A few weeks ago, I met up with two of my medical school classmates for a drink. I’ve known them for the past three years, but I never had a heart-to-heart with them before the other night. But it’s the time of year when fourth-year students, like us, have to decide which medical specialty we want to pursue, and our conversations these days are full of gossip about who is choosing what. News travels fast through the medical student grapevine, and we discovered we had something in common.
The three of us sought each other out that night because we all want to go into family medicine. In our medical school class, at the University of Pennsylvania, that makes us anomalies. We were an unofficial support group for a rare condition: becoming a primary-care doctor.
One friend described feeling ashamed at a recent class party, where all the chatter was all about specialty choice. Another classmate who wants to become a neurosurgeon — an extremely competitive specialty—grilled my friend on why he would waste his medical education by becoming a family doctor. My friend loved the breadth of family medicine, but he told me he couldn’t help wondering: “Am I being all that I can be?”
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. Millions of Americans are newly insured under the Affordable Care Act; the U.S. Department of Health and Human Services predicts a dearth of primary-care doctors in coming years, a shortage as great as 20,000 doctors by the year 2020. The recent Veterans Health Administration scandal came to light, in part, because there aren’t enough general internists working within the system to meet the primary care needs of American veterans. 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.