BACKGROUND: Growing numbers of postgraduate medical trainees pursue master's or PhD degrees together with professional education. This study explored students' motivation for undertaking these degrees and considered theoretical explanations for the forces shaping this phenomenon.

METHOD: Using constructivist grounded theory methods, interviews were conducted with 14 fellows pursuing higher degrees during subspecialty pediatric training. Emergent themes were identified from transcripts using constant comparative analysis.

RESULTS: Participants pursued higher degrees to be more competitive for academic jobs and to increase their credibility within their field. Academic medicine was felt to demand ever-increasing credentials to position trainees as a good investment. Clinical practice alone was not believed to earn respect and status in academia.

CONCLUSIONS: Through mostly tacit means, students absorb values from their academic training environment, learning to regard credentials, research publications, and grants as forms of capital, and also learning that success and status within academia depend on accumulating such capital.