Targeted efforts are needed to increase the number of medical students choosing psychiatry, but little is known about when students decide on their specialty or what factors influence their choice. The authors examined the timing and stability of student career choice of psychiatry compared with other specialties and determined what pre- and intra–medical school factors were associated with choosing a career in psychiatry.

Using survey data from students who graduated from U.S. allopathic medical schools in 2013 and 2014 (N=29,713), the authors computed rates of psychiatry specialty choice at the beginning and end of medical school and assessed the stability of that choice. A multivariate-adjusted logistic regression and recursive partitioning were used to determine the association of 29 factors with psychiatry specialty choice.

Choice of psychiatry increased from 1.6% at the start of medical school to 4.1% at graduation. The stability of psychiatry specialty choice from matriculation to graduation, at just over 50%, was greater than for any other specialty. However, almost 80% of future psychiatrists did not indicate an inclination toward the specialty at matriculation. A rating of “excellent” for the psychiatry clerkship (odds ratio=2.66), a major in psychology in college (odds ratio=2.58), and valuing work-life balance (odds ratio=2.25) were the factors most strongly associated with psychiatry career choice.

Students who enter medical school planning to become psychiatrists are likely to do so, but the vast majority of students who choose psychiatry do so during medical school. Increasing the percentage of medical students with undergraduate psychology majors and providing an exemplary psychiatry clerkship are modifiable factors that may increase the rate of psychiatry specialty choice.

需要有针对性的努力来增加选择精神病学的医学生的数量，但是对于学生何时决定他们的专业或影响他们选择的因素知之甚少。作者检查了与其他专业相比，学生选择精神病学的时机和稳定性，并确定了哪些医学前和医学内因素与选择精神病学有关。

利用2013年和2014年美国同种疗法医学院毕业的学生的调查数据（N = 29,713），作者计算了医学院校开始和结束时精神科专业选择的比率，并评估了这种选择的稳定性。多元调整的逻辑回归和递归划分用于确定29个因素与精神病学专业选择的关联。

精神病学的选择从医学院成立之初的1.6％增加到了毕业时的4.1％。从入学到毕业，精神病学专业选择的稳定性仅略高于50％，比任何其他专业都更高。但是，近80％的未来精神科医生并未预科就读该专业。与精神科工作最相关的因素是：精神科业务的“优秀”等级（优势比= 2.66），大学心理学专业的优势（优势比= 2.58）和评估工作与生活的平衡（优势比= 2.25）。职业选择。

计划进入医学院就读准备成为精神科医生的学生很可能会这样做，但是绝大多数选择精神病学的学生都是在医学院期间这样做的。增加具有心理学专业本科学位的医学生的比例并提供示例性的精神病学职务是可以改变的因素，可能会增加精神病学专业选择的比率。