Study showing fewer medical students intending to become primary-care physicians

Check out this new report and the corresponding JAMA article.
http://jama.ama-assn.org/cgi/content/full/300/10/1154

NBC Nightly News (9/9, story 10, 0:30, Williams) reported that a new study shows that few medical school students plan to become primary-care physicians. Most "are going into specialized fields instead."

USA Today (9/10, Rubin) reports that "medical students are shying away from careers in general internal medicine, which could exacerbate the U.S. doctor shortage expected by the time the youngest baby boomers head into their senior years," according to a study published in the Sept. 10 issue of the Journal of the American Medical Association.

In fact, "only two percent of graduating medical students say they" were considering practicing as primary-care physicians, the AP (9/10, Johnson) adds. By comparison, a similar survey conducted in 1990 showed that nine percent of medical students were interested in primary care. The data showed that "paperwork, the demands of the chronically sick, and the need to bring work home are among the factors pushing young doctors away from careers in primary care." Lead author Karen Hauer, M.D., of the University of California-San Francisco, pointed out that "it's hard work taking care of the chronically ill, the elderly, and people with complex diseases -- 'especially when...doing it with time pressures and inadequate resources.'"

For the study, researchers surveyed "1,177 medical students last year, found just 24 wanted to practice primary care, while 23 percent were interested in internal medicine, whose subspecialties include cardiology and cancer care," New York's Newsday /Bloomberg News (9/10) notes.

Salaries in primary care dissuade medical students from the field. The Columbus Dispatch (9/10, Hoholik) reports that "fewer U.S. medical students are choosing careers in family medicine because of long work hours and low pay," according to a research letter published in the Sept. 10 issue of the Journal of the American Medical Association.

Mark H. Ebell, M.D., of the University of Georgia, "examined whether there is an association between specialty selection and anticipated incomes using current data," MedPage Today (9/9, Groch) added. He used "residency information...from the National Residency Match Program," and "mean annual salary in 2007 came from the annual American Medical Group Association survey of physician salaries."

Dr. Ebell found that "family medicine had the lowest average salary ($185,740), and the lowest percentage of filled residency positions (42.1 percent)," Modern Healthcare (9/9, Robeznieks) noted. And, "internists, with the third-lowest salary of $193,162, had the third-lowest residency fill rate: 55.9 percent." In contrast, "radiologists -- whose average salary was $414,875 -- had a residency fill rate of 88.7 percent; and orthopedic surgeons -- whose average salary was $436,481 -- had a fill rate of 93.8 percent." Dr. Ebell wrote that "the correlation between salary and primary-care physician shortages -- which, in turn, may be tied to higher all-cause cardiovascular, cancer-specific, and infant mortality rates -- has persisted since his original research on this issue was published" in 1989.

Researchers say racially diverse medical schools may better prepare students. HealthDay (9/9, Preidt) reported that "attending medical schools with high levels of racial and ethnic diversity may better prepare white medical students to care for minority patients," according to a study published in the Sept. 10 issue of the Journal of the American Medical Association. Somnath Saha, M.D., of the Portland VA Medical Center, and colleagues, "analyzed data from a Web-based survey of 20,112 graduating medical students from 118 medical schools." The researchers "found that white students at medical schools with the highest quintile (one-fifth) for student body racial and ethnic diversity, measured by the proportion of underrepresented minority (URM) students, were 33 percent more likely to rate themselves as highly prepared to care for minority patients than white students at medical schools in the lowest diversity quintile -- 61.1 percent vs. 53.9 percent, respectively." Notably, "this association was strongest in schools in which there was positive interracial interaction."

The study also showed that "students from under-represented minorities were significantly more likely (at P<0.001) than either white or non-white/non-URM students to plan to work with the underserved, at 48.7 percent, versus 18.8 percent, versus 16.2 percent, respectively," MedPage Today (9/9, Smith) added. The authors of an accompanying editorial argued that these findings "might persuade medical schools to do more to encourage diversity." The St. Louis Post-Dispatch (9/10, Bernhard) also covers the story. This week's JAMA Report video features the study.