Pediatrics Specialty Choice Among Matriculants of MD-Granting US Medical Schools

TL;DR

This study finds that 10% of US medical school graduates choose pediatrics, with factors like clerkship quality and career plans influencing this choice.

Contribution

The study identifies specific variables associated with choosing pediatrics as a specialty, offering insights to support workforce development in the field.

Findings

10% of matriculants chose pediatrics at graduation, with higher odds for those who intended pediatrics at matriculation.

Odds of choosing pediatrics were lower for more recent matriculants and those planning research careers.

Women were more likely to choose pediatrics compared to men.

Abstract

What is the prevalence of, and variables associated with, pediatrics specialty choice at graduation among US MD-granting school matriculants?

In this cohort study of 7 US MD-granting school matriculant cohorts, 10% of matriculants chose pediatrics at graduation. Pediatrics specialty choice at graduation odds were higher for those who intended pediatrics at matriculation, rated their pediatrics clerkship quality more highly, and planned careers including patient care; odds were lower for more recent matriculants and those who planned careers including research, and, in models among men and among women, associations were similar.

These findings highlight opportunities before and during medical school to promote or sustain pediatrics specialty choice.

The numbers of US MD-granting school graduates choosing pediatrics have decreased over the past decade. Identifying variables associated with pediatrics specialty choice at graduation may inform efforts to strengthen the emerging pediatrics workforce.

To describe the prevalence of, and identify variables associated with, pediatrics specialty choice at graduation among 7 US MD-granting school matriculant cohorts.

This cohort study used deidentified, individual-level Association of American Medical Colleges (AAMC) data from 2013-2014 through 2019-2020 matriculant cohorts, followed up through 2022-2023, who graduated and responded to the AAMC Graduation Questionnaire (GQ) though 2022-2023. Data were analyzed from January 2025 to August 2025.

Demographic characteristics, medical school experiences, and career plans.

The main outcome, measured with GQ data, was specialty choice at graduation, dichotomized as pediatrics vs all other specialties. The χ2 test and analysis of variance were used to assess bivariate associations. Multilevel logistic regression was used to assess associations with the outcome.

Of 101 579 GQ respondents in the study (75% of all 134 759 study-eligible graduates), 52 810 (52%) were women, 55 027 (54%) self-identified as White, and 10 031 (10%) chose pediatrics at graduation. Odds of pediatrics specialty choice at graduation were higher for women (vs men; adjusted odds ratio [AOR], 2.34 [95% CI, 2.23-2.46]), those with pediatrics (vs all other specialties) intention at matriculation (AOR, 9.21 [95% CI, 8.68-9.76]), those who rated the quality of their pediatrics clerkship more highly (per unit increase in quality; AOR, 2.22 [95% CI, 2.13-2.32]), and those whose career plans at graduation included (vs did not include) patient care (AOR, 2.19 [95% CI, 1.77-2.71]); odds were lower for 2019-2020 (vs 2013-2014) matriculants (AOR, 0.72 [95% CI, 0.66-0.79]), and for those whose career plans at graduation included (vs did not include) research (AOR, 0.75 [95% CI, 0.72-0.79]). In separate models for men and for women, associations were of similar direction and magnitude.

In this cohort study, pediatrics specialty choice at graduation decreased among more recent matriculant cohorts. We identified variables independently associated with pediatrics specialty choice at graduation, which can inform efforts before and during medical school to promote or sustain pediatrics specialty choice among US MD-granting school matriculants.

This cohort study describes the prevalence of, and variables associated with, pediatrics specialty choice at graduation among matriculants of MD-granting medical schools in the US.