Factors Influencing Specialty Choice Among Medical Students in Korea; a Qualitative Study (Preprint)

BACKGROUND A decline in applications to vital medical specialties, particularly general surgery, obstetrics and gynecology, and pediatrics in Republic of Korea threatens the nation's healthcare infrastructure. Despite multiple contributing factors, there is limited qualitative research exploring medical students' specialty choice decisions. OBJECTIVE This study aimed to examine the key factors influencing Korean medical students' specialty selection processes, identify how recent healthcare policy changes affect their career decisions, and understand their preferences for training. METHODS We conducted 24 semi-structured interviews with medical students at various educational stages, exploring their demographics, career plans, and specialty preferences. Questions covered motivations for specialization choices, preferred practice locations, and the impact of government policies. Interviews were conducted from March to April 2024, with data coded using ATLAS.ti. RESULTS Career decisions were influenced by three main categories: personal factors (academic interest, self-perceived competence, sense of calling), social factors (legal risk, remuneration, long-term outlook), and inherent factors of specialties (workload). Recent healthcare policy changes significantly impacted students' career prospects, with some considering practice abroad. Training location preferences were primarily influenced by hospital volume and residency possibilities. CONCLUSIONS Medical students' specialty choices are shaped by personal, social, and inherent factors. Policy implementation should protect students from deterrents like legal risks, enabling choices based on aptitude and interest rather than external pressures, to maintain a well-balanced healthcare system.