Background: The National Cheng Kung University (NCKU) of School of Medicine in southern Taiwan, which was founded in 1984 with only a postgraduate (PG) program until 1995. In 1992, NCKU began undergraduate (UG) program. It has recently entered into an agreement with Taiwan's Ministry of Education and Ministry of Health and Welfare to help cultivate physicians who meet various market needs, including practice regions, goals, or specialties. Research problem & purpose: We aim to compare the differences between PG and UG trained alumni in terms of specialty selection and practice location. Methods: A total of 1,089 alumni were recruited, including 476 PG alumni from 1989 to 1998 and 613 UG alumni from 1999 to 2009. Taken graduates' first professional status of the specialty and practice region. Results: Based on the results, more than half of the alumni choose to practice in southern Taiwan, contributing to the quality of healthcare in the region. Differences in specialty choices between PG and UG alumni are noted, with PG alumni showing a higher preference for obstetrics & gynecology and pediatrics. We also explore gender differences, revealing an increasing ratio of female physicians compare to male physicians as well as variations in specialty preference. The analysis of practice locations indicates a significant presence of NCKU alumni addressing the historical south-north healthcare divide, and highlights the essential role in healthcare equality in Taiwan. Conclusions: The findings offer insights into the evolving landscape of medical education, specialty preferences, and their impact on regional healthcare disparities.