Using relationship styles based on attachment theory to improve understanding of specialty choice in medicine

We determined the relationship styles, demographic characteristics and resident specialty match of 106 fourth-year medical students. We assessed the associations between 1) relationship style and specialty choice factors; 2) specialty choice factors and specialty match, and 3) relationship style and specialty match. We also conducted mediation analyses to determine if factors examined in a specialty choice questionnaire mediate the association between relationship style and ultimately matching in a primary care specialty.Prevalence of attachment styles was similar to that found in the general population and other medical school settings with 59% of students rating themselves as having a secure relationship style. Patient centeredness was directly associated, and career rewards inversely associated with matching in a primary care specialty. Students with a self-reliant relationship style were significantly more likely to match in a non-primary care specialty as compared to students with secure relationship style (OR = 5.3, 95% CI 1.8, 15.6). There was full mediation of the association between relationship style and specialty match by the specialty choice factor characterized by patient centeredness.Assessing relationship styles based on attachment theory may be a potentially useful way to improve understanding and counsel medical students about specialty choice.Personality traits can significantly influence specialty choice in medicine [1,2] and may also play an important role in physicians' decisions to change their specialty [1]. Current Graduate Medical Education funding restrictions limit the number of years of residency training to those required within a single specialty, and may not provide full funding for training if residency specialty is changed mid-stream. As a result, medical schools work diligently to help prospective resident trainees make the best specialty choice by providing a variety of assessment and informational resources, including tools assess