisors Not important/slightly important 6 (15.4%) 33 (84.6%) Ref 0.044* Important/very important 26 (32.9%) 53 (67.1%) 2.75 Opportunity to work in rural/underserved areas Not important/slightly important 16 (31.4%) 35 (68.6%) NA 0.585 Important/very important 16 (31.4%) 44 (73.3%) Availability of the program Not important/slightly important 21 (26.3%) 59 (73.8%) NA NA Important/very important 21 (26.3%) 59 (73.8%) Prestige associated with the specialty Not important/slightly important 16 (29.1%) 39 (70.9%) NA 0.953 Important/very important 14 (28.6%) 35 (71.4%) Family expectations Not important/slightly important 24 (31.2%) 53 (68.9%) NA 0.288 Important/very important 10 (22.2%) 35 (77.8%) Discussion This study examined medical specialty preferences and the factors influencing career decision-making among students enrolled at the University of Global Health Equity (UGHE) in Rwanda. A key finding was that a majority of respondents (58%) had not yet selected a preferred specialty, reflecting the uncertainty characteristic of early-stage medical education. This indecision was more prevalent among preclinical students, suggesting that clinical exposure is a critical determinant in shaping career interests. These results are consistent with findings from previous studies in Rwanda and across sub-Saharan Africa, which highlight the influence of clinical rotations and mentorship on specialty choice ( 6 , 7 ). Surgery emerged as the most commonly preferred specialty (28.6%), followed by pediatrics (19.8%). These preferences are consistent with trends reported in other African countries, where surgical and pediatric specialties frequently rank among the top choices for medical students ( 10 – 13 ). Specifically, close to 30% of students expressed a preference for surgical careers in Nigeria and Ethiopia ( 10 , 11 ), while pediatrics was also highly ranked by medical students as their preferred specialty in Botswana, Congo, and Cameroon ( 12 , 13 ). Personal interest was the most important factor in specialty decision-making. This finding aligns with global literature underscoring the importance of intrinsic motivation in career selection ( 2 , 3 ), as well as regional studies in Nigeria and Botswana ( 10 , 13 ). In contrast, factors such as prestige and family expectations were rated as less influential, corroborating the findings of a recent systematic review of 152 African medical schools ( 14 ). These results suggest that intrinsic motivations such as personal interest and alignment with professional values may play a more prominent role than external pressures in shaping specialty preferences among medical students in the region. The findings revealed that students in clinical years were significantly more likely to have selected a specialty (p < 0.001), highlighting the important role of clinical exposure in shaping career choices. Engagement in clinical rotations provides students with direct experience in various specialties, allowing them to observe professional roles, interact with mentors, and gain practical insight into the day-to-day realities of medical practice. This hands-on exposure helps students make more informed decisions by aligning their interests with the demands and culture of specific fields. Such results aligned with previous research suggesting that access to reliable career information is an essential component in shaping informed specialty preferences ( 15 ). Gender-based differences were observed in the importance assigned to specific influencing factors. Male students were less likely to consider the duration of training as important in their specialty choice, while female students were less likely to identify the influence of mentors or supervisors as a key factor. These findings highlight the nuanced ways in which gender may shape career decision-making and point to the need for tailored guidance and support strategies within medical education. Efforts to ensure equitable access to mentorship and to address gender-specific concerns such as training length or role modeling remain essential for fostering an inclusive and responsive learning environment ( 15 , 16 ). A notable proportion of students (52.8%) expressed a preference to pursue postgraduate training abroad, while 44.1% were open to either local or international options. This reflects a broader trend seen in African medical schools and may be driven by perceptions of higher training quality or greater career opportunities overseas ( 12 , 13 ). However, this inclination raises concerns regarding potential brain drain and highlights the importance of strengthening domestic postgraduate training programs. The results of the study also showed that the underrepresentation of essential specialties such as psychiatry, emergency medicine, and anesthesiology points to a persistent mismatch between student interests and national health workforce needs. Similar imbalances have been reported in both high- and low-income settings ( 17 , 18 ). Addressing these gaps will require coordinated strategies, including early exposure to critical specialties, financial and professional incentives, and alignment of postgraduate training with national health priorities ( 19 ). Implications for medical education and workforce planning This study offers important insights for medical education and health workforce planning in Rwanda. The high proportion of students undecided about their specialty points to the need for more structured career guidance. Integrating career counseling, mentorship, and broad specialty exposure into the preclinical curriculum could support students in making more informed and confident decisions. The strong influence of personal interest and perceived job opportunities on specialty choice highlights the importance of aligning medical training with both student aspirations and national health system needs. While fields such as surgery and pediatrics continue to attract the most interest, critically underrepresented specialties, including psychiatry, emergency medicine, and anesthesia, remain overlooked. Promoting interest in these fields may require targeted interventions such as clinical rotations in underserved specialties, mentorship by practitioners in these areas, and incentive structures that make these careers more appealing. A notable proportion of students expressed a preference for postgraduate training abroad. This reflects both the perceived quality and appeal of international programs, as well as concerns about the availability and competitiveness of local training opportunities. Strengthening in-country residency programs through faculty development, infrastructure investment, and academic partnerships could enhance their attractiveness and reduce reliance on external training. Complementary policies such as bonded scholarships, rural service incentives, and guaranteed placements may further support retention of trained professionals within the national health system. Gender-based differences in specialty decision-making also emerged, underscoring the need for gender-sensitive educational and workforce policies. Supporting women through mentorship, flexible training pathways, and family-friendly environments can help ensure equitable access to all specialties and strengthen diversity within the health workforce. Limitations of the study This study adds to the body of literature on medical student specialty preferences in Rwanda. The high response rate and inclusion both preclinical and clinical students enabled comparisons across different stages of training, and the examination of a wide range of influencing factors provided a more comprehensive understanding of career decision-making. However, the results of this study must be viewed in light of some limitations. The cross-sectional design restricts the ability to draw causal inferences, and longitudinal studies would be more appropriate for tracking how preferences evolve and influence actual career trajectories. Additionally, the study was conducted at a single institution –UGHE- which, while distinct in its mission and curriculum, may not reflect the broader population of medical students in Rwanda or the region. Therefore, caution should be exercised when generalizing the results. Future research should employ multi-institutional or longitudinal study to capture a more representative and the change in medical students’ career preferences. Recommendations and conclusion The findings of this study suggest several key actions to improve medical education and inform future workforce planning in Rwanda and similar contexts. First, there is a need to integrate structured career guidance and mentorship into the early stages of medical education. Providing students with systematic exposure to a broad range of specialties - including those currently underrepresented - can support more informed, confident, and reflective career decision-making. Second, efforts should focus on strengthening the quality, visibility, and competitiveness of all local postgraduate training programs. This can be achieved through targeted investments in faculty development, infrastructure, and strategic partnerships with both regional and international academic institutions. Enhancing the appeal and perceived value of domestic residency training may also help reduce the preference for pursuing specialization abroad. Third, addressing gender disparities in specialty selection requires the implementation of gender-sensitive policies. These may include fostering inclusive academic environments, ensuring access to female mentorship, and creating flexible and family-friendly training pathways to support equitable participation in all specialties. In addition, aligning medical training more closely with national health priorities is essential. Policymakers and educational institutions should work collaboratively to develop incentive schemes such as rural service bonuses, bonded scholarships, and guaranteed placement opportunities that encourage students to pursue careers in high-need specialties. Finally, future research should adopt longitudinal designs to track how students’ preferences evolve throughout their training and transition into actual career choices. Expanding this research across multiple institutions will provide a more comprehensive and representative understanding of medical education trends in the region, thereby strengthening the evidence base for sustainable and context-specific interventions. Abbreviations UGHE University of Global Health Equity MBBS/MGHD Bachelor of Medicine and Bachelor of Surgery/ Master of Science in Global Health Delivery SPSS Statistical Package for the Social Sciences Declarations Ethics approval and consent to participate Ethics approval granted by University of Global Health Equity’s Institutional Review Board (Protocol’s reference number: UGHE-IRB/2025/371). Written informed consent to participate was obtained from each participant. The research was conducted following standards in accordance with the Declaration of Helsinki. Consent for publication Not Applicable Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request Competing interests None Funding No funding was acquired for this study Author information: Authors and affiliations University of Global Health Equity; Kigali Heights, Plot 772; KG 7 Ave., 5th Floor; PO Box 6955 Contributions AB conceived the study; AB and HM designed the work; HM acquired the data; HM analysed the data; AB and HM interpreted the results, and HM drafted the original manuscript. AB and HM revised the manuscript, approved the submitted version of this manuscript and agreed to be accountable for their contributions. Acknowledgements The authors wish to thank the participants of this study for sharing their time and experiences. 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Supplementary Files Datacollectiontool.docx Cite Share Download PDF Status: Published Journal Publication published 03 Mar, 2026 Read the published version in BMC Medical Education → Version 1 posted Editorial decision: Revision requested 29 Aug, 2025 Reviews received at journal 12 Aug, 2025 Reviews received at journal 05 Aug, 2025 Reviewers agreed at journal 21 Jul, 2025 Reviewers agreed at journal 20 Jul, 2025 Reviewers agreed at journal 19 Jul, 2025 Reviewers invited by journal 17 Jul, 2025 Editor invited by journal 16 Jul, 2025 Editor assigned by journal 11 Jul, 2025 Submission checks completed at journal 11 Jul, 2025 First submitted to journal 04 Jul, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7048690","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":488554973,"identity":"fe4b1947-ccf3-4a27-a220-833a423f27bc","order_by":0,"name":"Heritier Mfura","email":"data:image/png;base64,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","orcid":"","institution":"University of Global Health Equity","correspondingAuthor":true,"prefix":"","firstName":"Heritier","middleName":"","lastName":"Mfura","suffix":""},{"id":488554974,"identity":"c6b3b296-7cdb-46df-b4b2-f0dd5f9aaf7a","order_by":1,"name":"Abebe Bekele","email":"","orcid":"","institution":"University of Global Health Equity","correspondingAuthor":false,"prefix":"","firstName":"Abebe","middleName":"","lastName":"Bekele","suffix":""}],"badges":[],"createdAt":"2025-07-04 17:08:07","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7048690/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7048690/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12909-026-08939-9","type":"published","date":"2026-03-03T15:59:51+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":104251314,"identity":"8c6494f8-a3eb-45ae-9eb2-8fe6a273df38","added_by":"auto","created_at":"2026-03-09 16:12:50","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":791058,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7048690/v1/a824f4f6-a865-4428-ae73-270906a79ca6.pdf"},{"id":87261382,"identity":"a08b7910-fc73-4e77-89e6-023c94c556b9","added_by":"auto","created_at":"2025-07-22 07:15:39","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":22576,"visible":true,"origin":"","legend":"","description":"","filename":"Datacollectiontool.docx","url":"https://assets-eu.researchsquare.com/files/rs-7048690/v1/6877d1b771fdc5c4d50349e8.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Factors Influencing the Choice of Specialty by Medical Students in a new University in Rwanda","fulltext":[{"header":"Background","content":"\u003cp\u003eThe specialty preferences and choices of medical students have direct implications on future workforce composition, future healthcare delivery, workforce distribution, and policy planning (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Identifying the factors that shape these preferences is critical for informing career guidance, aligning training programs with national health priorities, and addressing imbalances in specialty distribution (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe choice of a medical specialty is influenced by a complex interplay of personal motivation and contextual factors. Intrinsic drivers such as intellectual interest, clinical engagement, and perceived fulfillment are often weighed alongside extrinsic considerations such as income expectations, job security, work-life balance, mentorship and societal norms (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eDemographic variables such as age, gender, clinical exposure, competitiveness of specialties, and availability of residency training programs further contribute to decision-making (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). These factors often vary by context. In Rwanda, a study has shown that intellectual challenge, interaction with residents, and core clerkship experiences significantly influenced students’ choices, with gender differences also evident in how students valued research opportunities or responded to negative training experiences (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Such findings highlight the importance of local context in shaping medical career trajectories.\u003c/p\u003e\u003cp\u003eThe Rwandan healthcare system has experienced notable transformation in recent years, marked by ambitious initiatives such as the \"Four by Four\" program, which seeks to quadruple the number of healthcare providers within four years (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). This effort emerged in response to Rwanda's continued shortfall relative to the WHO-recommended healthcare worker density of 4.45 per 1,000 population (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e); at present, Rwanda has approximately 1 healthcare worker per 1,000 people (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). In parallel, institutions like the University of Global Health Equity (UGHE) are contributing to workforce development by training physicians through a curriculum that emphasizes social medicine, health equity, and global health. These national and institutional efforts may shape medical students’ specialty preferences in ways that are distinct from those in other contexts.\u003c/p\u003e\u003cp\u003eThis study explored the specialty preferences and influencing factors among UGHE medical students. The findings aimed to inform educational strategies, guide workforce development, and contribute to evidence-based health planning in Rwanda.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cem\u003eObjectives of the study were to\u003c/em\u003e:\u003c/p\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eDetermine the preferences of medical specialty by medical students at UGHE\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eDetermine the factors that influence the choice of medical specialty by medical students at UGHE\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003cp\u003e\u003cem\u003eStudy setting and design\u003c/em\u003e\u003c/p\u003e\u003cp\u003eThe University of Global Health Equity (UGHE) offers a dual-degree Bachelor of Medicine, Bachelor of Surgery/Master in Global Health Delivery (MBBS/MGHD) program designed to train medical professionals committed to serving underserved and remote communities. The medical curriculum is divided into four main phases: a preparatory phase designed to help students manage the transition into a rigorous medical curriculum, a biosocial foundations of medicine phase where students acquire foundational knowledge and skills in the basic medical sciences, a clinical and health delivery phase consisting of two and a half years of hands-on clinical rotations that focus on the application of this knowledge in real-world patient care, and a final Exploration and development phase. UGHE emphasizes community engagement, social medicine, and global health principles, reflecting its mission to prepare graduates to address health disparities in resource-limited settings\u003c/p\u003e\u003cp\u003eA cross-sectional quantitative study design was used in this study, utilizing a self-administered online questionnaire.\u003c/p\u003e\u003cp\u003e\u003cem\u003eSample\u003c/em\u003e\u003c/p\u003e\u003cp\u003eA census sampling was conducted to invite all 214 medical students at UGHE in 2025 to the survey.\u003c/p\u003e\u003cp\u003e\u003cem\u003eData collection tool\u003c/em\u003e\u003c/p\u003e\u003cp\u003eThe online survey used in this study consisted of three sections. Section A included basic demographics and background information; section B assessed students preferred medical specialties; and section C examined the factors influencing their choices. The questionnaire was developed specifically for this study based on a review of relevant literature and expert input.\u003c/p\u003e\u003cp\u003e\u003cem\u003eData collection procedure\u003c/em\u003e\u003c/p\u003e\u003cp\u003eAn online survey was emailed to all medical students enrolled at UGHE and was open for two months from March to April 2025.\u003c/p\u003e\u003cp\u003e\u003cem\u003eKey measures\u003c/em\u003e\u003c/p\u003e\u003cp\u003eOur study had two key measures:\u003c/p\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eSpecialty preferences – the percentage of the respondents’ specialty of choice for the already decided and not fully decided participants.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eThe factors that influenced the preference of specialty. The percentage of respondents choosing “important” and “very important”, as well as the percentage of choosing “slightly important” and “not important” for each factor.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003ch2\u003eData analysis\u003c/h2\u003e\u003cp\u003eDescriptive statistics were used to summarize the demographics and all key measures. Chi square test was used to analyse the association between key measures and demographic variables. All statistical analyses were conducted using SPSS version 24, with P-value set at 0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 197 respondents completed the survey, translating to a 92% response rate. The mean age was 22 (range 18\u0026ndash;30), 146 (74.1%) were female, 66 (33.5%) were in their second year of medical school, and 172 (87.3%) were from Rwanda. One hundred fifty-five (78.7%) came from middle-income families, 170 (86.3%) were the first to study medicine as a profession amongst their first-degree relatives, and 123 (62.4%) came from urban settings. Eighty-five (52.8%) prefer to specialize outside of Rwanda, while 71 (44.1%) are comfortable with training either in Rwanda or outside Rwanda. One hundred fourteen (72.2%) are either very confident or somewhat confident in choosing the right specialty and 132 (85.2%) reported feeling very comfortable working in rural or underserved areas after their specialization (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSociodemographic and background information\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eN (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSample\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e197\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eSex\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e51 (25.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e146 (74.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003eYear of study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSixth\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e29 (14.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFifth\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e29 (14.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFourth\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e33 (16.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eThird\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e40 (20.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSecond\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e66 (33.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eNationality\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRwanda\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e172 (87.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eInternational*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e24 (12.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eIncome\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHigh\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e33 (16.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMiddle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e155 (78.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePoor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9 (4.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eFirst in family study medicine\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e27 (13.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e170 (86.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eFamily location\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUrban\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e123 (62.4%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRural\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e74 (37.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eTime participants started considering their future specialty\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBefore med school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e63 (37.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePre-clinical\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e44 (25.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eClinical\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e56 (32.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eInternship\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7 (4.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003ePreferred location of specialty training\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRwanda\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5 (3.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAbroad\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e85 (52.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEither\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e71 (44.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eConfidence in their selection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e(Very/somewhat) confident\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e114 (72.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e(Very/somewhat) uncertain\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14 (8.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eWould you consider working in rural or underserved areas\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e132 (85.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23 (14.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"3\"\u003e* Burundi, DRC, Lesotho, Tanzania, Uganda, Liberia, Malawi, Sierra Leone\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eWhile all respondents provided their specialty preference, 76 (42%) indicated that they had made their decision and 109 (58%) had not yet fully decided. The top two specialties preferred by the respondents were surgery (n\u0026thinsp;=\u0026thinsp;52, 27.6%) and pediatrics (n\u0026thinsp;=\u0026thinsp;36, 19.4%) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSpecialty preferences of the participants\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDecided\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNot fully decided\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSurgery\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e28 (36.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e24 (22.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e52 (28.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePediatrics\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18 (23.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18 (17%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e36 (19.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGlobal Health\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2 (2.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19 (17.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e21 (11.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInternal Medicine\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5 (6.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12 (11.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17 (9.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDermatology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5 (6.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11 (10.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16 (8.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOncology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2 (2.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8 (7.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10 (5.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOphthalmology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3 (3.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6 (5.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9 (4.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eObstetrics and gynecology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6 (7.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2 (1.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8 (4.4%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRadiology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2 (2.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (0.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3 (1.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmergency\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2 (2.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2 (1.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDentistry\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2 (2.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2 (1.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eENT\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1 (1.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (0.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAnesthesiology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0 (0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (0.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (0.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePsychology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0 (0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (0.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (0.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOther\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0 (0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3 (2.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3 (1.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e76 (42%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e109 (58%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e185\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eMore than 60% of respondents identified four key factors that were important or very important in influencing their specialty choice: 1) personal interest (75.2%), 2) work-life balance (66.5%), 3) job opportunities (66%), and 4) financial rewards in the specialty (61.9%). While two factors were seen as least influential to their specialty choice, less than 30% of respondents indicated they were important or very important: 1) family expectations (22.8%), and 2) prestige associated with the specialty (24.9%) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eFactors that influence the specialty preference\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot important/slightly important\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eImportant/very important\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePersonal interest in the specialty\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2 (1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e148 (75.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWork-life balance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e12 (6.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e131 (66.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eJob opportunities\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7 (3.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e130 (66%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFinancial rewards in the specialty\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e17 (8.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e122 (61.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLength of training required\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e24 (12.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e103 (52.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInfluence of mentors/supervisors\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e39 (19.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e79 (40.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOpportunity to work in rural/underserved areas\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e51 (25.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e60 (30.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAvailability of the program\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e81 (50.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e80 (49.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrestige associated with the specialty\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e55 (28%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e49 (24.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFamily expectations\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e77 (39.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e45 (22.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eStudents in clinical years had 4.5 higher odds than those in pre-clinical years in making the decisions on the specialty of their preference (Unadj OR\u0026thinsp;=\u0026thinsp;4.5, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Students who have more confidents in their ability to choose the specialty were 6.4 times more likely to have made their decisions compared to those who were not confident (Unadj OR\u0026thinsp;=\u0026thinsp;6.4, P\u0026thinsp;=\u0026thinsp;0.01) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAssociation between decision status and year of study and confidence in choosing a specialty\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eDecided\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNot decided\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eUnadj OR\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eYear of study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePre-clinical years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e25 (32.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e75 (68.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eRef\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eClinical years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e51 (67.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e34 (31.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eConfidence in choosing a specialty\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot confident\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2 (14.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e12 (85.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eRef\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.01*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eConfident\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e59 (51.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e55 (48.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e6.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eNo significant statistical differences were found whether they are first to study medicine in family or not in determining the time they considered the specialty (P\u0026thinsp;=\u0026thinsp;0.577) or their confidence in choosing the specialty (P\u0026thinsp;=\u0026thinsp;0.521) (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAssociation between the first in family to study medicine status and time to consider specialty and confidence\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFirst in family to study medicine\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eOther family members studied medicine\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eWhen considered\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBefore med school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e56 (37.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7 (31.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.577\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePre-clinical\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e40 (27.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4 (18.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eClinical\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e46 (31.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e10 (45.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eInternship\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6 (4.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (4.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eConfidence in choosing a specialty\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eConfident\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15 (93.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e99 (88.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.521\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot confident\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1 (6.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e13 (11.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eNo significant statistical differences were found between their year of study and their confidence in choosing the specialty (P\u0026thinsp;=\u0026thinsp;0.209) (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAssociation between year of study and confidence in choosing a specialty\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eYear of study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePre-clinical years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eClinical years\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eConfidence in choosing a specialty\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot confident\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9 (64.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5 (35.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.209\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eConfident\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e53 (46.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e61 (53.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTwo factors were found to have significant difference between male and female medical students in deciding their specialty of preference: 1) male students were less likely to found the length of training as an important factor in deciding the specialty compared to female (unadj OR\u0026thinsp;=\u0026thinsp;0.32, P\u0026thinsp;=\u0026thinsp;0.012), and 2) male students were 2.75 times more likely to found the influences of mentors or supervisor as an important factor in deciding the specialty compared to female (unadj OR\u0026thinsp;=\u0026thinsp;2.75, P\u0026thinsp;=\u0026thinsp;0.044) (Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAssociation between gender and importance of factors that influence the choice of specialty\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eM\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eF\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eUnadj OR\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ePersonal interest in the specialty\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot important/slightly important\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2 (1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;0.999\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eImportant/very important\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e41 (0.277%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e107 (0.723%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eWork-life balance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot important/slightly important\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 (33.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8 (66.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.416\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eImportant/very important\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e30 (22.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e101 (77.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eJob opportunities\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot important/slightly important\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3 (43.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4 (57.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.281\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eImportant/very important\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e32 (24.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e98 (75.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eFinancial rewards in the specialty\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot important/slightly important\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6 (35.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11 (64.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.388\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eImportant/very important\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e31 (25.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e91 (74.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eLength of training required\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot important/slightly important\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12 (50%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12 (50%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eRef\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.012*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eImportant/very important\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e25 (24.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e78 (75.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.32\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eInfluence of mentors/supervisors\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot important/slightly important\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6 (15.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e33 (84.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eRef\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.044*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eImportant/very important\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e26 (32.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e53 (67.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.75\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eOpportunity to work in rural/underserved areas\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot important/slightly important\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16 (31.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35 (68.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.585\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eImportant/very important\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16 (31.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e44 (73.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAvailability of the program\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot important/slightly important\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e21 (26.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e59 (73.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eNA\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eImportant/very important\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e21 (26.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e59 (73.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ePrestige associated with the specialty\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot important/slightly important\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16 (29.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e39 (70.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.953\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eImportant/very important\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14 (28.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35 (71.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eFamily expectations\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot important/slightly important\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e24 (31.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e53 (68.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.288\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eImportant/very important\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10 (22.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35 (77.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003e This study examined medical specialty preferences and the factors influencing career decision-making among students enrolled at the University of Global Health Equity (UGHE) in Rwanda. A key finding was that a majority of respondents (58%) had not yet selected a preferred specialty, reflecting the uncertainty characteristic of early-stage medical education. This indecision was more prevalent among preclinical students, suggesting that clinical exposure is a critical determinant in shaping career interests. These results are consistent with findings from previous studies in Rwanda and across sub-Saharan Africa, which highlight the influence of clinical rotations and mentorship on specialty choice (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eSurgery emerged as the most commonly preferred specialty (28.6%), followed by pediatrics (19.8%). These preferences are consistent with trends reported in other African countries, where surgical and pediatric specialties frequently rank among the top choices for medical students (\u003cspan additionalcitationids=\"CR11 CR12\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Specifically, close to 30% of students expressed a preference for surgical careers in Nigeria and Ethiopia (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e), while pediatrics was also highly ranked by medical students as their preferred specialty in Botswana, Congo, and Cameroon (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e\u003cp\u003ePersonal interest was the most important factor in specialty decision-making. This finding aligns with global literature underscoring the importance of intrinsic motivation in career selection (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e), as well as regional studies in Nigeria and Botswana (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn contrast, factors such as prestige and family expectations were rated as less influential, corroborating the findings of a recent systematic review of 152 African medical schools (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). These results suggest that intrinsic motivations such as personal interest and alignment with professional values may play a more prominent role than external pressures in shaping specialty preferences among medical students in the region.\u003c/p\u003e\u003cp\u003eThe findings revealed that students in clinical years were significantly more likely to have selected a specialty (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), highlighting the important role of clinical exposure in shaping career choices. Engagement in clinical rotations provides students with direct experience in various specialties, allowing them to observe professional roles, interact with mentors, and gain practical insight into the day-to-day realities of medical practice. This hands-on exposure helps students make more informed decisions by aligning their interests with the demands and culture of specific fields. Such results aligned with previous research suggesting that access to reliable career information is an essential component in shaping informed specialty preferences (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eGender-based differences were observed in the importance assigned to specific influencing factors. Male students were less likely to consider the duration of training as important in their specialty choice, while female students were less likely to identify the influence of mentors or supervisors as a key factor. These findings highlight the nuanced ways in which gender may shape career decision-making and point to the need for tailored guidance and support strategies within medical education. Efforts to ensure equitable access to mentorship and to address gender-specific concerns such as training length or role modeling remain essential for fostering an inclusive and responsive learning environment (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eA notable proportion of students (52.8%) expressed a preference to pursue postgraduate training abroad, while 44.1% were open to either local or international options. This reflects a broader trend seen in African medical schools and may be driven by perceptions of higher training quality or greater career opportunities overseas (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). However, this inclination raises concerns regarding potential brain drain and highlights the importance of strengthening domestic postgraduate training programs.\u003c/p\u003e\u003cp\u003eThe results of the study also showed that the underrepresentation of essential specialties such as psychiatry, emergency medicine, and anesthesiology points to a persistent mismatch between student interests and national health workforce needs. Similar imbalances have been reported in both high- and low-income settings (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Addressing these gaps will require coordinated strategies, including early exposure to critical specialties, financial and professional incentives, and alignment of postgraduate training with national health priorities (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cb\u003eImplications for medical education and workforce planning\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis study offers important insights for medical education and health workforce planning in Rwanda. The high proportion of students undecided about their specialty points to the need for more structured career guidance. Integrating career counseling, mentorship, and broad specialty exposure into the preclinical curriculum could support students in making more informed and confident decisions.\u003c/p\u003e\u003cp\u003eThe strong influence of personal interest and perceived job opportunities on specialty choice highlights the importance of aligning medical training with both student aspirations and national health system needs. While fields such as surgery and pediatrics continue to attract the most interest, critically underrepresented specialties, including psychiatry, emergency medicine, and anesthesia, remain overlooked. Promoting interest in these fields may require targeted interventions such as clinical rotations in underserved specialties, mentorship by practitioners in these areas, and incentive structures that make these careers more appealing.\u003c/p\u003e\u003cp\u003eA notable proportion of students expressed a preference for postgraduate training abroad. This reflects both the perceived quality and appeal of international programs, as well as concerns about the availability and competitiveness of local training opportunities. Strengthening in-country residency programs through faculty development, infrastructure investment, and academic partnerships could enhance their attractiveness and reduce reliance on external training. Complementary policies such as bonded scholarships, rural service incentives, and guaranteed placements may further support retention of trained professionals within the national health system.\u003c/p\u003e\u003cp\u003eGender-based differences in specialty decision-making also emerged, underscoring the need for gender-sensitive educational and workforce policies. Supporting women through mentorship, flexible training pathways, and family-friendly environments can help ensure equitable access to all specialties and strengthen diversity within the health workforce.\u003c/p\u003e\u003cp\u003e\u003cb\u003eLimitations of the study\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis study adds to the body of literature on medical student specialty preferences in Rwanda. The high response rate and inclusion both preclinical and clinical students enabled comparisons across different stages of training, and the examination of a wide range of influencing factors provided a more comprehensive understanding of career decision-making.\u003c/p\u003e\u003cp\u003eHowever, the results of this study must be viewed in light of some limitations. The cross-sectional design restricts the ability to draw causal inferences, and longitudinal studies would be more appropriate for tracking how preferences evolve and influence actual career trajectories. Additionally, the study was conducted at a single institution \u0026ndash;UGHE- which, while distinct in its mission and curriculum, may not reflect the broader population of medical students in Rwanda or the region. Therefore, caution should be exercised when generalizing the results. Future research should employ multi-institutional or longitudinal study to capture a more representative and the change in medical students\u0026rsquo; career preferences.\u003c/p\u003e\u003cp\u003e\u003cb\u003eRecommendations and conclusion\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe findings of this study suggest several key actions to improve medical education and inform future workforce planning in Rwanda and similar contexts. First, there is a need to integrate structured career guidance and mentorship into the early stages of medical education. Providing students with systematic exposure to a broad range of specialties - including those currently underrepresented - can support more informed, confident, and reflective career decision-making.\u003c/p\u003e\u003cp\u003eSecond, efforts should focus on strengthening the quality, visibility, and competitiveness of all local postgraduate training programs. This can be achieved through targeted investments in faculty development, infrastructure, and strategic partnerships with both regional and international academic institutions. Enhancing the appeal and perceived value of domestic residency training may also help reduce the preference for pursuing specialization abroad.\u003c/p\u003e\u003cp\u003eThird, addressing gender disparities in specialty selection requires the implementation of gender-sensitive policies. These may include fostering inclusive academic environments, ensuring access to female mentorship, and creating flexible and family-friendly training pathways to support equitable participation in all specialties.\u003c/p\u003e\u003cp\u003eIn addition, aligning medical training more closely with national health priorities is essential. Policymakers and educational institutions should work collaboratively to develop incentive schemes such as rural service bonuses, bonded scholarships, and guaranteed placement opportunities that encourage students to pursue careers in high-need specialties.\u003c/p\u003e\u003cp\u003eFinally, future research should adopt longitudinal designs to track how students\u0026rsquo; preferences evolve throughout their training and transition into actual career choices. Expanding this research across multiple institutions will provide a more comprehensive and representative understanding of medical education trends in the region, thereby strengthening the evidence base for sustainable and context-specific interventions.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eUGHE\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eUniversity of Global Health Equity\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eMBBS/MGHD\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eBachelor of Medicine and Bachelor of Surgery/ Master of Science in Global Health Delivery\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eSPSS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eStatistical Package for the Social Sciences\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthics approval granted by University of Global Health Equity\u0026rsquo;s Institutional Review Board (Protocol\u0026rsquo;s reference number: UGHE-IRB/2025/371). Written informed consent to participate was obtained from each participant. The research was conducted following standards in accordance with the Declaration of Helsinki.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was acquired for this study\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor information:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors and affiliations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUniversity of Global Health Equity; Kigali Heights, Plot 772; KG 7 Ave., 5th Floor; PO Box 6955\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eContributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAB conceived the study; AB and HM designed the work; HM acquired the data; HM analysed the data; AB and HM interpreted the results, and HM drafted the original manuscript. AB and HM revised the manuscript, approved the submitted version of this manuscript and agreed to be accountable for their contributions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors wish to thank the participants of this study for sharing their time and experiences.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorresponding author\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHeritier Mfura\u003c/p\u003e\n\u003cp\u003eEmail : [email protected]\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eRowson M, Smith A, Hughes R, Johnson O, Maini A, Martin S, Martineau F, Miranda JJ, Pollit V, Wake R, Willott C. The evolution of global health teaching in undergraduate medical curricula. Globalization and health. 2012 Dec;8:1-8.\u003c/li\u003e\n\u003cli\u003eDorsey ER, Jarjoura D, Rutecki GW. Influence of controllable lifestyle on recent trends in specialty choice by US medical students. Jama. 2003 Sep 3;290(9):1173-8.\u003c/li\u003e\n\u003cli\u003eScott IM, Abu-Laban RB, Gowans MC, Wright BJ, Brenneis FR. Emergency medicine as a career choice: a descriptive study of Canadian medical students. Canadian Journal of Emergency Medicine. 2009 May;11(3):196-206.\u003c/li\u003e\n\u003cli\u003eSawan D, Alrefaei GM, Alesawi A, Abualross O, Alsuwaida SA, Meer N, Alsuwaida S. Preferences, career aspects, and factors influencing the choice of specialty by medical students and interns in Saudi Arabia: a cross-sectional study. Cureus. 2023 Aug 6;15(8).\u003c/li\u003e\n\u003cli\u003eAl-Ansari SS, Khafagy MA. Factors affecting the choice of health specialty by medical graduates. Journal of Family and Community Medicine. 2006 Sep 1;13(3):119-23.\u003c/li\u003e\n\u003cli\u003eMohammed TA, Abdulrahman AA, Saud KA, Alaa NT. Specialty preferences and factors affecting future career choice among medical graduates in Saudi. Journal of family medicine and primary care. 2020 Mar 1;9(3):1459-63.\u003c/li\u003e\n\u003cli\u003eKansayisa G, Yi S, Lin Y, Costas-Chavarri A. Gender-based analysis of factors affecting junior medical students\u0026rsquo; career selection: addressing the shortage of surgical workforce in Rwanda. Human resources for health. 2018 Dec;16:1-8.\u003c/li\u003e\n\u003cli\u003eMinistry of Health Rwanda. The 4x4 Reform: A Path to Quality Health Care in Rwanda [Internet]. Kigali: Ministry of Health Rwanda; 2024. Available from: https://www.moh.gov.rw/news-detail/the-4x4-reform-a-path-to-quality-health-care-in-rwanda. \u003c/li\u003e\n\u003cli\u003eHealth workforce requirements for universal health coverage and the Sustainable Development Goals [Internet]. www.who.int. 2018. Available from: https://www.who.int/publications/i/item/9789241511407\u003c/li\u003e\n\u003cli\u003eAdebajo GO, Ijadunola MY, Akinwamide ES, Oluduro MI, Eluyinka OD, Odedeyi CA, Elugbaju OT. Speciality preferences and influencing factors among medical students at a South-Western Nigerian University. Discover Education. 2024 Nov 13;3(1):230.\u003c/li\u003e\n\u003cli\u003eSeyoum N, Biluts H, Bekele A, Seme A. Medical students\u0026apos; choice of specialty and factors determining their choice: a cross-sectional survey at the Addis Ababa University, School oF Medicine, Ethiopia. Ethiopian medical journal. 2014 Jul 1;52(3):129-35.\u003c/li\u003e\n\u003cli\u003eKanmounye US, Temgoua M, Endomba FT. Determinants of residency program choice in two central African countries: an internet survey of senior medical students. International Journal of Medical Students. 2020 Apr 30;8(1):20-5.\u003c/li\u003e\n\u003cli\u003eRukewe A, Abebe WA, Fatiregun AA, Kgantshang M. Specialty preferences among medical students in Botswana. BMC research notes. 2017 Dec;10:1-5.\u003c/li\u003e\n\u003cli\u003eBernard A, Mengesha D, Flaharty K, Tiertoore N, Tolera A, Wubishet H, Gebeyehu T, Abdullahi H, Abdu A, Adem Y, Berzack S. Personal and Contextual Influences on African Medical Students\u0026rsquo; Career Choices in Primary Care: A Cross-Sectional Mixed-Methods Study. Family Medicine. 2025;57(5):371-8.\u003c/li\u003e\n\u003cli\u003eL. Neil K, Umucyo D, Binagwaho A, Waka TY. Gender-based support systems influencing female students to pursue a bachelor of medicine, bachelor of surgery (MBBS) in Rwanda. BMC Medical Education. 2024 Jun 7;24(1):641.\u003c/li\u003e\n\u003cli\u003eGeorgi M, Morka N, Patel S, Kazzazi D, Karavadra K, Nathan A, Hardman G, Tsui J. The impact of same gender speed-mentoring on women\u0026apos;s perceptions of a career in surgery\u0026ndash;a prospective cohort study. Journal of Surgical Education. 2022 Sep 1;79(5):1166-76.\u003c/li\u003e\n\u003cli\u003eHarris JC. Meeting the Workforce Shortage: Toward 4-Year Board Certification in Child and Adolescent Psychiatry. Journal of the American Academy of Child and Adolescent Psychiatry. 2018 Oct 1;57(10):722-4.\u003c/li\u003e\n\u003cli\u003eKhan IA, Karim HM, Khan IA. Anesthesia services in low-and middle-income countries: The fragile point for safe surgery and patient safety. Cureus. 2023 Aug 8;15(8).\u003c/li\u003e\n\u003cli\u003eWeissman C, Avidan A, Tandeter H, Zisk Rony RY. Unpopular medical specialties: exploring the concept that \u0026ldquo;the customer knows best\u0026rdquo;. BMC Medical Education. 2023 Apr 20;23(1):268.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"specialty preference, specialty choice, factors, medical students, UGHE, Rwanda","lastPublishedDoi":"10.21203/rs.3.rs-7048690/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7048690/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground:\u003c/h2\u003e\u003cp\u003eMedical students\u0026rsquo; specialty preferences directly impact future health workforce distribution and service delivery. Understanding the factors influencing these preferences is essential for shaping career guidance, aligning education with national health priorities, and mitigating gaps in critical specialties.\u003c/p\u003e\u003ch2\u003eMethods:\u003c/h2\u003e\u003cp\u003eA cross-sectional study was conducted among all medical students at the University of Global Health Equity, Rwanda, between March and April 2025 using a self-administered questionnaire. The questionnaire explored participants' specialty preference and factors influencing their choice of specialty.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eA total of 197 respondents completed the survey. Seventy-six (42%) of the participants indicated that they had made their decision and 109 (58%) had not yet fully decided on the specialty of choice. Surgery (27.6%) and pediatrics (19.4%) were the top two specialties preferred by the respondents. Four factors that were seen as important in determining their choice of specialty were: 1) personal interest, 2) work-life balance, 3) job opportunities, and 4) financial rewards in the specialty. Most decisions were made during clinical years.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eA significant number of students remained undecided about their specialty, with personal interest being the most influential factor. Surgery and pediatrics were the most preferred specialties, while critical fields like psychiatry and emergency medicine were underrepresented. These findings highlight the need for early career guidance and alignment medical training with national health priorities.\u003c/p\u003e","manuscriptTitle":"Factors Influencing the Choice of Specialty by Medical Students in a new University in Rwanda","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-22 07:15:35","doi":"10.21203/rs.3.rs-7048690/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-08-29T11:08:13+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-12T10:26:06+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-06T02:57:54+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"311242312632079299386453796236243494182","date":"2025-07-21T12:10:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"60380676116629207569548839802208652405","date":"2025-07-20T11:46:26+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"32058553680327830173737240176961808324","date":"2025-07-19T22:26:51+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-07-17T21:17:46+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-07-16T15:59:42+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-07-11T11:49:37+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-11T11:48:46+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2025-07-04T16:56:29+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8b005c37-3611-4b3e-b9ed-d3357bc879d7","owner":[],"postedDate":"July 22nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-03-09T16:05:39+00:00","versionOfRecord":{"articleIdentity":"rs-7048690","link":"https://doi.org/10.1186/s12909-026-08939-9","journal":{"identity":"bmc-medical-education","isVorOnly":false,"title":"BMC Medical Education"},"publishedOn":"2026-03-03 15:59:51","publishedOnDateReadable":"March 3rd, 2026"},"versionCreatedAt":"2025-07-22 07:15:35","video":"","vorDoi":"10.1186/s12909-026-08939-9","vorDoiUrl":"https://doi.org/10.1186/s12909-026-08939-9","workflowStages":[]},"version":"v1","identity":"rs-7048690","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7048690","identity":"rs-7048690","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}