Relationship between medical students' career priority and specialty choice: A nationwide multicenter survey.

Background: The shortage of physicians in several specialties has been brought to public attention in several countries. However, little is known about factors affecting medical students' specialty choice. The objectives of our study were to illustrate medical students' career priority clusters and to assess their association with specialty preference.

Methods: We conducted a nationwide multicenter survey in 2015 at 17 medical schools. The study participants were asked their top three specialty preferences, demographic characteristics, and 14 career priority questions. Multilevel logistic regression models were used to determine the effect of each variable on student career choice.

Results: A total of 1264 responses were included in the analyses. The top five specialty choices were internal medicine: 833, general practice: 408, pediatrics: 372, surgery: 344, and emergency medicine: 244. An exploratory factor analysis mapped the 14 career priorities into 3-factor solution: "primary care orientation," "advanced and specific care," and "personal life orientation." Multilevel logistic regression models yielded satisfactory accuracy with the highest ROC curve (AUROC) noted in surgery (0.818), general practice (0.769), and emergency medicine (0.744). The career priorities under "primary care orientation" had positive association with choosing general practice, emergency medicine, internal medicine, and pediatrics. The "advanced and specific care" career priorities facilitated surgery and emergency medicine choice, while reducing the likelihood of choosing less procedure-oriented specialties, such as internal medicine, general practice, and pediatrics.

Conclusions: Our results demonstrated medical students' career priorities and their association with specialty preference. Individualized career support may be beneficial for both medical students and each specialty fields.