1249 The Influence of Gender, Race, and Clinical Exposure on Medical Students’ Specialty Decision-Making

INTRODUCTION: Understanding the factors that influence specialty decision-making, particularly for underrepresented students, is crucial for addressing disparities within the physician workforce. METHODS: A cross-sectional study was conducted using survey responses from currently enrolled medical students. The survey was distributed via email and social media to current or incoming U.S. medical students. A total of 540 respondents completed the survey, which assessed the impact of various factors on specialty decision-making using a 7-point Likert scale. RESULTS: Clinical exposure during clerkships, elective rotations, and shadowing were the most influential factors in specialty decision-making. Gender analysis revealed that females were less influenced by the job market/job security (p=0.0080) and salary (p=0.019) compared to males. Intersectional analysis showed that female URM students were less influenced by salary compared to male non-URM students (p=0.019). Female non-URM students were more influenced by research opportunities than male URM students (p=0.018). Post-clerkship students were more influenced by the perceived "malignancy" of the field in their specialty choice than pre-clerkship students (p=0.045). Pre-clerkship students were more influenced by shadowing experiences, specialty interest group events, and classmates’ perceptions, underscoring the importance of these experiences in early medical training. CONCLUSIONS: This study identifies key factors that guide medical student specialty decision-making and highlights significant differences based on gender, URM status, and clerkship exposure. Understanding these factors can inform strategies to support diverse student populations in their specialty choice, ultimately contributing to a more equitable physician workforce.