Factors influencing choice of residency program among medical intern doctors and medical students: a cross-sectional survey
The global deficit of competent medical professionals is an urgent problem influencing health systems all over the world, compromising nations’ abilities to dispense essential health services, respond to emerging health needs, and ensure overall health security . The world is facing a rising shortage of healthcare workers, predicted to reach an 18 million deficit by the year 2030, which is a significant increase from the 7 million shortages registered in 2013. Furthermore, this shortage is predicted to rise to 12.9 million skilled health professionals by 2035 . The lack of medical professionals is more substantial in low-to-middle-income countries and rural areas, with the latter reporting 56% of their population as being devoid of health coverage, more than twice the figure observed in urban communities . Lately, Oman’s population has exceeded 5 million, with a notable upward trajectory in life expectancy reaching approximately 78.58 years for both genders in 2023 . According to official national statistics, over 50% of the current population falls within the 25–64 age range . Despite this, Oman is experiencing a significant decline in both fertility and mortality rates, attributed to diverse socioeconomic factors. This demographic shift indicates a forthcoming rise in the elderly population over the next 20–30 years, posing increased challenges to the healthcare system . Oman faces a particularly acute deficit of qualified doctors, evident in its doctor-to-population ratio, which is lower than that of many other countries. As indicated by the World Bank collection of development indicators, the doctor-to-population ratio in Oman was approximately 1.7 physicians per 1,000 people in 2020, falling below the global average of 3.5 physicians per 1,000 people . This shortage is especially pronounced in primary healthcare, where the demand for general practitioners (GPs) is rising to meet the population’s healthcare needs. The limited number of GPs, alongside the overall shortage of doctors, intensifies the pressure on Oman’s healthcare system, emphasizing the urgent necessity for more medical professionals, particularly in the primary care sector . The Arab world has an average of 8.5 medical doctors per 10,000 population, though this varies widely across countries. For instance, Somalia has just 0.6 doctors per 10,000 population, while Qatar has 17.5. Arab countries can be grouped into categories based on medical staffing: some countries have low medical density and rely on foreign doctors (e.g., Yemen, Somalia), others have strengthened local medical training and may face oversupply risks (e.g., Algeria, Syria), while countries like Egypt and Jordan have relatively high medical density and export medical manpower. Oil-rich nations with high medical density, such as Saudi Arabia and the UAE, still rely heavily on foreign-trained physicians. This diversity reflects both shortages and oversupply of doctors across the region, underscoring the need for collaborative action in workforce planning .Several factors contribute to the shortage, including an increase in chronic diseases and limited investment in medical education and training . The proportion of female medical students and doctors in Oman has increased significantly in recent years. For example, data from the Ministry of Health (MoH) and Sultan Qaboos University (SQU) show that female enrollment in medical schools and residency programs has risen steadily, with women now representing a substantial portion of the workforce. Specifically, 64% of medical students at SQU were female as of 2015, and women made up 42% of the total doctor workforce in the MoH, reflecting a broader national trend toward greater female participation in medicine . Internal medicine is a cornerstone of the medical profession, offering comprehensive, patient-centered care that spans a wide range of conditions and diseases. Its holistic approach, integration with subspecialties, and critical role in both acute and primary care settings underline its enduring significance . Additionally, specialists in this field manage comorbidities and provide holistic, person-centered care, especially beneficial for elderly patients with multiple long-term conditions . The deficiency of qualified doctors in Oman includes the field of internal medicine (IM), a pivotal specialty within the healthcare system responsible for addressing the needs of chronically ill and medically complex patients. Globally, there has been a diminishing interest among medical students in enrolling in IM training programs, a trend warranting closer examination . Over the years, there has been a shift in medical students’ perceptions of careers in IM, marked by increasingly negative attitudes toward managing complex medical issues over time . A comprehensive survey of medical students conducted in 1990 revealed that factors such as the demanding time and workload of IM, perceived physician satisfaction in the field, and the types of patients encountered were significant deterrents to pursuing a career in internal medicine . Many studies have been conducted across diverse regions globally to identify the factors influencing the choice of medical specialties among students . These determinants include individual traits, features tied to medical curricula, perceived advantages, and the allure of specialties. Intern doctors are recent medical school graduates who participate in a supervised clinical training program, typically lasting one year, aimed at gaining practical experience and essential skills before progressing to residency programs. In Oman, there exists a single internship program under the College of Medicine and Health Sciences at Sultan Qaboos University Hospital. Annually, approximately 300 intern doctors enroll in this program, with the number varying based on the graduating medical students from both Oman and overseas institutions. A significant portion of these graduates typically applies for local residency programs administered by the Oman Medical Specialty Board. Over the past five years, the number of applicants to the internal medicine residency program has exhibited fluctuation, varying between 20 and 50 applicants annually. These fluctuations raise concerns as they may result in notable shortages of internal medicine physicians, particularly considering the anticipated aging population and the rise in chronic non-communicable diseases. Given the growing demand for healthcare professionals in Oman, it is essential to investigate the factors influencing the residency program choices of Omani medical students and intern doctors. This study aims to provide a comprehensive analysis of the decision-making process involved in selecting internal medicine and other specialties as future career paths. By examining the motivations and influences on these decisions, we seek to understand the key factors that shape the career trajectories of medical students and interns in Oman.   Study design and selection criteria This study used a cross-sectional survey approach to evaluate the factors influencing medical students’ and intern doctors’ choice of medical specialization in Oman. The survey instrument used is a modified version of a Takeda et al. validated questionnaire that was modified to take into account local demands and settings . The survey was anonymously administered to intern doctors and medical students in their clinical clerkship years, excluding non-Omani intern doctors whose postgraduate training was not locally supported. Sample size calculation and questionnaire adjustment Considering the annual output of medical school graduates in Oman, approximately ranging from 200 to 250, and our target audience, which includes intern doctors and medical students in their last 3 years of medical school, our estimated target population size was approximately 1000 individuals. In line with conventional survey research guidelines, it is recommended to have a sample size equivalent to at least 5–10% of the population size. Consequently, our survey would require a sample size ranging from 50 to 100 subjects. For our survey, we employed a previously validated questionnaire developed by Takeda and colleagues in 2013, which is grounded in the theory of reasoned action (TRA) . This theory posits that an individual’s behavior is influenced by their intention to perform the behavior, shaped by two key components: attitude towards the behavior (determined by beliefs about outcomes and their importance) and subjective norms (involving beliefs about how close individuals perceive the behavior and the motivation to meet their expectations) . The variables used in the questionnaire were adapted from a study by Gorenflo et al., presenting a “model of medical student specialty choice based on the theory of reasoned action“ . The questionnaire comprises 45 questions in total, including 14 general inquiries about participant demographics and 31 specific queries aimed at evaluating factors influencing specialty selection. During the survey development, four questions from the original survey by Takeda et al. were excluded due to their lack of relevance to the Oman medical education system or geographical context. Additionally, two questions were adjusted to align with the characteristics of our local medical education system (supplementary 1). The questionnaire validation process was guided by a structured approach to identify the primary themes and domains relevant to specialty choice, including personal interest, perceived job market demand, societal factors, and lifestyle considerations. These domains were defined based on a review of the relevant literature and adapted to suit the cultural and educational context of Oman. Each theme was reviewed and refined by expert members of the research team to ensure that all pertinent factors influencing specialty choice were included. To ensure the validity of the questionnaire, we sought input from faculty members and medical education experts, who reviewed each item for clarity, relevance, and cultural appropriateness, ensuring the content was both comprehensive and contextually appropriate for the Omani setting. To assess the reliability of the instrument, a pilot test was conducted with a small group of medical students and interns. This pilot test helped evaluate the clarity, comprehension, and consistency of the questions. Based on their feedback, we made minor adjustments to improve item clarity and ensure the questionnaire accurately reflected the factors influencing specialty choice among Omani medical students and interns. The feedback also helped ensure that the questionnaire was consistent in measuring the intended constructs, contributing to its overall reliability. Participants and questionnaire administration The survey was distributed across the only two medical schools in Oman: Sultan Qaboos University and the National University. A total of 803 surveys were distributed: 125 to 6th -year students and 127 to 7th -year students at the National University, 125 to 6th -year students and 126 to 7th -year students at Sultan Qaboos University, and 300 surveys to medical interns who are graduates of both universities. The distribution and collection of the questionnaire were managed by our research team or administrators from November to December 2023. Participation in the survey was voluntary, and individual responses were kept anonymous. Ethics This study was approved by the Medical Research Ethics Committee of the College of Medicine and Health Sciences of Sultan Qaboos University (REF. NO. SQU-EC/ 211/2023 MREC #3115) as well as Ethics and Biosafety Committee (EBC) of the College of Medicine and Health Sciences of National University (REF. NO/CONHS/EBC0021/2023). Consent to publish the survey results was obtained from all participants. Data analysis Descriptive statistics were applied to present participant demographics, career options, and factors guiding these decisions. Age and other continuous variables were conveyed as means and standard deviations, whereas categorical variables like gender and marital status were represented as frequencies and percentages. For inferential analysis, the key outcome variable, career choice (internal medicine versus non-internal medicine), was dichotomized. Univariable logistic regression was utilized to examine the relationship between each explanatory variable (for example, gender, marital status, influence of role models) and career choice. A p-value of 0.05 or lower was deemed statistically significant, with a two-tailed significance threshold set at a p-value of less than 0.05. All statistical examinations were performed using STATA version 17.0 (STATA Corporation, College Station, TX, USA).   This study used a cross-sectional survey approach to evaluate the factors influencing medical students’ and intern doctors’ choice of medical specialization in Oman. The survey instrument used is a modified version of a Takeda et al. validated questionnaire that was modified to take into account local demands and settings . The survey was anonymously administered to intern doctors and medical students in their clinical clerkship years, excluding non-Omani intern doctors whose postgraduate training was not locally supported.   Considering the annual output of medical school graduates in Oman, approximately ranging from 200 to 250, and our target audience, which includes intern doctors and medical students in their last 3 years of medical school, our estimated target population size was approximately 1000 individuals. In line with conventional survey research guidelines, it is recommended to have a sample size equivalent to at least 5–10% of the population size. Consequently, our survey would require a sample size ranging from 50 to 100 subjects. For our survey, we employed a previously validated questionnaire developed by Takeda and colleagues in 2013, which is grounded in the theory of reasoned action (TRA) . This theory posits that an individual’s behavior is influenced by their intention to perform the behavior, shaped by two key components: attitude towards the behavior (determined by beliefs about outcomes and their importance) and subjective norms (involving beliefs about how close individuals perceive the behavior and the motivation to meet their expectations) . The variables used in the questionnaire were adapted from a study by Gorenflo et al., presenting a “model of medical student specialty choice based on the theory of reasoned action“ . The questionnaire comprises 45 questions in total, including 14 general inquiries about participant demographics and 31 specific queries aimed at evaluating factors influencing specialty selection. During the survey development, four questions from the original survey by Takeda et al. were excluded due to their lack of relevance to the Oman medical education system or geographical context. Additionally, two questions were adjusted to align with the characteristics of our local medical education system (supplementary 1). The questionnaire validation process was guided by a structured approach to identify the primary themes and domains relevant to specialty choice, including personal interest, perceived job market demand, societal factors, and lifestyle considerations. These domains were defined based on a review of the relevant literature and adapted to suit the cultural and educational context of Oman. Each theme was reviewed and refined by expert members of the research team to ensure that all pertinent factors influencing specialty choice were included. To ensure the validity of the questionnaire, we sought input from faculty members and medical education experts, who reviewed each item for clarity, relevance, and cultural appropriateness, ensuring the content was both comprehensive and contextually appropriate for the Omani setting. To assess the reliability of the instrument, a pilot test was conducted with a small group of medical students and interns. This pilot test helped evaluate the clarity, comprehension, and consistency of the questions. Based on their feedback, we made minor adjustments to improve item clarity and ensure the questionnaire accurately reflected the factors influencing specialty choice among Omani medical students and interns. The feedback also helped ensure that the questionnaire was consistent in measuring the intended constructs, contributing to its overall reliability.   The survey was distributed across the only two medical schools in Oman: Sultan Qaboos University and the National University. A total of 803 surveys were distributed: 125 to 6th -year students and 127 to 7th -year students at the National University, 125 to 6th -year students and 126 to 7th -year students at Sultan Qaboos University, and 300 surveys to medical interns who are graduates of both universities. The distribution and collection of the questionnaire were managed by our research team or administrators from November to December 2023. Participation in the survey was voluntary, and individual responses were kept anonymous.   This study was approved by the Medical Research Ethics Committee of the College of Medicine and Health Sciences of Sultan Qaboos University (REF. NO. SQU-EC/ 211/2023 MREC #3115) as well as Ethics and Biosafety Committee (EBC) of the College of Medicine and Health Sciences of National University (REF. NO/CONHS/EBC0021/2023). Consent to publish the survey results was obtained from all participants.   Descriptive statistics were applied to present participant demographics, career options, and factors guiding these decisions. Age and other continuous variables were conveyed as means and standard deviations, whereas categorical variables like gender and marital status were represented as frequencies and percentages. For inferential analysis, the key outcome variable, career choice (internal medicine versus non-internal medicine), was dichotomized. Univariable logistic regression was utilized to examine the relationship between each explanatory variable (for example, gender, marital status, influence of role models) and career choice. A p-value of 0.05 or lower was deemed statistically significant, with a two-tailed significance threshold set at a p-value of less than 0.05. All statistical examinations were performed using STATA version 17.0 (STATA Corporation, College Station, TX, USA).   The survey achieved 459 responses out of 803 potential participants, resulting in an overall response rate of 58.8%. The corresponding rates by group were: 72.0% (90 out of 125) for 6th -year students at the National University, 75.6% (96 out of 127) for its 7th -year students, 68.0% (85 out of 125) for 6th -year students at Sultan Qaboos University (SQU), 53.9% (68 out of 126) for its 7th -year students, and 40.0% (120 out of 300) for medical interns. The study included 459 participants, consisting of 120 males (26.1%) and 339 females (73.9%). Participants had an average age of 23.85 years, with a standard deviation of 1.70. Regarding marital status, 26 participants (5.7%) were married, and 433 (94.3%) were single. Only 6 participants (1.3%) had children, while 453 (98.7%) did not. The distribution of participants by governorate showed that 109 (23.8%) were from Muscat, 90 (19.7%) from Al Dakhilia, 31 (6.8%) from Al Dahira, 111 (24.2%) from North Al Batinah, 40 (8.7%) from South Al Batinah, 6 (1.3%) from Al Burimi, 41 (8.9%) from North Al Sharqia, 22 (4.8%) from South Al Sharqia, 6 (1.3%) from Dhufar, and 2 (0.4%) from Musandam. Most participants resided in urban areas (310, 67.6%), while 148 (32.4%) were from rural areas. Regarding their medical school, 20 (4.4%) studied overseas, 206 (44.9%) at SQUH, and 233 (50.7%) at NU. The educational level of participants included 114 interns (24.9%), 259 senior clerkship students (56.5%), and 85 junior clerkship students (18.5%). A small portion of participants had physician parents (38, 8.3%) or knew a close physician (82, 17.9%). Additionally, 118 participant s (25.7%) had a role model physician. The career choices varied, with family medicine being the choice for 75 participants (16.4%), internal medicine for 91 (19.9%), general surgery for 65 (14.2%), pediatrics for 44 (9.6%), and various other specialties each representing smaller percentages of the cohort (Table ; Fig. ). Notably, one student did not choice any specialty. Out of 458 participants, 91 (19.87%) chose internal medicine, with a gender distribution of 26.4% men and 73.6% women, similar to the non-internal medicine group. Age, marital status, parenthood status, governorate distribution, residence type, education level, closeness to a physician, and having a role model physician showed no statistically significant difference between the internal medicine group and other specialties group (refer to Table -A). When comparing internal medicine to other specialties, several factors demonstrated significant differences among participants. Interest in surgical procedures showed a notable distinction, with internal medicine participants being less likely to express extreme interest in surgical procedures compared to non-internal medicine participants ( p = 0.008). Additionally, participants favoring internal medicine placed greater importance on high societal respect associated with their specialty ( p = 0.037) and a comfortable atmosphere within the specialty department ( p = 0.038), both of which emerged as key influences in their decision-making process. Despite these significant differences, many other factors did not show statistical significance between the two groups. Interest in clinical work ( p = 0.216), specific organ-based practice ( p = 0.266), and working with targeted populations ( p = 0.326) were similar across participants regardless of their chosen specialty. Likewise, interest in research ( p = 0.431) and the prospect for further development ( p = 0.144) were comparable between internal medicine and non-internal medicine groups (refer Table -B). Checking gender disparities, most factors related to career preferences and influences showed no significant differences between male and female participants. Marital status ( p = 0.409) and having children ( p = 0.687) were similar across genders, with the majority being single and childless. Residence type also showed no gender disparity ( p = 0.614), with both males and females predominantly residing in urban areas. In terms of familial and professional influences, the proportions of participants with physician parents ( p = 0.980), knowledge of a close physician ( p = 0.876), and identifying a role model physician ( p = 0.238) were consistent between the genders. Similarly, preferences for the type of physician role—whether highly specialized, working directly with patients, or flexible to either—did not differ significantly ( p = 0.212). Career choices showed no notable gender differences ( p = 0.143). Internal medicine was the most frequently selected specialty for both males and females, followed by family medicine and general surgery. Other specialties, such as pediatrics, dermatology, and emergency medicine, were chosen in comparable proportions by both genders. Overall, the majority of career preferences, familial influences, and lifestyle factors did not vary significantly between male and female participants (refer Table -A). When examining gender differences in career choice influences, significant disparities were observed in specific areas. Men demonstrated a stronger interest in surgical procedures ( p = 0.003) and mastering their specialty ( p = 0.008) compared to women. They were also more likely to report aptitude for their specialty ( p = 0.024) and emphasized attainable lifestyle ( p = 0.023) and the risk of malpractice lawsuits ( p = 0.036) as influencing factors. Additionally, men placed higher importance on the availability of residency or training programs in Oman ( p = 0.013). In contrast, no significant gender differences were observed in interest in clinical work ( p = 0.782), research ( p = 0.595), working hours ( p = 0.060), or job availability ( p = 0.676). Responses regarding personal experiences, such as family or friends suffering from illness ( p = 0.236) or memorable experiences during medical school ( p = 0.389), were also consistent across genders. Regarding willingness to work in rural areas, no significant gender difference was observed ( p = 0.788). Both men and women showed similar proportions of keen motivation, willingness to work for a certain period, or preference to avoid rural practice (refer Table -B).   This study is the first from Oman and one of the few from the region which investigates the factors that influence residency program selection. It well represents the target population and used a questionnaire that has been validated and tailored to suit local setting. The response rate was excellent. The study reveals that the majority of respondents were female, mirroring the increasing trend of women graduating from medical school. In Oman, this is influenced by the demographics of the surveyed institutions, where female enrollment is notably higher, aligning with the global rise in women entering the medical workforce. Previous research has previously shown that women in healthcare tended to work fewer hours, see fewer patients, but spent more time with each patient and addressed a wider range of issues . However, there is no recent data available to determine if these patterns still hold true. Additionally, women face challenges related to family responsibilities and gender stereotypes, which may impact career progression. Although there is a trend toward part-time work among female physicians, this choice—often influenced by both personal factors and systemic barriers—has implications for workforce planning and patient care continuity . Moreover, women remain underrepresented in certain specialties, not solely due to personal preferences but also potentially due to factors such as gender bias and structural constraints. While women bring strong empathy and relational skills that enhance patient care, these attributes may be undervalued in traditional productivity models. Current workplace structures may not fully address women’s specific challenges, underscoring the need for gender-equitable policies. Addressing these issues can contribute to a more balanced and effective medical workforce . Most surveyed medical interns and students are single and has no children. Previous studies have shown that parenthood significantly influences specialty choice among doctors; women, in particular, frequently prefer family-friendly specializations . Parenthood also tends to diminish career focus and promote part-time work. Woman physicians who are mothers often have lower employment rates and view their career success as less than that of their man counterparts . A majority of the survey participants lived in urban areas, possibly due to the greater presence of medical schools and healthcare facilities there. Yet, a small percentage showed interest in rural employment, with a significant proportion willing to undertake short-term roles in less serviced areas. This hints at the possibility of future lack of healthcare professionals in rural areas. Healthcare professionals with rural origins are more inclined to serve in similar areas. Educational strategies, financial incentives, and professional support networks have shown effectiveness in retaining these professionals in rural areas . The scarcity of healthcare workers in rural areas adversely impacts their health outcomes when compared to those residing in urban areas. These healthcare systems hold significant economic value for rural communities, and their downfall could negatively affect local economies . Improvement measures include creating a supportive atmosphere with adequate supervision, close family proximity, and addressing feelings of isolation, coupled with clear recruitment and education policies, and incentives . A significant proportion of participants did not have physician parents or close connections with physicians, and no significant gender difference was observed in these factors. However, a notable percentage of participants identified a physician role model, which had a profound impact on their career decisions. Role modeling and mentorship remain crucial elements in shaping medical students’ career choices, including their interest in both primary and non-primary care specialties . These relationships can positively or negatively influence students’ decisions, depending on the experiences and qualities of the role models. Exposure to exemplary clinicians as role models during medical school has been strongly associated with students’ decisions to pursue specific fields for residency training, emphasizing the pivotal role of mentorship in professional formation and specialty selection . In this study, internal medicine was the most desired specialty among the surveyed participants, which is consistent with previous studies . It has been shown that medical students pursue internal medicine as their preferred specialty for several reasons. Many students are genuinely interested in the field, finding it intellectually stimulating and rewarding . Additionally, the perceived better work-life balance and lifestyle compared to other specialties, along with the good career opportunities and job security it offers, make internal medicine an attractive choice. It is also seen as a challenging and prestigious field . In this study, we identified additional factors affecting the decision to specialize in internal medicine. These factors included societal respect and a comfortable atmosphere in the specialized department. These findings reinforce the notion that career decisions are typically influenced by both personal passion and the perceived working environment within a field. The findings of this study highlighted significant gender differences in the factors influencing career choices. Men showed greater interest in surgical procedures, mastering their specialty, and emphasized factors such as attainable lifestyle and the risk of malpractice lawsuits. Additionally, men placed more importance on the availability of residency or training programs in Oman. On the other hand, while women highlighted the comfort of the specialty department, this was not statistically significant. These findings suggest that gender may influence career priorities, with men focusing on procedural skills, career advancement, and external challenges, while women tend to consider aspects related to the working environment. Previous studies have shown that gender significantly influences career choices within the medical field with differences existing in specialty selections, advancement possibilities, and work-life balance considerations . Male medical students often choose surgery or internal medicine, while woman medical students are more likely to favor specialties like gynecology, pediatrics, and general practice. Such preferences may be influenced by societal gender norms and expectations . Additionally, Laskin (2001) highlighted that men demonstrate a stronger interest in surgical procedures, perceive themselves as more suited to surgical specialties, and view the associated lifestyle as attainable, aligning with the findings of this study . The presence of role models from the same gender significantly influences a student’s specialty choice. Mentorship programs play a crucial role in mitigating gender discrepancies in specialty selection and career progress. Moreover, women often consider work-life balance and family duties when choosing a specialty, leading to preference for fields that are perceived as family-friendly. Conversely, man medical students are less swayed by these considerations. Cases of gender discrimination and bias are often experienced by woman medical students and practitioners, especially in male-dominated fields like surgery. Organizational culture and invisible biases within healthcare institutions contribute to these disparities. Furthermore, man medical students and residents reported increased confidence in procedural skills, correlating with a preference for procedural specialties, whereas woman medical students’ confidence levels don’t greatly affect their specialty choice . Efforts to address physician shortages, especially in regional areas, require strategic workforce planning and capacity-building initiatives. According to the WHO’s recommendations for the Eastern Mediterranean Region, a strong healthcare workforce necessitates improving four key dimensions: availability, competence, responsiveness, and productivity . Building these capabilities often involves not only enhancing educational and training opportunities but also implementing supportive supervision, feedback systems, and continuous learning. Within the Gulf Cooperation Council (GCC), countries like Saudi Arabia and Qatar have developed national strategies to strengthen their healthcare workforce through initiatives such as the Nursing and Midwifery Strategy in Qatar and Saudi Arabia’s National Transformation Program. These efforts underscore the importance of building local educational capacity to reduce dependence on expatriate workers, developing national recruitment strategies, and aligning healthcare training with local needs. Furthermore, establishing standardized indicators to monitor and evaluate healthcare performance, as seen in Qatar and the UAE, helps ensure quality improvement and supports sustainable workforce development across the region . Several limitations should be acknowledged in this study. The cross-sectional design limits the ability to establish causality between the identified factors and career choices. The study relied on self-reported data, which may be subject to recall bias and social desirability bias. The sample may limit the generalizability of the findings related to interns’ responses to other settings, as it includes graduates from both international medical schools and the two national medical schools in Oman. Furthermore, the study did not investigate how profession decisions are influenced by financial concerns or individual health situations, which might offer more information. Future research should think about carrying out longitudinal studies to monitor changes in profession preferences over time and pinpoint the causal linkages between influencing factors and career choices in order to improve on the findings of this study. Including qualitative research methods, such as interviews and focus groups, would help gain a deeper understanding of the motivations and barriers influencing career decisions. Investigating the impact of financial incentives, personal health experiences, and mentorship programs on career choices could help develop targeted interventions that support medical students and interns in making informed career decisions.   This study highlights the complex factors influencing the residency program choices of Omani medical students and interns. Internal medicine emerged as a popular specialty due to its intellectual stimulation, perceived work-life balance, and job security. Gender differences played a significant role, with men more likely to value societal respect and women prioritizing a comfortable work environment. While internal medicine remains a favoured choice, the study emphasize the importance of addressing gender disparities and improving mentorship programs to guide future physicians. The findings also indicate a potential shortage of healthcare professionals in rural areas, further emphasizing the need for educational strategies and financial incentives to retain medical talent in underserved regions.   Below is the link to the electronic supplementary material. Supplementary Material 1   