Sandeep Jauhar:

And to attract more of the best and brightest in our medical schools [to become primary-care physicians], let’s find a way to increase their pay.

While pay disparities between specialties contribute to the dwindling numbers of med students choosing primary care, they are not the core problem.

The core problem is who we select to become doctors.

The premed curriculum focuses exclusively on basic sciences. Admissions committees emphasize basic science education by favoring applicants majoring in a basic science or those with research experience. [1] These fields focus on using advanced technology to find a single answer to a narrowly-defined question. Is it any wonder that when we select students from these backgrounds—students who spend 4 years doing such work and are deeply interested in it—that they choose to go into subspecialties the focus on a narrow set of problems and employ high-tech tools to find answers?

Certainly the money helps, but I think students are far more interested in happiness and doing work that suits their interests. Our admissions criteria biases our selection of candidates towards those predisposed to enter the ever-growing number of highly technical subspecialties. Until we adjust these criteria, we will continue to have primary care physician shortages, no matter how compensation is adjusted.

An excellent, complementary discussion of how medical education erodes ‘primary care skills’ written by med student Michael Bradfield was recently posted over at KevinMD.

I know, I know…it doesn’t matter what you major in and you don’t have to have research experience. The truth is, you improve your chances of admission if you do. ↩