Background Factors which influence medical students’ decisions to pursue surgical careers include clinical exposure, role-modelling, and perception of fit to a specialty. The Royal Australasian College of Surgeons has a commitment to improve diversity within surgery in Australia. Addressing barriers to pursuing a career in surgery may improve the diversity of the surgical workforce, to better represent and serve the community. Methods Eight medical students in Australia participated in semi-structured individual interviews conducted over Zoom. Interviews were transcribed and analysed using Reflexive Thematic Analysis. Results Five themes were identified: Navigating tensions between prioritising family and a surgical career; The challenging pathway to becoming a surgeon; A sense of belonging and other sources of influence; Perceived surgical culture; and, Experience on clinical placements. There were 16 subthemes including: Consideration of the impact of surgery on family life; Lack of diversity within surgery; and the importance of having “nice enough” colleagues. Conclusion While this study found that medical students in Australia cited similar factors to existing literature regarding their decision to pursue or avoid a career in surgery, new concepts were also reported. These included the challenging prevocational registrar (trainee) years, the shifting culture within surgery, and the influence of social media on this generation of students. Women and individuals from minority ethnic backgrounds lacked representation, and some participants still thought they needed to have a certain ‘personality’ to become a surgeon.