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Objectives: Since 2005, newly qualified doctors in the UK have had their time to prepare for career subspecialization application cut short to 16 months. To have enough time to become a competitive applicant, the choice of specialization may now have to be made as early as in medical school. This study aimed to assess how prepared medical students are towards committing to a specialty while in medical school, and their opinion about having to make such a decision. Design: A cross-sectional questionnaire. A list of all career specialties available to doctors at the point of specialization was provided and asked students to rank their top choice. An assessment of the certainty of their choice was then determined. Setting: Questionnaires were distributed at the end of an optional final year medical student academic meeting held at a leading London medical school university. Participants: One hundred and thirty final year students attended the meeting. Questionnaires were distributed to all attenders; 115 responses were collected. Main outcome measures: The certainty of career specialization choice was assessed in qualitative form, with responses ranging from 'not likely', 'maybe', 'probably', 'almost certainly' and 'definitely'. Their feelings in having to decide upon career specialty while in medical school was assessed through either a 'yes' or 'no' response. Results: A total of 115 responses were collected. The second most common selection was the 'undecided' option at 15%. The highest certainty factor occurred at 'maybe' with 41% and progressively fewer responses occurred as the certainty factor increased, with only 10% at 'definitely'; 95% voted 'no' to having to decide what they want to specialize in by the end of medical school. Conclusions: The majority of students have yet to commit to a specialty and almost all agree that they should not have to decide what they want to specialize in by the end of medical school. There is thus greater responsibility from medical schools to incorporate more career discussions into their syllabus. [ABSTRACT FROM AUTHOR]