Pre-Matriculation Experiences Minimally Impact the Specialty Interests of First-Year Medical Students

Abstract

Introduction: Understanding the factors influencing medical students' specialty interests can help educators shape curricula and career advancement opportunities. While previous studies have focused on factors that influence a career choice in surgery, little work has examined students' desires to match into competitive specialties. The University of Massachusetts Medical School provides a unique student body to investigate these factors, given its emphasis on primary care, diverse student body, and recently revised curriculum. This study aimed to illustrate the factors that guide students' interest in specialties before medical school. We hypothesized that students with more clinical and research experience upon entry to medical school would have greater interest in competitive specialties.

Methods: Students at a nationally accredited medical school were surveyed upon matriculation regarding demographic information, specialty interests, and clinical experiences. Twelve specialties were defined as competitive due to a match rate of <90%, which included U.S. M.D. seniors who ranked each specialty as their only choice. Factors influencing students' interest in these specialties were analyzed using logistic regression. Statistical significance was defined as p<0.05.

Results: 159 of 200 first-year medical students completed the survey. Respondents were 69% female, had a median age of 24, and 59% reported their ethnicity as white. The overall class demographics are 72% female and 47% white. 49% of students reported their top choice as a competitive specialty. We created a multivariate logistic regression model with the variables age at matriculation, gender, and ethnicity; the model also accounted for whether students had a parent in medicine, a parent with a bachelor’s degree or higher, a childhood household income >150,000, and an anticipated debt after medical school >200,000. Male students had less interest in competitive specialties (OR: 0.32, 95% CI: 0.12-0.78). Students with >50 hours of clinical or research experience in their top specialty were not more likely to be interested in a competitive specialty (OR: 1.1, 95% CI: 0.33-3.7). All other odds ratios were non-significant.

Conclusion: For students entering medical school at our institution, few factors captured by the survey influenced interest in competitive versus non-competitive specialties. The minimal impact of pre-matriculation experiences may indicate that interest in certain specialties primarily develops during medical school. Additional research into how interests change throughout medical school may prove useful in guiding how the structure of medical education and formal career exploration can influence students' specialty choices.

Aris Paschalidis

Medical Student

My research interests include health analytics, infectious diseases, and artificial intelligence.