This study was undertaken to examine the extent to which there are differences between preferences and choices of specialty areas among medical students. A total of 350 medical students completed a questionnaire dealing with various aspects of a career in medicine, including specialty preference and choice decisions. The Intolerance of Ambiguity Scale was included as part of the questionnaire. Differences between specialty preference and choice were found for the total group as well as for male and female comparisons. Intolerance of ambiguity was found to be associated with the specialty decision process. Factors contribution to the differences were examined and recommendations for further research were discussed.