From First-Year Dreams to Sixth-Year Realities: A Repeat Cross-Sectional Study of Medical Students’ Specialty Preferences

Medical students often begin their studies with preconceived notions about specialties, which may evolve as they gain clinical experience. This study aimed to assess changes in specialty preferences over six years of medical training and to compare two cohorts of first-year students. A repeat cross-sectional design was used, analyzing survey data from the 2019 class during preclinical (first–second year) and clinical (sixth year) stages, and from the 2024 first-year cohort. A total of 367 students participated. Comparing preclinical and clinical students revealed a significant increase in interest in ophthalmology (2.9% vs. 11%, p = 0.012), along with non-significant upward trends in obstetrics and gynecology and family medicine. Declines were observed in psychiatry, oncology, neurosurgery, and surgery. The 2024 cohort included a higher proportion of students with a prior medical background compared with the 2019 cohort (43% vs. 23%, p = 0.002), but no other demographic or specialty preference differences were identified. These findings suggest that specialty preferences among medical students may shift during clinical training, while initial preferences appear relatively consistent across cohorts. Understanding how medical education influences career development may guide curricular strategies to balance specialty distribution and address workforce needs.