Factors influencing the choice of specialty by medical students in a new university in Rwanda

Abstract

Medical students’ specialty preferences directly impact future health workforce distribution and service delivery. Understanding the factors influencing these preferences is essential for shaping career guidance, aligning education with national health priorities, and mitigating gaps in critical specialties. A cross-sectional study was conducted among all medical students at the University of Global Health Equity, Rwanda, between 1st March 2025 to 30th April 2025 using a self-administered questionnaire. The questionnaire explored participants’ specialty preference and factors influencing their choice of specialty. A total of 197 respondents completed the survey translating to a 92% response rate. Ninety-one students (46.2%) were in clinical phase of training. Seventy-six (41%) of the participants indicated that they had made their decision and 109 (59%) had not yet fully decided on the specialty of choice. Surgery (n = 52, 28.1%) and pediatrics (n = 36, 19.5%) were the top two specialties preferred by the respondents. Four factors that were seen as important in determining their choice of specialty were: (1) personal interest, (2) work-life balance, (3) job opportunities, and (4) financial rewards in the specialty. Most decisions were made during clinical years. A significant number of students remained undecided about their specialty, with personal interest being the most influential factor. Surgery and pediatrics were the most preferred specialties, while critical fields like psychiatry and emergency medicine were underrepresented. We suggest that these findings highlight the need for early career guidance and aligning medical training with national health priorities.