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Objectives: To study early and eventual career choices for nephrology among UK medical graduates and investigate factors which influenced career preferences. Design: Self-completed survey questionnaires mailed to medical graduates 1, 3, 5 and 10 years after graduation. Setting: United Kingdom. Participants: UK medical graduates in 15 year-of-qualification cohorts between 1974 and 2015. Main outcome measures: Early career specialty choices, career specialty destinations at 10 years and ratings of factors affecting career choices. Results: Around 0.4%-1.1% of these junior doctors expressed a career preference for nephrology, varying by year of qualification and years after qualification. Among all graduates of 1993-2002 combined, 0.4% expressed a career preference for nephrology 1 year after qualification rising to 1.0% in year 5. Among graduates of 2005-2008, the corresponding figures were 1.0% in year 1 falling to 0.7% in year 5. Only 18% of doctors who chose nephrology in year 1 eventually became nephrologists. Of doctors who were practising as nephrologists for 10 years and more after qualification, 74% of the women and 56% of the men had decided to pursue a career in nephrology by year 5 after qualification. 'Enthusiasm/commitment' had a great deal of influence on those who chose nephrology, for all cohorts and all years studied. Conclusions: The most recent data suggest that the proportion of young doctors who sustain an interest in nephrology through the early postgraduate training years may be lower than among their predecessors. Efforts are needed to reverse the declining trend and increase interest in nephrology.

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career choice, doctors, medical education, nephrology, specialisation, workforce