Navigating early career intentions: A qualitative study of influences on specialty choices for medical students

Medical students' career intentions and choices are shaped early in their education, at a time when their interaction with various specialties and professional influences is both formative and essential. Despite this being a pivotal period, the literature offers limited insights into what drives students' specialty choices during these early stages. Our study seeks to address this gap by exploring how medical trainees engage in sensemaking around specialty choice, navigating the interplay between individual aspirations, institutional contexts and perceived professional expectations.

We conducted an interpretive descriptive study with two consecutive student cohorts at a francophone university in Canada during the implementation of a new medical campus site. Using purposive convenience and snowball sampling, we held 10 focus groups (in-person and virtual): six with first- and second-year medical students and four with clinical teachers. Inductive thematic analysis was employed to interpret the data, enabling us to identify key patterns and relationships between participant perspectives.

The participants' perspectives organised around five key themes including (a) navigating career indecision and decision-making processes, (b) role of lifestyle, work-life balance, and career sustainability, (c) role of early educational experiences in career selection, (d) influence of mentorship and role models on career orientation, and (e) hidden curriculum and perceptions of specialty prestige.

This study offers insights into the factors influencing medical students' specialty choices early in their training. By identifying actionable elements within the undergraduate medical curriculum and the broader learning environment, training programmes can better support students in making well-informed career decisions.