BACKGROUND: Medical education in Poland consists of a six-year course, a 13-month postgraduate internship, and a Final Medical Examination. The possible further career path is to specialise in a particular field of medicine, and the choice of speciality is one of the most important decisions made by young doctors. Therefore, the decision-making process creates challenges. We conducted this study to determine the factors considered during the process of choosing a medical speciality and to investigate the influence of student performance in the Final Medical Examination on this choice. METHODS: A descriptive cross-sectional survey was conducted between 4 January and 7 February 2024. The data were collected via an online survey in Polish. The survey was disseminated to doctors engaged in postgraduate internships via social networks. The Chi-square test (χ RESULTS: The survey included 336 postgraduate trainees. Internal medicine subspecialties, surgical specialities, and paediatrics were of most interest to the respondents. The average age of respondents was 26 years. In the multiple-choice question, most people (86.6%) marked their individual interests as a key factor influencing their choice of specialisation, followed by earning opportunities in the private sector (58%) and work-life balance (54.2%). The Final Medical Examination score is a significant factor in the selection of a speciality, as indicated by 68% of respondents. CONCLUSIONS: The process of selecting a medical speciality involves overcoming numerous limitations. The outcome of the Final Medical Examination is a significant factor influencing the choice of future specialisation. Furthermore, the decision-making process is affected by several different factors and the distinctive complexities of practising a specific speciality within the Polish healthcare system.