Factors associated with intentions to pursue pediatric subspecialties: a cross-sectional study among medical residents of the Federal District, Brazil

The choice of a medical specialty is multifactorial, influenced by personal, professional, and institutional factors. In pediatrics, understanding the factors associated with attitudes and intentions toward pursuing subspecialty training is crucial for addressing workforce planning and educational strategies. This study aimed to identify the factors associated with pediatric residents' attitudes and intentions toward pursuing subspecialty training in the Federal District, Brazil. A cross-sectional, survey-based study was conducted among pediatric residents from programs affiliated with the Federal District Health Department. Data were collected via a structured electronic questionnaire. The instrument included sociodemographic variables and items assessing attitudes toward subspecialization using a Likert-scale. Statistical analysis included descriptive statistics, cluster analysis, mediation analysis, and longitudinal evaluation. Among 73 respondents (response rate 49.6%), the majority were female (83.6%), with a median age of 28 years. About 74.5% expressed interest in pursuing a pediatric subspecialty. Key influencing factors included: procedural nature of the subspecialty, clinical exposure during training, improved employability, work-life balance, program quality, and job security. Cluster analysis revealed three attitudinal profiles: “Enthusiasts,” “Neutrals/Pragmatists,” and “Satisfied with General Pediatrics.” Mediation analysis confirmed that perceived employability partially mediated the relationship between belief in quality of life in general pediatrics and attitude toward subspecialization. The intention to pursue a pediatric subspecialty is associated with combination of experiential, lifestyle, and career-related factors. Early positive clinical exposure, role models, and perceptions of employability and work-life balance play significant roles. These findings contribute to understanding the factors associated with subspecialization intentions during residency and may inform the development of more nuanced career guidance within pediatric training programs. Approved by the Research Ethics Committee of the Health Sciences Education and Research Foundation (CAAE: 75,757,023.8.0000.5553). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.