Aims To report on the factors that influence final year medical students' career choices, their attitudes to and experiences of paediatrics, and how these have impacted upon their decision to consider or reject paediatrics as a career choice.

Background Competition ratios for paediatric training are amongst the lowest of all hospital specialties. In order to delicer a high class child health service in the future, paediatrics needs to attract trainees. Junior doctors in the UK are selecting their specialty at an earlier stage than previously, so experiences of paediatrics during medical school are even more important than in the past in influencing career choice.

Methods Questionnaire study of 135 final-year medical students.

Results Significantly more of the students who were considering paediatrics were female (76%, with 60% of the respondents overall being female, p<0.0001). 73% of female students and 12% of male students agreed that the opportunity to work less-than-full-time was important to them when considering their career choice. The majority of students felt that paediatrics offered good opportunities for variety of work (89%) and career progression (78%), but only 55% agreed that there were good opportunities for being involved in research. Under half of students (48%) agreed that paediatricians have well balanced lives, yet only 43% felt that paediatricians do lots of out-of-hours work and 35% that paediatricians are busier than other doctors; between 63% and 78% of students reported that these factors did not impact on their career decision. Most students (75%) agreed that paediatricians are positive role models, though only 65% agreed that paediatricians are well respected by other doctors. A considerable number of students (40%) did not feel involved in the team during paediatric attachments, despite agreeing that people were friendly and they felt welcome.

Conclusions Students should be offered greater patient exposure and team involvement during paediatric attachments, along with targeted and specific careers advice. Opportunities for flexible working within paediatrics should be explored and developed, and it would be valuable to investigate further the professional image of the specialty.