In the January 2012 issue of the journal Family Medicine [full text available here], a survey of medical students’ attitudes toward primary care and specialties reveals some sobering information about primary care and the overall practice of medicine.
At three medical schools, Michigan, Michigan State and Brown, 1533 students were sent surveys during the years 2006-2008, with 983 [64%] responding, an excellent rate of return for a survey. My theory about exposure to primary care may be wrong because third and fourth year students were significantly more inclined to choose primary care as a career than first or second year students. But the overall percentage of students who said they would opt for primary care was only 14.8%. This is consistent with matching program data, which indicate that 14% of US medical graduates match in primary care.
The students had negative opinions about the work life of all physicians, but they were particularly down on primary care. Senior students were more negative about primary care than juniors [maybe my theory about exposing them to a primary care clerkship is right] and more positive about the work life of specialists. Despite the increased negativity of senior students, the clerkship in primary care did not really have much of an impact on the students’ career choices.
The paper has some limitations, most notably that the students were only polled once. It is well-known that many change their minds as they progress through school. Also, this study involved students from only three medical schools.
The authors conclude: “Our learners’ negativity about their future work lives reflects and portends a pessimistic culture of medicine. Student views of primary care work life are particularly negative, but some students indicate an interest in primary care despite negative perceptions.”
The authors feel that to attract more students into primary care, the work life of primary care doctors needs to be improved. However, they did not offer any suggestions on how this could be done. And the website FierceHealthcare reports that the government is trying to lure students into primary care. Other than mentioning a $877,000 grant to The University of Maryland Medical School for development of a “primary care track,” which to me seems somewhat short of innovative, the article does not describe any “lures.” They might have been better off giving the money directly to the students as a bribe.
Of even more concern is that the surveyed students perceived the work life of all physicians, primary care MDs and specialists alike, negatively. As I have stated before, I agree with the authors that the future of medicine is not bright.