BackgroundIn 2005, in response to a decline in residency applications in obstetrics and gynecology (OB GYN), the American College of Obstetrics and Gynecology Presidential Task Force outlined strategies for attracting medical students to OB GYN. Application rates have increased since then, but little is known about which interventions are effective. We aimed to identify modifiable and nonmodifiable variables that may contribute to students choosing OB GYN for their careers; this information could be used to inform curriculum design, faculty development, and innovative exposures to women’s health.MethodsThis qualitative study received institutional review board approval. Eligible participants were students who applied or recently matched into OB GYN residency programs from the class of 2014–2016 at our institution. Students were interviewed with open-ended questions and a Likert-type survey. Thematic analysis was performed.ResultsTen qualitative interviews were completed and analyzed. Intrinsic themes such as the potential for a meaningful job in women’s health, advocacy for women, or empowerment of women were identified as factors contributing to participant career choice. Extrinsic themes such as positive impressions during the clinical clerkship and welcoming teams were also identified. Most students indicated that the clerkship was the most influential experience.ConclusionsParticipants identified important events, including some that even preceded medical school that guided them toward OB GYN. The data guide us to consider the importance of emphasizing the unique combination of characteristics in OB GYN and improving the learning environment in the clerkship as a way to encourage student recruitment.Electronic supplementary materialThe online version of this article (10.1186/s12909-018-1362-4) contains supplementary material, which is available to authorized users.