Determinants of Postgraduate Students' Choices of Speciality

  • Bikash Shrestha Grande International Hospital, Kathmandu, Nepal
  • Yagya Raj Pokhrel Patan Academy of Health Sciences, Patan Hospital, Nepal
  • Katrina Butterworth Patan Academy of Health Sciences, Patan Hospital, Nepal


Introduction: Postgraduate specialization is perceived as essential for success with high competition for enrolment. The reasons how medical students choose their postgraduate specialty are complex. Understanding the factors that influence career choice helps in workforce planning. So, we tried to identify the specialty preferred by postgraduate students and the factors that influenced these choices in a post graduate institution.
Methods: A cross-sectional observational study was conducted in National Academy of Medical Sciences. All the postgraduate students of batch 2011 AD were enrolled for the study. The responses were rated on a five point Likert scale.
Results: Significant gender preference was observed in specialties. General Surgery, Internal Medicine and Orthopedics were chosen by male students (P-Values, respectively, 0.001, 0.033 and 0.000) while Obstetrics and Gynecology and Ophthalmology being chosen by female students (P-Values, respectively, 0.000 and 0.006). Significant difference was observed between male and female student responses to the factor – scope in future (P – value 0.042), between married and unmarried students to the factor – workload flexibility (P – value 0.011), students who tried to go abroad versus who didn’t, for the factor – Illness of self/family/friend (P – value 0.016), and between those who worked in rural area versus those who didn’t, to the factor – Influence of friends/ seniors (P – value 0.038).
Conclusions: Various factors affect the choices for preferred specialty. Policy makers should look at the needs of the nation, and ensure that specialty postgraduate education programs reflect those needs. 
Keywords: career choices; likert scale; medical education; postgraduate specialty. | PubMed


Bhat S, D’souza L, Fernandez J. Factors influencing the career
choices of medical graduates. J Clin Diagn Res. 2012;l-6:61–4.
2. Chew YW, Rajakrishnan S, Low CA, Jayapalan PK,
Sreeramareddy CT. Medical students' choice of specialty
and factors determining their choice: a cross-sectional
questionnaire survey in Melaka-Manipal Medical College,
Malaysia. Bioscience trends. 2011;5(2):69-76.
3. Rehman A, Rehman T, Shaikh MA, Yasmin H, Asif A, Kafil
H. Pakistani medical students' specialty preference and the
influencing factors. J Pak Med Assoc. 2011 Jul;61(7):713-8.
4. Saigal P, Takemura Y, Nishiue T, Fetters M. Factors
considered by medical students when formulating their
specialty preferences in Japan: findings from a qualitative
study. BMC Med Educ. 2007;7:31.
5. Mehmood SI, Kumar A, Al-Binali A, Borleffs JC. Specialty
preferences: trends and perceptions among Saudi
undergraduate medical students. Med Teach. 2012;34 Suppl
6. Butterworth K, Hayes B, Neupane B. Retention of general
practitioners in rural Nepal: A qualitative study. Aust J Rural
Health. 2008 Jul;16(4):201-6.
7. Lamichhane J. Dilemma of medical graduates in
Nepal. Journal of Nepal Health Research Council. 2010
8. Zimmerman M, Shakya R, Pokhrel BM, Eyal N, Rijal BP,
Shrestha RN, Sayami A. Medical students' characteristics as
predictors of career practice location: retrospective cohort
study tracking graduates of Nepal's first medical college.
BMJ. 2012 Aug 13;345:e4826.
9. Wright B, Scott I, Woloschuk W, Brenneis F, Bradley J. Career
choice of new medical students at three Canadian universities:
Family medicine versus specialty medicine. CMAJ : Canadian
Medical Association journal. 2004(170):1920–4.
10. Rosenblatt RA, Andrilla CH. The impact of U.S. medical
students’ debt on their choice of primary care careers: An
analysis of data from the 2002 medical school graduation
questionnaire. Academic medicine : journal of the Association
of American Medical Colleges. 2005(80):815–9.
11. Dyrbye LN, Eacker AM, Harper W, Power DV, Massie FS,
Jr., Satele D, et al. Distress and empathy do not drive changes
in specialty preference among US medical students. Med
Teach. 2012;34(2):e116-22.
12. Hayes B, Shakya R. Career choices and what influences
Nepali medical students and young doctors: a cross-sectional
study. Human Resources for Health. 2013;11(1):5.
13. Kumar R, Dhaliwal U. Career choices of undergraduate
medical students. The National medical journal of India.
2011 May-Jun;24(3):166-9.

Zarkovic A, Child S, G. N. Career choices of New Zealand
junior doctors. The New Zealand medical journal.
15. Aslam M, Ali A, Taj T, Badar N, Mirza W, Ammar A, et al.
Specialty choices of medical students and house officers in
Karachi, Pakistan. Eastern Mediterranean health journal.
2011 Jan;17(1):74-9.
16. Bittaye M, Odukogbe A-TA, Nyan O, Jallow B, Omigbodun
A. Medical students' choices of specialty in The Gambia: the
need for career counseling. BMC Med Educ. 2012;12(1):72.
17. Huntington I, Shrestha S, Reich N, Hagopian A. Career
intentions of medical students in the setting of Nepal's
rapidly expanding private medical education system. Health
Policy and Plan. 2012;27:417-28.
18. National Academy of Medical Sciences, Bir Hospital. http:// 2014.
19. Dikici MF, Yaris F, Topsever P, Tuncay Muge F, Gurel
FS, Cubukcu M, Gorpelioglu S. Factors affecting choice
of specialty among first-year medical students of four
universities in different regions of Turkey. Croat Med J. 2008;
20. Dorsey ER, Jarjoura D, Rutecki GW. Influence of controllable
lifestyle on recent trends in specialty choice by US medical
students. JAMA. 2003; 290:1173-1178.
21. Paik JC, Howard G, Lorenz RG. Postgraduate choices
of graduates from medical scientist training programs,
2004-2008. JAMA. 302:1271-3.
22. Fukuda Y, Harada T. Gender differences in specialty
preference and mismatch with real needs in Japanese
medical students. BMC Med Educ. 2010; 10:15.
23. Newton DA, Grayson MS. Trends in career choice by US
medical school graduates. JAMA. 2003; 290:1179-82.
24. Dikici MF, Yaris F, Topsever P, Tuncay Muge F, Gurel
FS, Cubukcu M, Gorpelioglu S. Factors affecting medical
students in formulating their specialty preferences in Jordan.
BMC Med Educ. 2008; 8:32.
25. Mariolis A, Mihas C, Alevizos A, Gizlis V, Mariolis T,
Marayiannis K, Tountas Y, Stefanadis C, Philalithis A,
Creatsas G. General Practice as a career choice among
undergraduate medical students in Greece. BMC Med Educ.
2007; 7:15.
26. Jeffe DB, Whelan AJ, Andriole DA. Primary care specilaty
choices of United States medical graduates, 1996-2006.
Academic medicine : journal of the Association of American
Medical Colleges. 2010 Jun;85(6):947-58.
27. Pawełczyk A, Pawełczyk T, Bielecki J. Determinants of
primary care specialty choice. Pol Merkur Lekarski. 2007
28. Hauer KE, Durning SJ, Kernan WN, Fagan MJ, Mintz M,
O'Sullivan PS, et al. Factors associated with medical students'
career choices regarding internal medicine. JAMA. 2008 Sep
29. Chang PY, Hung CY, Wang KI, Huang YH, Chang KJ.
Factors influencing medical students' choice of specialty. J
Formos Med Assoc. 2006 Jun;105(6):489-96.
How to Cite
Shrestha, B., Pokhrel, Y. R., & Butterworth, K. (2016). Determinants of Postgraduate Students’ Choices of Speciality. Journal of Nepal Medical Association, 54(201), 01-07.
Original Article