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Learn more: PMC Disclaimer | PMC Copyright Notice BMC Med Educ . 2026 Mar 3;26:587. doi: 10.1186/s12909-026-08939-9 Search in PMC Search in PubMed View in NLM Catalog Add to search Factors influencing the choice of specialty by medical students in a new university in Rwanda Heritier Mfura Heritier Mfura 1 School of Medicine, University of Global Health Equity, Kigali, Rwanda Find articles by Heritier Mfura 1, ✉ , Abebe Bekele Abebe Bekele 1 School of Medicine, University of Global Health Equity, Kigali, Rwanda Find articles by Abebe Bekele 1 Author information Article notes Copyright and License information 1 School of Medicine, University of Global Health Equity, Kigali, Rwanda ✉ Corresponding author. Received 2025 Jul 4; Accepted 2026 Feb 26; Collection date 2026. © The Author(s) 2026 Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/ . PMC Copyright notice PMCID: PMC13067440 PMID: 41776491 Abstract Background 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. Methods 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. Results 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. Conclusion 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. Supplementary Information The online version contains supplementary material available at 10.1186/s12909-026-08939-9. Keywords: specialty preference, specialty choice, factors, medical students, UGHE, Rwanda Background The specialty preferences and choices of medical students have direct implications on future workforce composition, future healthcare delivery, workforce distribution, and policy planning [ 1 ]. Identifying the factors that shape these preferences is critical for informing career guidance, aligning training programs with national health priorities, and addressing imbalances in specialty distribution [ 2 , 3 ]. The choice of a medical specialty is influenced by a complex interplay of personal motivation and contextual factors. Intrinsic drivers such as intellectual interest, clinical engagement, and perceived fulfillment are often weighed alongside extrinsic considerations such as income expectations, job security, work-life balance, mentorship and societal norms [ 4 ]. Demographic variables such as age, gender, clinical exposure, competitiveness of specialties, and availability of residency training programs further contribute to decision-making [ 5 , 6 ]. These factors often vary by context. In Rwanda, a study has shown that intellectual challenge, interaction with residents, and core clerkship experiences significantly influenced students’ choices, with gender differences also evident in how students valued research opportunities or responded to negative training experiences [ 7 ]. Such findings highlight the importance of local context in shaping medical career trajectories. The Rwandan healthcare system has experienced notable transformation in recent years, marked by ambitious initiatives such as the “Four by Four” program, which seeks to quadruple the number of healthcare providers within four years [ 8 ]. This effort emerged in response to Rwanda’s continued shortfall relative to the WHO-recommended healthcare worker density of 4.45 per 1,000 population [ 9 ]; at present, Rwanda has approximately 1 healthcare worker per 1,000 people [ 8 ]. In parallel, institutions like the University of Global Health Equity (UGHE) are contributing to workforce development by training physicians through a dual degree program that emphasizes not only clinical medicine but also social medicine, health equity, and global health. This unique approach at UGHE could shape students’ career choices toward underserved specialties or global health-oriented fields different from students from other universities. These national and institutional efforts may shape medical students’ specialty preferences in ways that are distinct from those in other contexts. This study explored the specialty preferences and influencing factors among UGHE medical students. The findings aimed to inform educational strategies, guide workforce development, and contribute to evidence-based health planning in Rwanda. Methods Objectives of the study were to: Explore the preferences of medical specialty by medical students at UGHE. Explore the factors that influence the choice of medical specialty by medical students at UGHE. Study setting and design The University of Global Health Equity (UGHE) offers a dual-degree Bachelor of Medicine, Bachelor of Surgery/Master in Global Health Delivery (MBBS/MGHD) program designed to train medical professionals committed to serving underserved and remote communities. The medical curriculum is divided into four main phases: a preparatory phase designed to help students manage the transition into a rigorous medical curriculum, a biosocial foundations of medicine phase where students acquire foundational knowledge and skills in the basic medical sciences, a clinical and health delivery phase consisting of two and a half years of hands-on clinical rotations that focus on the application of this knowledge in real-world patient care, and a final Exploration and development phase. UGHE emphasizes community engagement, social medicine, and global health principles, reflecting its mission to prepare graduates to address health disparities in resource-limited settings. A cross-sectional quantitative study design was used in this study, utilizing a self-administered online questionnaire. Sample A census sampling was conducted to invite all 214 medical students at UGHE in the academic year 2024/2025 to the survey. Data collection tool The online survey administered through REDCap web application used in this study consisted of three sections. Section A included basic demographics and background information; section B assessed students preferred medical specialties; and section C examined the factors influencing their choices. Income categorization in section A was based on participant’s subjective comparison of their family’s annual income to the average income of families in their country. Medical students in year two and three were at pre-clinical phase of their training while those in year four, five and six (internship) were at the clinical phase. Completion of individual questionnaire items was optional; therefore, some variables contain missing responses. For all analyses, proportions were calculated using item-level denominators based on the number of participants who responded to each specific question. The questionnaire was developed specifically for this study based on a review of relevant literature and medical education expert input. Data collection procedure An online survey was emailed to all medical students enrolled at UGHE and was open for two months from 1st March 2025 to 30th April 2025. Key measures Our study had two key measures: Specialty preferences – the percentage of the respondents’ specialty of choice for the already decided and not fully decided participants. Participants who are decided were those who answered yes to the question “ have you decided on a specialty you would like to pursue after graduation from the MBBS/MGHD program?” while those not fully decided were participants who are considering certain specialties but not yet decided. The factors that influenced the preference of specialty. The percentage of respondents choosing “important” and “very important”, as well as the percentage of choosing “slightly important” and “not important” for each factor. Data analysis Descriptive statistics were used to summarize the demographics and all key measures. Chi square test was used to analyse the association between key measures and demographic variables. Logistic regression was used to examine the independent associations between the key measures and demographic variables, adjusting for potential confounders. All statistical analyses were conducted using SPSS version 24, with P-value set at 0.05. Results A total of 197 respondents completed the survey, translating to a 92% response rate. The mean age was 22 (range 18–30), 146 (74.1%) were female, 91 (46.2%) were in their clinical phase of training, and 172 (87.3%) were from Rwanda. One hundred fifty-five (78.7%) came from middle-income families, 170 (86.3%) were the first to study medicine as a profession amongst their first-degree relatives, and 123 (62.4%) came from urban settings. Eighty-five (52.8%) prefer to specialize outside of Rwanda, while 71 (44.1%) are comfortable with training either in Rwanda or outside Rwanda. One hundred fourteen (72.2%) are either very confident or somewhat confident in choosing the right specialty and 132 (85.2%) reported feeling very comfortable working in rural or underserved areas after their specialization (Table 1 ). Table 1. Sociodemographic and background information Sample N (%) 197 Sex Male 51 (25.9%) Female 146 (74.1%) Year of study Sixth 29 (14.7%) Fifth 29 (14.7%) Fourth 33 (16.8%) Third 40 (20.3%) Second 66 (33.5%) Nationality Rwanda 172 (87.3%) International* 24 (12.2%) Missing data 1 (0.5%) Income High 33 (16.8%) Middle 155 (78.7%) Poor 9 (4.6%) First in family study medicine No 27 (13.7%) Yes 170 (86.3%) Family location Urban 123 (62.4%) Rural 74 (37.6%) Time participants started considering their future specialty Before med school 63 (32%) Pre-clinical 44 (22.3%) Clinical 56 (28.4%) Internship 7 (3.6%) Missing data 27 (13.7%) Preferred location of specialty training Rwanda 5 (2.5%) Abroad 85 (43.1%) Either 71 (36%) Missing data 36 (18.3%) Confidence in their selection (Very/somewhat) confident 114 (57.9%) Neutral 30 (15.2%) (Very/somewhat) uncertain 14 (7.1%) Missing data 39 (19.8%) Would you consider working in rural or underserved areas Yes 132 (67%) No 23 (11.7%) Missing data 42 (21.3%) Open in a new tab * Burundi, DRC, Lesotho, Tanzania, Uganda, Liberia, Malawi, Sierra Leone With all respondents who provided their specialty preference, 76 (41%) indicated that they had made their decision and 109 (59%) had not yet fully decided. There were 12 missing data. The top two specialties preferred by the respondents were surgery ( n = 52, 28.1%) and pediatrics ( n = 36, 19.5%) (Table 2 ). Table 2. Specialty preferences of the participants Surgery Decided Not fully decided Total 28 (36.8%) 24 (22%) 52 (28.1%) Pediatrics 18 (23.7%) 18 (16.5%) 36 (19.5%) Global Health 2 (2.6%) 19 (17.4%) 21 (11.3%) Internal Medicine 5 (6.6%) 12 (11%) 17 (9.2%) Dermatology 5 (6.6%) 11 (10.1%) 16 (8.6%) Oncology 2 (2.6%) 8 (7.3%) 10 (5.4%) Ophthalmology 3 (3.9%) 6 (5.5%) 9 (4.8%) Obstetrics and gynecology 6 (7.9%) 2 (1.8%) 8 (4.3%) Radiology 2 (2.6%) 1 (0.9%) 3 (1.6%) Emergency 2 (2.6%) 0 (0%) 2 (1.1%) Dentistry 2 (2.6%) 0 (0%) 2 (1.1%) ENT 1 (1.3%) 0 (0%) 1 (0.5%) Anesthesiology 0 (0%) 1 (0.9%) 1 (0.5%) Psychology 0 (0%) 1 (0.9%) 1 (0.5%) Other 0 (0%) 6 (5.5%) 6 (3.2%) Total 76 (100%) 109 (100%) 185 (100%) Open in a new tab More than 60% of respondents identified four key factors that were important or very important in influencing their specialty choice: (1) personal interest (75.2%), (2) work-life balance (66.5%), (3) job opportunities (66%), and (4) financial rewards in the specialty (61.9%). While two factors were seen as least influential to their specialty choice, less than 30% of respondents indicated they were important or very important: (1) family expectations (22.8%), and (2) prestige associated with the specialty (24.9%) (Table 3 ). Table 3. Factors that influence the specialty preference Not important/slightly important Important/very important Personal interest in the specialty 2 (1%) 148 (75.2%) Work-life balance 12 (6.1%) 131 (66.5%) Job opportunities 7 (3.5%) 130 (66%) Financial rewards in the specialty 17 (8.6%) 122 (61.9%) Length of training required 24 (12.2%) 103 (52.3%) Influence of mentors/supervisors 39 (19.8%) 79 (40.1%) Opportunity to work in rural/underserved areas 51 (25.9%) 60 (30.5%) Availability of the program 81 (50.3%) 80 (49.7%) Prestige associated with the specialty 55 (28%) 49 (24.9%) Family expectations 77 (39.1%) 45 (22.8%) Open in a new tab * Responses to these Likert-scale items were optional; therefore, the total number of responses varies across factors Students in clinical years had 3.8 higher odds than those in pre-clinical years in making the decisions on the specialty of their preference (AOR = 3.8, P < 0.001). Students who have more confidents in their ability to choose the specialty were 5.9 times more likely to have made their decisions compared to those who were not confident (AOR = 5.9, P = 0.02) (Table 4 ). Table 4. Association between decision status and year of study and confidence in choosing a specialty Variables Categories Decision status COR (CI) P -value AOR (CI) P -value Decided Not decided Year of study Pre-clinical years 25 (32.9%) 75 (68.8%) Ref < 0.001* Ref < 0.001* Clinical years 51 (67.1%) 34 (31.2%) 4.5 (2.4–8.4) 3.8 (1.7–8.1) Confidence in choosing a specialty Not confident 2 (14.3%) 12 (85.7%) Ref 0.01* Ref 0.02 Confident 59 (51.8%) 55 (48.2%) 6.4 (1.3–30.0) 5.9 (1.2–29.0) Open in a new tab No significant statistical differences were found whether they are first to study medicine in family or not in determining the time they considered the specialty ( P = 0.577) or their confidence in choosing the specialty ( P = 0.521) (Table 5 ). Table 5. Association between the first in family to study medicine status and time to consider specialty and confidence Variables Categories First in family to study medicine P -value Yes No When considered Before med school 56 (37.8%) 7 (31.8%) 0.577 Pre-clinical 40 (27.0%) 4 (18.2%) Clinical 46 (31.1%) 10 (45.5%) Internship 6 (4.1%) 1 (4.5%) Confidence in choosing a specialty Confident 15 (93.8%) 99 (88.4%) 0.521 Not confident 1 (6.3%) 13 (11.6%) Open in a new tab No significant statistical differences were found between their year of study and their confidence in choosing the specialty ( P = 0.209) (Table 6 ). Table 6. Association between year of study and confidence in choosing a specialty Variable Category Year of study P -value Pre-clinical years Clinical years Confidence in choosing a specialty Not confident 9 (64.3%) 5 (35.7%) 0.209 Confident 53 (46.5%) 61 (53.5%) Open in a new tab In the unadjusted analysis, two factors showed statistically significant differences between male and female medical students in deciding their specialty of preference. Male students were less likely than female students to consider the length of training as important (COR = 0.32, p = 0.012). Conversely, male students were more likely to consider the influence of mentors or supervisors as important (COR = 2.75, p = 0.044) (Table 7 ). However, after adjustment, these associations were no longer statistically significant, suggesting that the initial findings may not represent independent effects. Table 7. Association between gender and importance of factors that influence the choice of specialty Variables Categories Sex COR (CI) P -value AOR (CI) P -value M F Personal interest in the specialty Not important/slightly important 0 (0%) 2 (100%) NA > 0.999 NA NA Important/very important 41 (27.7%) 107 (72.3%) Work-life balance Not important/slightly important 4 (33.3%) 8 (66.7%) NA 0.416 Ref 0.75 Important/very important 30 (22.9%) 101 (77.1%) 0.49 (0.00-38.52) Job opportunities Not important/slightly important 3 (43.9%) 4 (57.1%) NA 0.281 Ref 0.428 Important/very important 32 (24.6%) 98 (75.4%) 7.58 (0.05-1136.88) Financial rewards in the specialty Not important/slightly important 6 (35.5%) 11 (64.7%) NA 0.388 Ref 0.807 Important/very important 31 (25.4%) 91 (74.6%) 1.55 (0.04–52.92) Length of training required Not important/slightly important 12 (50%) 12 (50%) Ref 0.012* NA NA Important/very important 25 (24.3%) 78 (75.7%) 0.32 Influence of mentors/supervisors Not important/slightly important 6 (15.4%) 33 (84.6%) Ref 0.044* Ref 0.361 Important/very important 26 (32.9%) 53 (67.1%) 2.75 0.29 (0.02–4.02) Opportunity to work in rural/underserved areas Not important/slightly important 16 (31.4%) 35 (68.6%) NA 0.585 Ref 0.49 Important/very important 16 (31.4%) 44 (73.3%) 0.49 (0.06–3.70) Prestige associated with the specialty Not important/slightly important 16 (29.1%) 39 (70.9%) NA 0.953 Ref 0.727 Important/very important 14 (28.6%) 35 (71.4%) 0.69 (0.08–5.51) Family expectations Not important/slightly important 24 (31.2%) 53 (68.9%) NA 0.288 Ref 0.383 Important/very important 10 (22.2%) 35 (77.8%) 2.49 (0.32–19.37) Open in a new tab Discussion This study examined medical specialty preferences and the factors influencing career decision-making among students enrolled at the University of Global Health Equity (UGHE) in Rwanda. A key finding was that a majority of respondents (58%) had not yet selected a preferred specialty, reflecting the uncertainty characteristic of early-stage medical education. This indecision was more prevalent among preclinical students, suggesting that clinical exposure is a critical determinant in shaping career interests. These results are consistent with findings from previous studies in Rwanda and across sub-Saharan Africa, which highlight the influence of clinical rotations and mentorship on specialty choice [ 6 , 7 ]. Surgery emerged as the most commonly preferred specialty (28.6%), followed by pediatrics (19.8%). These preferences are consistent with trends reported in other African countries, where surgical and pediatric specialties frequently rank among the top choices for medical students [ 10 – 13 ]. Specifically, close to 30% of students expressed a preference for surgical careers in Nigeria and Ethiopia [ 10 , 11 ], while pediatrics was also highly ranked by medical students as their preferred specialty in Botswana, Congo, and Cameroon [ 12 , 13 ]. Personal interest was the most important factor in specialty decision-making. This finding aligns with global literature underscoring the importance of intrinsic motivation in career selection [ 2 , 3 ], as well as regional studies in Nigeria and Botswana [ 10 , 13 ]. In contrast, factors such as prestige and family expectations were rated as less influential, corroborating the findings of a recent systematic review of 152 African medical schools [ 14 ]. These results suggest that intrinsic motivations such as personal interest and alignment with professional values may play a more prominent role than external pressures in shaping specialty preferences among medical students in the region. The findings revealed that students in clinical years were significantly more likely to have selected a specialty ( p < 0.001), highlighting the important role of clinical exposure in shaping career choices. Engagement in clinical rotations provides students with direct experience in various specialties, allowing them to observe professional roles, interact with mentors, and gain practical insight into the day-to-day realities of medical practice. This hands-on exposure helps students make more informed decisions by aligning their interests with the demands and culture of specific fields. Such results aligned with previous research suggesting that access to reliable career information is an essential component in shaping informed specialty preferences [ 15 ]. Gender-based differences were observed in the importance assigned to specific influencing factors. Male students were less likely to consider the duration of training as important in their specialty choice, while female students were less likely to identify the influence of mentors or supervisors as a key factor. These findings highlight the nuanced ways in which gender shape career decision-making and point to the need for tailored guidance and support strategies within medical education. Efforts to ensure equitable access to mentorship and to address gender-specific concerns such as training length or role modeling remain essential for fostering an inclusive and responsive learning environment [ 15 , 16 ]. A notable proportion of students (52.8%) expressed a preference to pursue postgraduate training abroad, while 44.1% were open to either local or international options. This reflects a broader trend seen in African medical schools and may be driven by perceptions of higher training quality or greater career opportunities overseas [ 12 , 13 ]. However, this inclination raises concerns regarding potential brain drain and highlights the importance of strengthening domestic postgraduate training programs. The results of the study also showed that the underrepresentation of essential specialties such as psychiatry, emergency medicine, and anesthesiology points to a persistent mismatch between student interests and national health workforce needs. Similar imbalances have been reported in both high- and low-income settings [ 17 , 18 ]. Addressing these gaps will require coordinated strategies, including early exposure to critical specialties, financial and professional incentives, and alignment of postgraduate training with national health priorities [ 19 ]. Implications for medical education and workforce planning This study offers important insights for medical education and health workforce planning in Rwanda. The high proportion of students undecided about their specialty points to the need for more structured career guidance. Integrating career counseling, mentorship, and broad specialty exposure into the preclinical curriculum could support students in making more informed and confident decisions. The strong influence of personal interest and perceived job opportunities on specialty choice highlights the importance of aligning medical training with both student aspirations and national health system needs. While fields such as surgery and pediatrics continue to attract the most interest, critically underrepresented specialties, including psychiatry, emergency medicine, and anesthesia, remain overlooked. Promoting interest in these fields may require targeted interventions such as clinical rotations in underserved specialties, mentorship by practitioners in these areas, and incentive structures that make these careers more appealing. A notable proportion of students expressed a preference for postgraduate training abroad. This reflects both the perceived quality and appeal of international programs, as well as concerns about the availability and competitiveness of local training opportunities. Strengthening in-country residency programs through faculty development, infrastructure investment, and academic partnerships could enhance their attractiveness and reduce reliance on external training. Complementary policies such as bonded scholarships, rural service incentives, and guaranteed placements may further support retention of trained professionals within the national health system. Gender-based differences in specialty decision-making also emerged, underscoring the need for gender-sensitive educational and workforce policies. Supporting women through mentorship, flexible training pathways, and family-friendly environments can help ensure equitable access to all specialties and strengthen diversity within the health workforce. Limitations of the study This study adds to the body of literature on medical student specialty preferences in Rwanda. The high response rate and inclusion both preclinical and clinical students enabled comparisons across different stages of training, and the examination of a wide range of influencing factors provided a more comprehensive understanding of career decision-making. However, the results of this study must be viewed in light of some limitations. The cross-sectional design restricts the ability to draw causal inferences, and longitudinal studies would be more appropriate for tracking how preferences evolve and influence actual career trajectories. Additionally, the study was conducted at a single institution –UGHE- which, while distinct in its mission and curriculum, may not reflect the broader population of medical students in Rwanda or the region. Therefore, caution should be exercised when generalizing the results. Future research should employ multi-institutional or longitudinal study to capture a more representative and the change in medical students’ career preferences. Moreover, although the questionnaire was adopted from similar studies and reviewed by medical education experts, it was not pre-tested or formally validated, which may affect the reliability of the findings. Finally, as the study relied on self-reported responses, the results may have been influenced by social desirability bias. Recommendations and conclusion The findings of this study suggest several key actions to improve medical education and inform future workforce planning in Rwanda and similar contexts. First, there is a need to integrate structured career guidance and mentorship into the early stages of medical education. Providing students with systematic exposure to a broad range of specialties - including those currently underrepresented - can support more informed, confident, and reflective career decision-making. Second, efforts should focus on strengthening the quality, visibility, and competitiveness of all local postgraduate training programs. This can be achieved through targeted investments in faculty development, infrastructure, and strategic partnerships with both regional and international academic institutions. Enhancing the appeal and perceived value of domestic residency training may also help reduce the preference for pursuing specialization abroad. Third, addressing gender disparities in specialty selection requires the implementation of gender-sensitive policies. These may include fostering inclusive academic environments, ensuring access to female mentorship, and creating flexible and family-friendly training pathways to support equitable participation in all specialties. In addition, aligning medical training more closely with national health priorities is essential. Policymakers and educational institutions should work collaboratively to develop incentive schemes such as rural service bonuses, bonded scholarships, and guaranteed placement opportunities that encourage students to pursue careers in high-need specialties. Finally, future research should adopt longitudinal designs to track how students’ preferences evolve throughout their training and transition into actual career choices. Expanding this research across multiple institutions will provide a more comprehensive and representative understanding of medical education trends in the region, thereby strengthening the evidence base for sustainable and context-specific interventions. Supplementary Information Supplementary Material 1. (22KB, docx) Acknowledgements The authors wish to thank the participants of this study for sharing their time and experiences. Abbreviations UGHE University of Global Health Equity MBBS/MGHD Bachelor of Medicine and Bachelor of Surgery/ Master of Science in Global Health Delivery SPSS Statistical Package for the Social Sciences AOR Adjusted Odds Ratio COR Crude Odds Ratio Authors’ contributions AB conceived the study; AB and HM designed the work; HM acquired the data; HM analysed the data; AB and HM interpreted the results, and HM drafted the original manuscript. AB and HM revised the manuscript, approved the submitted version of this manuscript and agreed to be accountable for their contributions. Funding No funding was acquired for this study. Data availability The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Declarations Ethics approval and consent to participate Ethics approval granted by University of Global Health Equity’s Institutional Review Board (Protocol’s reference number: UGHE-IRB/2025/371). Written informed consent to participate was obtained from each participant. The research was conducted following standards in accordance with the Declaration of Helsinki. Consent for publication Not Applicable. Competing interests The authors declare no competing interests. Clinical trial number Not applicable. Footnotes Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Reference 1. Rowson M, Smith A, Hughes R, Johnson O, Maini A, Martin S, Martineau F, Miranda JJ, Pollit V, Wake R, Willott C. The evolution of global health teaching in undergraduate medical curricula. Globalization health. 2012;8:1–8. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 2. Dorsey ER, Jarjoura D, Rutecki GW. Influence of controllable lifestyle on recent trends in specialty choice by US medical students. JAMA. 2003;290(9):1173–8. [ DOI ] [ PubMed ] [ Google Scholar ] 3. Scott IM, Abu-Laban RB, Gowans MC, Wright BJ, Brenneis FR. Emergency medicine as a career choice: a descriptive study of Canadian medical students. Can J Emerg Med. 2009;11(3):196–206. [ DOI ] [ PubMed ] [ Google Scholar ] 4. Sawan D, Alrefaei GM, Alesawi A, Abualross O, Alsuwaida SA, Meer N, Alsuwaida S. Preferences, career aspects, and factors influencing the choice of specialty by medical students and interns in Saudi Arabia: a cross-sectional study. Cureus. 2023;15(8). [ DOI ] [ PMC free article ] [ PubMed ] 5. Al-Ansari SS, Khafagy MA. Factors affecting the choice of health specialty by medical graduates. J Family Community Med. 2006;13(3):119–23. [ PMC free article ] [ PubMed ] [ Google Scholar ] 6. Mohammed TA, Abdulrahman AA, Saud KA, Alaa NT. Specialty preferences and factors affecting future career choice among medical graduates in Saudi. J family Med Prim care. 2020;9(3):1459–63. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 7. Kansayisa G, Yi S, Lin Y, Costas-Chavarri A. Gender-based analysis of factors affecting junior medical students’ career selection: addressing the shortage of surgical workforce in Rwanda. Hum Resour health. 2018;16:1–8. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 8. Ministry of Health Rwanda. The 4x4 Reform: A Path to Quality Health Care in Rwanda [Internet]. Kigali: Ministry of Health Rwanda. 2024. Available from: https://www.moh.gov.rw/news-detail/the-4x4-reform-a-path-to-quality-health-care-in-rwanda 9. Health workforce requirements for universal health coverage. and the Sustainable Development Goals [Internet]. www.who.int.2018. Available from: https://www.who.int/publications/i/item/9789241511407 10. Adebajo GO, Ijadunola MY, Akinwamide ES, Oluduro MI, Eluyinka OD, Odedeyi CA, Elugbaju OT. Speciality preferences and influencing factors among medical students at a South-Western Nigerian University. Discover Educ. 2024;3(1):230. [ Google Scholar ] 11. Seyoum N, Biluts H, Bekele A, Seme A. Medical students’ choice of specialty and factors determining their choice: a cross-sectional survey at the Addis Ababa University, School oF Medicine, Ethiopia. Ethiop Med J. 2014;52(3):129–35. [ PubMed ] [ Google Scholar ] 12. Kanmounye US, Temgoua M, Endomba FT. Determinants of residency program choice in two central African countries: an internet survey of senior medical students. Int J Med Students. 2020;8(1):20–5. [ Google Scholar ] 13. Rukewe A, Abebe WA, Fatiregun AA, Kgantshang M. Specialty preferences among medical students in Botswana. BMC Res Notes. 2017;10:1–5. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 14. Bernard A, Mengesha D, Flaharty K, Tiertoore N, Tolera A, Wubishet H, Gebeyehu T, Abdullahi H, Abdu A, Adem Y, Berzack S. Personal and Contextual Influences on African Medical Students’ Career Choices in Primary Care: A Cross-Sectional Mixed-Methods Study. Fam Med. 2025;57(5):371–8. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 15. Neil L, Umucyo K, Binagwaho D, Waka A. Gender-based support systems influencing female students to pursue a bachelor of medicine, bachelor of surgery (MBBS) in Rwanda. BMC Med Educ. 2024;24(1):641. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 16. Georgi M, Morka N, Patel S, Kazzazi D, Karavadra K, Nathan A, Hardman G, Tsui J. The impact of same gender speed-mentoring on women’s perceptions of a career in surgery–a prospective cohort study. J Surg Educ. 2022;79(5):1166–76. [ DOI ] [ PubMed ] [ Google Scholar ] 17. Harris JC. Meeting the Workforce Shortage: Toward 4-Year Board Certification in Child and Adolescent Psychiatry. J Am Acad Child Adolesc Psychiatry. 2018;57(10):722–4. [ DOI ] [ PubMed ] [ Google Scholar ] 18. Khan IA, Karim HM, Khan IA. Anesthesia services in low-and middle-income countries: The fragile point for safe surgery and patient safety. Cureus. 2023;15(8). [ DOI ] [ PMC free article ] [ PubMed ] 19. Weissman C, Avidan A, Tandeter H, Zisk Rony RY. Unpopular medical specialties: exploring the concept that the customer knows best. BMC Med Educ. 2023;23(1):268. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] Associated Data This section collects any data citations, data availability statements, or supplementary materials included in this article. Supplementary Materials Supplementary Material 1. (22KB, docx) Data Availability Statement The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. 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