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Background & Objective: Medical students form an integral part of future taskforce for the healthcare sector. We aimed to assess the impact of demographic charcateristics and COVID-19 pandemic affecting choice of speciality among medical graduates in Pakistan. Materials & Methods: A cross-sectional study was carried out on fresh medical graduates using two self-designed online questionnaire surveys before and after two months of house job, inquiring choice of specialty, reasons for choosing it, exposure to pandemic and its effect on choice of specialty using Chi-Square test. Results: Fifty nine percent of medical graduates had chosen field of speciality, significantly impacted by higher socioeconomic class (p=0.006), fathers with higher education (p=0.046) and advice about specialty selection (p=0.044). Internal medicine (20%), surgery (19%), obstetrics and gynaecology (O&G) (17%) and dermatology (13%) were most commonly selected. Age (p=0.027), female gender (p=0.009) and mothers with higher education (p=0.022) significantly affected choosing O&G, while advice to choose this specialty impacted choosing O&G (p=0.027) and dermatology (p=0.022). Better patient outcomes, challenging specialty, reputation/prestige and inspiration from a doctor were common reasons to choose a specialty. 9.1% changed their initial choice of specialty based on exposure to COVID-19 pandemic of whom majority switched to COVID unrelated fields, but it was not statistically significant. Conclusion: This study identifies that demographic, patient outcome and personal factors were primary determinants of specialty choice. COVID-19 pandemic did not significantly affect career choices among medical graduates.

Abstract This retrospective cohort study aimed to compare the one-year outcomes of anterior–posterior (AP) and anterior—lateral (AL) methods of cardioversion for atrial fibrillation (AF). A total of 2168 patients were included, with 1125 patients in the AP cardioversion group (Group 1) and 1043 patients in the AL cardioversion group (Group 2). Baseline characteristics, primary and secondary outcomes, safety outcomes, and logistic regression predictors of sinus rhythm were analyzed. The results showed comparable rates of maintaining sinus rhythm at the one-year follow-up between the two groups (65.8% in Group 1 vs. 65.7% in Group 2, p = 0.042). There were no significant differences in the incidence of AF recurrence or safety outcomes between the groups. Logistic regression analysis identified the duration of AF and the presence of coronary artery disease as significant predictors of sinus rhythm maintenance. Additionally, the use of the AL method was associated with a higher likelihood of AF recurrence compared to the AP method (p = 0.043). These findings suggest that both the AP and AL methods of cardioversion are effective in achieving and maintaining sinus rhythm in AF patients. The duration of AF and the presence of coronary artery disease should be considered when selecting the cardioversion approach. These results contribute to the understanding of optimal treatment strategies for AF and support personalized management decisions based on individual patient characteristics.