BACKGROUND: The specialization of medical students is essential for enhancing healthcare quality, and meeting the diverse needs of patients, with medical training programs significantly influencing their career trajectories and expertise development. This study aimed to investigate the future specialty preferences of medical students from various medical schools in Zambia. MATERIALS AND METHODS: The study included participants from seven medical schools who had completed at least their first clinical clerkship. Data collection involved distributing structured questionnaires containing Likert scale items and open-ended questions via an online Google Sheets platform. Data collected included: demographics, name of medical school, year of study, specialty preferences, factors influencing specialty preferences, awareness about medical specialties, and career pathways. RESULTS: A study involving 127 medical students in clinical clerkships revealed a gender ratio of 1.1:1 male to female, with 73% aged between 20 and 25 years. Specialty preferences varied, with internal medicine (12%) and cardiovascular surgery (10%) being popular choices, and 62% changing their preferences during clerkships. Key factors influencing specialty choice were personal interest (74%), work-life balance (41%), and career prospects (30%). Only 21% were very familiar with medical specialties, and 83% rated mentorship availability poorly and suggested organizing workshops to enhance awareness. Future plans included further specialization (54%), international humanitarian work (54%), and medical academics (27%). CONCLUSION: Despite recognizing the importance of mentorship, students rated the availability of mentorship and informational resources as inadequate. The findings emphasize the need for enhanced mentorship programs, comprehensive career guidance, and targeted informational workshops to support informed specialty choices, contributing to a better-prepared and more satisfied medical workforce.