For most medical students, the physician specialty they plan on pursuing as a career path the day of their white-coat ceremony changes by the time Match Day rolls around four years later.
2025 data shows that 71% of medical students change their specialty preference between entering medical school and graduating. Those shifts, however, were less pronounced in certain specialties.
So, which specialties tend to hold students’ interest most consistently? And which fields see the biggest surges in interest as students’ progress in their training? Here’s what the data reveals.
Sticky specialties
As part of its 2025 Report on Residents, researchers at the Association of American Medical Colleges (AAMC) analyzed the continuity of U.S. MD medical students’ specialty preference. The data, compiled from the responses of more than 3,700 medical students, was assembled by comparing AAMC’s Matriculating Student Questionnaire, taken before entering medical school, and its Graduation Questionnaire, which is completed upon graduation. Researchers tracked specialty preference continuity in a specialty or subspecialty that falls under that discipline.
Looking at specialties that had at least 50 respondents who participated in both AAMC surveys, only one specialty had a preference continuity that exceeded 50% and eight had a figure higher than 30%. The five physician specialties in which respondents indicated the same specialty preference at medical school matriculation and graduation were:
- Orthopaedic surgery—54.1% of respondents who listed it as their preferred specialty at matriculation also listed it at graduation.
- Neurological surgery or subspecialty—47.5%.
- Pediatrics—41.9%.
- Dermatology—38.9%.
- Emergency medicine—38.2%.
Chad Tracy, MD, is a clinical professor of urology and directs the urology residency program at University of Iowa (UI) Health Care, which is part of the AMA Health System Member Program that provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Dr. Tracy’s anecdotal experiences align with the AAMC data showing that medical students’ specialty preferences frequently change.
When medical students express a specialty preference early on, Dr. Tracy encourages them to keep an open mind and make sure their interest persists as they gain real-world experience in rotations.
“A lot of people come in with an idea of what a specialty is going to be, they do the rotation and they love it, they work hard,” said Dr. Tracy, an AMA member. “It’s everything they thought it would be. Sometimes people come in, and it’s not what they expected.”
Even medical students who might have the strongest inclination should keep an open mind, he said.
“I just worked with a student who has always wanted to be an orthopaedic surgeon,” he said. “He's done ortho research for four years and is on a research-distinction track in the orthopaedics department. He did a two-week rotation with us in urology and now he's decided that he wants to go into urology. So, you know, there is no point [in medical school] at which you're too far in to change your mind.”
Physician specialties that gain traction
For medical students seeking insight into how specialty decisions evolve, researchers at the AAMC also examined the inverse of continuity: the share of MD graduates who ultimately chose a specialty different from their initial preference at matriculation.
Among specialties with at least 50 respondents to both surveys, those showing the greatest growth in preference were:
- Thoracic surgery—68.7% of graduates chose it as their final specialty after initially preferring another field.
- Urology or a urology subspecialty—67.7%.
- Internal medicine-pediatrics: 64.9%
- Vascular surgery—64.3%.
- Anesthesiology—60.5%.
As a urologist, Dr. Tracy reported that it’s uncommon for medical students to have a strong preference for that field on day one of medical school. But like many physician specialties, it tends to gain traction with medical students throughout medical school.
“The number 1 predictor of interest in urology is exposure,” he said. “And that’s not limited to us as a specialty. Some things are just part of your lived experiences. Whereas, if you haven't been to a urologist or been exposed to urology, I don't think a lot of people know exactly what we do.
“More medical schools are allowing students to get in clinical settings early on,” he added. “That’s a chance for students to really explore their options.”
Dr. Tracy’s personal experiences back up the AAMC data showing that “most students don’t really have a great idea what they want to do” at the start of medical school.
“If you work hard and you get good grades and you have good experiences, [those attributes] will apply to every residency.”
When it does come time to finalize a specialty choice, Dr. Tracy’s advice is to make sure the basic aspects of practicing in that field are appealing to you.
“You’ve got to choose something where the day-to-day things that you're doing are interesting to you,” he said. “So you can't choose a specialty based on the coolest, neatest, 1-in-10,000 thing that you've seen. You’ve got to base it on what you're seeing every single day and if that makes you happy and you can come to work and do that.”
