Abstract
PURPOSE: Physician involvement in healthcare leadership is essential for improving healthcare systems, yet medical students' interest in future leadership roles is underexplored. This study aimed to examine first- and final-year medical students' interest in leadership roles. METHODS: In 2021, online questionnaires were distributed to both cohorts, yielding response rates of 94% (109/116) and 87% (95/109), respectively. A mixed-methods approach was employed to examine leadership interest. Free-text responses were first analyzed through inductive content analysis and subsequently, a quantification analysis was performed. Cohort comparisons were conducted to evaluate differences, and age and gender data were collected as background variables. RESULTS: First-year students exhibited greater optimism, viewing leadership as a natural extension of their careers. Final-year students increasingly prioritized clinical roles, reflecting the influence of physicians' identity formation and the demands of clinical practice. Final-year students exhibited lower levels of strong interest in leadership and higher levels of disinterest than first-year students. The quantified results aligned with these findings, as 38.5% of first-year students expressed strong interest, compared with 30.5% of final-year students. Conditional interest was higher among first-year students (30.3%) than among final-year students (24.2%), whereas disinterest was higher among final-year students (37.9%) than among first-year students (24.8%). Uncertainty regarding leadership roles was observed in both groups (6.4% of first-year and 7.4% of final-year students). CONCLUSIONS: Differences in leadership interest suggest that increasing clinical responsibilities and physicians' identity formation may influence students' interest in leadership roles. Integrating early and longitudinal leadership education into clinical practice-emphasizing its clinical relevance and alignment with physicians' professional identity-may help sustain interest, support career-aligned leadership decisions, and better prepare future physician leaders.