US graduates opt for primary care

For the fourth year in a row, graduates of US medical schools are picking primary care as their most popular career choice. Final year medical students are asked to rank their choices for postgraduate education specialties and programmes. Those choices are placed into a computer, and last week students were handed envelopes telling them whether they had the job that they wanted.

Similarly, other general specialties saw continued growth. Internal medicine saw a 2.9% growth over 1995 and paediatrics a 6.1% growth. The three general specialties together attracted about 54% of the students. US policy makers hope eventually to see 50% of all doctors in primary care. But that number, says a report by the American Academy of Family Practice, is not likely to be reached soon.

The reason is that many students who choose general specialties, especially those in internal medicine, often specialise later on. Just over a third are likely to practise primary care eventually.

This year showed a 50% drop in applications to anaesthesiology and a reduction of nearly a third in students looking for careers in diagnostic radiology. “The results of the match show that US medical students understand the changing needs of the nation's evolving health care system,” said Dr Jordan Cohen, president of the Association of American Medical Colleges.—JOHN ROBERTS, North American editor, BMJ