Specialty and Lifestyle Preference Changes during Medical School



Medical student specialty choices have significant downstream effects on the availability of physicians and, ultimately, the effectiveness of health systems. This study investigated how medical student specialty preferences change over time in relation to their demographics and lifestyle preferences.


Students from ten medical schools were surveyed at matriculation (2012) and graduation (2016). The two surveys included questions about specialty and lifestyle preferences, demographics, educational background, and indebtedness. Student data from 2012 to 2016 were paired together and grouped into those whose specialty preferences remained constant or switched.


Response rates in 2012 and 2016 were 65% (997/1530) and 50% (788/1575), respectively. Fourth-year students ranked “enjoying the type of work I am doing” as less important to a good physician lifestyle than did first-year students (from 59.6 to 39.7%). The lifestyle factors “having control of work schedule” and “having enough time off work” were ranked as more important to fourth-year students than first-year students (from 15.6 to 18.2% and 14.8 to 31.9%, respectively). The paired dataset included 19% of eligible students (237/1226). Demographic and lifestyle factors were not significantly associated with specialty preference switching. Additionally, no significant association existed between changing lifestyle preferences and switching specialty preference (p = 0.85).


During the course of medical school, lifestyle preferences became more focused on day-to-day factors and less on deeper motivational factors. Neither demographics nor lifestyle preferences appear to relate to a student’s decision to switch specialty preference during medical school. These findings represent an important step in uncovering causes of specialty preference trends.

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The authors wish to thank Sydeaka Watson, PhD, and Mihai Giurcanu, PhD, for their assistance with statistical analyses.


The study was funded by the University of Chicago Pritzker School of Medicine Summer Research Program.

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Correspondence to Jonathan P. Fischer.

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The authors declare that they have no conflict of interest.

Ethical Approval

This study was approved or deemed exempt by the institutional review boards of all participating institutions.



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Previous Presentations

Medical Education Day, University of Chicago, Dec. 1, 2016 (poster presentation); Learn Serve Lead, the Annual Meeting of the American Academy of Medical Colleges, Nov. 7, 2017 (oral presentation), Senior Scientific Session, University of Chicago Pritzker School of Medicine, May 15, 2019 (poster presentation).

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Fischer, J.P., Clinite, K., Sullivan, E. et al. Specialty and Lifestyle Preference Changes during Medical School. Med.Sci.Educ. 29, 995–1001 (2019). https://doi.org/10.1007/s40670-019-00790-6

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  • Career choice
  • Undergraduate medical education
  • Attitudes and psychosocial factors
  • Curriculum development