286 - Choosing Pediatrics – A Qualitative Study of Post-Match Medical Student Perspectives

Publication Number: 1272.286

Kim Tran Lopez, CHOP, Philadelphia, PA, United States; Lolita Alkureishi, University of chicago, Chicago, IL, United States; Marguerite Costich, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Daniel Herchline, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Katherine S. Kellom, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Erin McMaster, UMass Chan Medical School, Auburn, MA, United States; Margarita Ramos, Children's National Health System, Washington, D.C, DC, United States; Sarina Shah, Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, United States; Hana Smith, University of Colorado School of Medicine, Denver, CO, United States; Catherine M. Soprano, Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, DE, United States; Jessica Tomaszewski, Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, DE, United States; Amanda Van Pelt, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Katherine Wu, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Rebecca Tenney-Soeiro, CHOP/PENN, Philadelphia, PA, United States

Background: Despite stable pediatric residency match rates of 97-98% since 2017, pediatrics has seen a troubling decrease in filled residency positions (1). While the 2025 Match showed improvement, the percentage of allopathic students matching into pediatrics continues to decline (2). Existing literature suggests factors that influence students towards pediatrics including early exposure, presence of role models, work life balance, and clinical work, (3-13) but little is known about how these motivations have shifted in recent years.

Objective: This multi-site qualitative study examines the perspectives of post-match fourth year medical students who considered pediatrics but chose a different specialty to:
1. Perform inductive qualitative analysis of semi-structured interviews of fourth year medical students who considered pediatrics but matched into another specialty.
2. Explore factors that positively and negatively influence students’ interest in pediatrics.

Design/Methods: Fourth-year medical students from four institutions completed a REDCap survey to determine eligibility and collect demographic data. An interview guide was generated and guided by Careership theory as described by Hodkinson and Sparkes (14). Semi-structured virtual interviews incorporated a timeline mapping elicitation technique to invite participants to create a visual timeline of key experiences and encourage deeper reflection (15-16). A codebook was created after group review of transcripts representing different institutions and specialties. Reflexive thematic analysis was conducted by multiple team members.

Results: Sixteen interviews were completed across four institutions with medical students who chose psychiatry, internal medicine, emergency medicine, obstetrics/gynecology, or family medicine. The codebook included major categories of drivers for career choice, perceptions of pediatrics, and training experiences. Codes were further organized as factors pulling towards another specialty or pushing away from pediatrics, and as modifiable or non-modifiable. While students were drawn to certain aspects of pediatrics, distinct factors influenced them towards alternate specialties.

Conclusion(s): By examining the experiences of students who seriously considered pediatrics but selected another field, this study highlights potentially modifiable factors contributing to their decision-making. Findings may inform targeted interventions to enhance exposure, mentorship, and structural support within pediatrics, with the goal of sustaining interest and addressing workforce challenges.

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