Factors influencing pharmacy program choice and attitudes toward career in pharmacy among students studying in tertiary institutions in Tanzania.

Background While pharmacy education has expanded in Tanzania, students’ motivations for choosing the profession and their career expectations remain underexplored. Understanding these drivers is crucial for aligning training with healthcare needs, enhancing professional satisfaction, and ensuring graduates contribute effectively to national health priorities. Methods A descriptive cross-sectional study was conducted between March and July 2025 among 324 undergraduate pharmacy students from three tertiary institutions in Tanzania. Data were collected using a structured questionnaire and analyzed using STATA version 17. Descriptive statistics, chi-square tests, and multivariate logistic regression were employed to identify associations between factors influencing program choice and career attitudes, with statistical significance set at p < 0.05. Results Pharmacy was the first-choice program for 76.2% of participants, and 53.7% demonstrated positive career attitudes. Significant associations with selecting pharmacy as first choice were found for institution attended (χ²=13.587, p = 0.001), program level (χ²=13.862, p < 0.001), confidence in choice (χ²=7.438, p = 0.006), program reputation (χ²=14.75, p < 0.001), source of influence (χ²=14.742, p = 0.002), advice from pharmacists/healthcare workers (χ²=4.105, p = 0.043), and attitudinal disposition (χ²=7.342, p = 0.007). After adjustment, significant predictors of choosing pharmacy first included institution (KIUT: AOR = 9.06, p = 0.007), degree program (AOR = 0.13, p = 0.002), low confidence (AOR = 0.33, p = 0.046), program reputation (AOR = 0.39, p = 0.017), negative attitude (AOR = 0.54, p = 0.047), and community pharmacy career goals (AOR = 3.82, p = 0.045). Conclusion Pharmacy program choice among Tanzanian students is influenced by institutional factors, professional reputation, mentorship from healthcare professionals, and attitudinal disposition rather than financial incentives. Structured mentorship programs and enhanced career guidance are recommended to align student expectations with workforce needs.