Purpose A surgical career should be inclusive and encourage diversity. Understanding influencers for/against choosing surgery may inform strategies to encourage doctors to consider a surgical career. Methodology By comparing career intentions on medical graduation and at PGY5, we identified four groups: 1. consistently wanting, 2. never wanting, 3. change to, 4. change away from a surgical career. Doctors from PGY6-11 completed a zoom semi-structured interview regarding career choices. Interviews were transcribed and analysed inductively to generate themes using grounded theory. Results Forty doctors were interviewed. The reasons given by doctors never interested in surgery included perceived nonalignment of skill set and/or not wishing to work in a hospital. Those who changed away were turned off by poor work-life balance, difficulty of getting onto training, arduous training. Doctors consistently considering surgery highlighted similar influences as the turned-away group to make training and work as a surgeon more tolerable. Those changing towards were attracted to surgery’s alignment with their skill set and surgery adhering to their concept of being a doctor (“Fixing problems”). Features influencing career selection for all groups were role models, speciality culture, identifying with a “tribe” and support to pursue their career. Conclusion The reasons given by doctors never interested in surgery are likely to negate any useful strategies to attract them. However, this study can inform interventions to modify career choices of those who move away from a surgical career and to encourage greater diversity such as support, work culture, role models and the nature of surgical training.