Factors associated with medical students’ preference for surgical specialties at a Vietnamese medical school: a cross-sectional study

Abstract Background Medical students’ specialty preferences are shaped by personal, educational, and contextual influences. Understanding preference for surgical specialties is particularly relevant in settings where the surgical workforce is limited, but stated preferences should not be equated with subsequent entry into surgical training. This study examined factors associated with surgical specialty preference among medical students at a private, not-for-profit medical school in Vietnam. Methods A cross-sectional analysis used the specialty-preference module of a broader institutional survey conducted from September to November 2024. Students in years 2–4 reported three ranked specialty preferences before rating perceived influences and stereotypes. The primary outcome was a first-ranked surgical preference. The secondary outcome was any surgical specialty among the three ranks. Study-specific item ratings were summarized as median (interquartile range), with Benjamini-Hochberg adjustment across 33 comparisons. Exploratory Firth regression included gender, permanent residence, cohort, and concurrent administrative/leadership-role and research/teaching ratings. Model variables were selected after data examination. Results Of 144 eligible students, 131 responded (91.0%). Forty-nine students (37.4%) reported a first-ranked surgical preference, and 74 (56.5%) listed a surgical specialty at any rank. None of the 33 item-level comparisons reached q < 0.05. In the primary model ( n = 131), the odds ratio (OR) for male versus female gender was 2.46 (95% confidence interval [CI] 1.14–5.46). In the numerical-score specification, the administrative/leadership-role OR per 1-point rating difference was 1.62 (95% CI 1.17–2.33). Categorical analyses did not establish a linear gradient. These estimates describe concurrent associations conditional on the selected model, not antecedent determinants. Patterns for cohort and research/teaching ratings varied across outcome definitions and model specifications. Conclusion Surgical preference co-occurred with male gender and higher self-reported importance of administrative/leadership roles in exploratory models. The ratings describe perceived influences reported after students stated their preferences, not independent antecedent predictors. Prospective studies are needed to establish temporal relationships and links with subsequent training decisions.