Introduction: Choosing a final clerkship that suits their goals and aspirations is felt as one of the most important decisions by medical students. Understanding preferences for medical students’ clerkship choices and the factors that drive them may help clinical educators ensure optimal support throughout students’ clinical training. Our objective was to identify what factors influence medical students’ clerkship choices.

Methods: We conducted individual semi-structured interviews with 16 final-year medical students enrolled in clinical clerkships. We analyzed the data under a constructivist paradigm, using template analysis, a form of thematic analysis.

Results: Students highlighted four main themes influencing the choice of their final clerkship: “emotions involved in making the decision”, “between now and next”, “the learning environment beyond the clerkship” and “decisions under structural pressures”. A climate of high competition, peer pressure and haste seem to add to the difficulty of choosing a clerkship.

Discussion: When choosing their clinical clerkships, final year medical students prioritize immediate well-being, social support, and a sense of belonging, searching for ‘a good work-life balance’ and ‘an informal collegial work environment’.