2% of U.S. medical students plan to become primary care physicians, study says

Two percent of medical students in a survey said they planned to go into general internal medicine, according to a study published Wednesday in the Journal of the American Medical Association, USA Today reports.

According to the study, general internists provide a large portion of care for older patients and people with chronic illnesses, but the number of students becoming general internists is declining as the number of older U.S. residents is expected to nearly double between 2005 and 2030. The survey notes that according to one estimate, there will be a shortage of 200,000 doctors in the U.S. by 2020.

Study author Karen Hauer, a general internist and University California-San Francisco faculty member, said the survey of 1,177 students at 11 U.S. medical schools found that quality-of-life factors, such as income and work hours, influenced the students' decisions not to practice general internal medicine. Hauer said that medical students' amount of debt did not seem to influence their choice of specialty (Rubin, USA Today, 9/10). According to the Association of American Medical Colleges, the average medical school graduate in 2007 had $140,000 in student debt, up by nearly 8% from 2006 (Johnson, AP/Boston Globe, 9/10).

A letter to the editor by Mark Ebell of the University of Georgia, which also was published this month in JAMA, ranks internal medicine as one of the lowest paying medical specialties (USA Today, 9/10). A study by Ebell found that U.S. medical students are seeking residencies in higher paying specialties. In 2007, family medicine had the lowest average salary of $186,000, with 42% of residency spots filled by U.S. students. Meanwhile, orthopedic surgery had an average salary of $436,000, with 94% of residency spots filled by U.S. students.

A separate study in JAMA found that while from 2002 to 2007 there were 2,600 fewer U.S. doctors training in primary care specialties, the number of foreign graduates pursuing those careers rose by 3,300. Study co-author Edward Salsberg of AAMC said, "Primary care is holding steady but only because of international medical school graduates" (AP/Boston Globe, 9/10).

An abstract of Hauer's study is available online.

An abstract of Ebell's letter is available online.

An abstract of Salsberg's study also is available online.

NBC's "Nightly News" on Tuesday reported on the study (Williams, "Nightly News," NBC, 9/9).


Kaisernetwork.orgThis article is republished with kind permission from our friends at The Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery of in-depth coverage of health policy developments, debates and discussions. The Kaiser Daily Health Policy Report is published for Kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. Copyright 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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