Students entering three Australian medical schools were followed over a 15-year period to trace both movement into the profession and the longer-term outcomes of early career aspirations. A variety of student entry characteristics are examined together with aspirations, attainments and self-images. The results indicate that women, rather than men, are more likely to enter medical school with aspirations that involve specialty training. As they proceed through medical school, both groups move away from the idea of pursuing specialty training, although women tend to decide earlier than men that specialty practice is not for them. Women students are more likely than men to attain career goals if these involve general practice and less likely to if these involve specialization. The results indicate that although at graduation women medical practitioners have the same career goals and desires as men, if additional training is required women are unlikely to have their aspirations fulfilled.