Concerns about recruiting physicians into academic careers is an international issue. A qualitative study with United States (US) women physicians revealed insights into how, when, and why physicians choose an academic career in medicine. The current study explored international women physicians’ perspectives on their career choice of academic medicine and determined if different themes emerged. We expanded the 2012 study of US women physicians by interviewing women physicians in Canada, Pakistan, Mexico, and Sweden to gain an international perspective on choosing an academic career. Interviews were thematically analyzed against themes identified in the previous study. Based on themes identified in the study of US physicians, qualitative analysis of 7 international women physicians revealed parallel themes for the following areas:

• Why academic medicine? Fit; People; Aspects of academic health centre environment.
• How the decision to enter academic medicine was made? Decision–making style; Emotionality
• When the decision to enter academic medicine was made? Practising physician; Fellowship; Medical student.

Work-life balance, choosing academic medicine by default, serendipity, intellectual stimulation, mentors, research and teaching were among the areas specifically highlighted. Conclusion: Parallel themes exist regarding how, why, and when US and international women physicians choose academic medicine as a career path.