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Modernising Medical Careers (MMC) asks trainees to commit to their specialty sooner than ever before. There has been a great deal of good-quality research on the career intentions of doctors in training. It is time to review this data with MMC's changes in mind and reflect on how earlier enforced choice may affect trainees. There are distinct patterns to career choice: those who commit strongly and early; those who wait and commit later; and those who move on from previous career choices. The specialty is imperative for some that commit early. Those in this group who fail to be selected will need focused career support. Doctors who commit late are more likely to be affected by quality of life and flexibility. The present 'one size fits all' system does not reflect the natural history of present career selection and commitment to specialty.

How do doctors choose their specialty: first love, arranged marriage or second time around? And how may an affair with MMC change this?