Many first-year medical students arrive at university with a specialty already in mind, while others remain undecided, and a new study from Japan suggests that two factors measured at entry are linked to which group a student falls into. In a three-cohort observational study at a Japanese national university, students who reported having a career role model, and those who assigned greater importance to academic interest, were more likely to name a specific field early in their first year.
The study, published in BMC Medical Education, surveyed the 2023, 2024 and 2025 first-year classes, with participation rates of 63, 84 and 89 percent respectively. Students were surveyed early in the first year and again in the second semester. The researchers used Social Cognitive Career Theory as an interpretive lens and examined two entry-measurable factors, role model presence and academic-interest importance, while adjusting for regional quota admission.
Among 282 students, the presence of a role model was associated with a 17 percentage point higher probability of reporting a named specialty, with a 95 percent confidence interval of 7 to 28 points and an adjusted odds ratio of 2.99. Each standard deviation increase in the importance assigned to academic interest was associated with a 7 point higher probability, with an interval of 2 to 12 points and an odds ratio of 1.49. The academic-interest association held even after accounting for all ten motives assessed in the survey.
Regional quota admission was also strongly associated with early preference reporting, adding 19 percentage points, with an interval of 7 to 31 and an odds ratio of 3.62. The authors suggest this likely reflects self-selection into a policy-defined admission pathway rather than an effect of the policy itself.
The pattern of role-model associations differed by source. In post hoc analysis, all 21 students who named a non-family role model, mostly physicians, reported a named specialty, a proportion of 100 percent. By comparison, 74 percent of students with a family role model and 68 percent of those with no role model had named a field.
The study also examined whether depressive and anxiety symptoms were related to preference status, as a secondary question. In separate models, the odds ratios were 0.89 for depressive symptoms and 0.93 for anxiety symptoms per standard deviation, with confidence intervals compatible with either negligible or modest associations in either direction. The authors caution that an undecided response should not be used as a stand-alone indicator of psychological distress.
Stability emerged as a notable limitation of early preferences. Only 48 percent of the fields named in the first-year survey were named again in the second-semester survey, suggesting that many early preferences are tentative and may change within months.
The authors emphasize that these are mutually adjusted cross-sectional associations and do not establish how specialty preferences form over time. Because the data come from a single Japanese national university and the outcome was measured at a single early time point, the findings describe who reports a preference at entry rather than explaining the development of career choices. The estimates for depressive and anxiety symptoms were imprecise, and the role-model comparison was conducted post hoc. The study identifies entry-measurable characteristics associated with early specialty preference reporting among first-year medical students, while leaving open the question of how those preferences develop and consolidate during medical training.
Subject of Research: Factors associated with early specialty preference reporting among first-year medical students
Article Title: Early specialty preference status among first-year medical students: a three-cohort observational study of role models and academic interest
Article References: Hattori, M., Hasunuma, N., & Nakashima, Y. (2026). Early specialty preference status among first-year medical students: a three-cohort observational study of role models and academic interest. BMC Medical Education. https://doi.org/10.1186/s12909-026-10598-9
Image Credits: AI Generated
DOI: 10.1186/s12909-026-10598-9
Keywords: medical education, specialty preference, first-year medical students, role models, academic interest, Social Cognitive Career Theory, regional quota admission, cross-sectional study, Japan, career choice, depressive symptoms, anxiety symptoms
News Source: Courtney Benton. (October 27, 2026). Role models and academic interest linked to early specialty choices in first-year medical students. Scienmag.
