A two point entry to specialty programmes could facilitate natural variation in career aspirations In the linked longitudinal study (doi: 10.1136/bmj.c3199) , Goldacre and colleagues compare medical graduates’ early career choices with their eventual career specialty destinations. 1 Previous studies have assessed factors that influence the choice of medical career, 2 but few studies have focused on the durability of specialty interests. 3 The current study, which looked at five cohorts of medical graduates in the United Kingdom, found that 10 years after graduation nearly half were in a considerably different specialty from their choice at the end of their first year of professional practice. About a quarter of doctors were also in a considerably different specialty group than they were in seven years ago, at the end of their third year of postgraduate training. This again raises the concern first highlighted by the Tooke report, 4 that medical education and Modernising Medical Careers policy in the UK encourages foundation trainees to make career choices when many are not ready to make such commitments.