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Most Medical Students Don’t Choose Primary Care

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A recent article in The Atlantic by fourth-year medical student Mara Gordon examined the reasons why she and some of her fellow students have decided to become primary-care doctors, especially since many haven’t.

In a rather interesting passage from the article, she writes: “At medical schools, general medicine is often considered unchallenging and quaint, even though primary-care doctors are what our nation needs most from its medical schools… Primary care is where there are the greatest gaps in public health and the most job opportunities for recent graduates. But medical students, at least the ones I know, still shun it.”

She continues, “I am planning on applying in family medicine in the 2015 Match, the national system that pairs medical school graduates with slots in residency-training programs. As I prepare my application, I’ve been doing a lot of thinking about why my career choice seems so unimaginable to so many of my classmates. Why do students at elite medical schools think primary care is boring?”

This is an especially potent question, since many medical students begin school to be trained as primary-care doctors, she writes. “But somewhere between orientation and Match Day, the high-pressure moment when med school seniors find out where they will be training, the idealism wears off. “

Where she studies, only “12 out of 162 students in this past year’s graduating class have started primary-care residency programs. Nationwide, about 12 percent of graduates in the 2014 Match entered residencies dedicated specifically to primary care (though graduates who do general internal medicine or pediatrics programs may still end up in primary care).”

This means that most medical students are pursuing other specialties, leaving primary care in the minority. There are several reasons for this, she writes. For one, most of their core clerkship is spent in the specialized setting, meaning “[t] he role models we work with every day are specialists, and we start to imagine our future careers looking like theirs. As a classmate who is also going into family medicine said, ‘We don’t get to see the primary-care rockstars.’”

Instead, they’re seeing specialists tell patients to follow up with their primary-care doctor.

But according to Gordon, this shunning of primary care goes deeper than that, which we’ll get into in our next post.

In the meantime, as physicians looking for jobs, why did you choose the specialty you’re in? If it’s primary care, why did you go in that direction? If not, why did you opt out of primary care?

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