Why Aren’t Medical Students Choosing Primary Care Specialties

Medical student interest in family medicine has been slowly declining over the past 10 years. Family medicine is now one of the least competitive specialties that medical students can enter. In fact, there are a few medical schools out there that don’t even offer rotations in family medicine during the clinical years of med school.

Because of the limited amount of interest from medical students within the United States, a significant percentage of family medicine residency spots are filled by international medical graduates.

These facts lead to the obvious question, “why is there so little interest in family medicine?”. Actually, general internal medicine residency programs aren’t doing that much better lately. So what is it about being a primary care physician that turns medical students away?

Well, there are studies that have evaluated this very question. This issue is important because primary care physicians such as family med docs and general internists are supposed to form the backbone of our health care system.

Health care reform is attempting to assist a significantly greater percentage of the American people in accessing medical care. This is a noble idea, and necessary indeed, but where exactly are these people supposed to go for medical care once they have the means to get there?

The primary care field doesn’t have enough providers to compensate for a large influx of patients. Even if physician extenders such as physician assistants and nurse practitioners are included in the pot, there still aren’t enough primary care providers to go around.

So how can we get more medical students to go into primary care? Why are they choosing other specialties?

Most studies on this topic have picked up on two interrelated observations that med students make about primary care fields: Compared to other specialties, the pay in primary care is significantly lower, with a significantly higher amount of time spent dealing with paperwork, insurance companies, business management, and legalities.

This is certainly true. But many other med student focused studies have also found that in general future income ranks lower in criteria for specialty selection than perceived future lifestyle and interest in the knowledge and skill of the specialty.

Given this information, it seems that a specialty such as family medicine would rank highly. The family physician lifestyle is significantly more relaxed than other specialties and the knowledge base and skill that is practiced is broader than any other physician specialty that exists.

It is difficult to understand how the nation’s best and brightest, most naturally competitive of individuals can’t look at the benefits of a career in primary care medicine and be even more intrigued by the challenges this career presents in the present health care system.

Most medical students want to become physicians because they have a natural drive to fix what is broken. Well, the health care system seems to be a great opportunity in this respect. As a family physician, general internist or pediatrician, a medical student has the opportunity to simultaneously work at healing their patients and the healthcare system in which they function.

Medical students haven’t gotten to where they are by taking the easy path in life. As they choose their future career, they should be reminded that this is no time to start taking the easy way out. A strong, intelligent mind is an incredibly powerful thing and with this power medical students may do well to heed these infamous words of Ghandi: “Be the change you wish to see in the world.”